Paclitaxel (Taxol, Onxal)  

Brand name: Taxol ^®, Onxal ^TM  

Generic name: Paclitaxel 

Therapeutic Class: plant alkaloid, taxane and antimicrotubule agent 

Availability: Paclitaxel is available by prescription only  

FDA Approval: in 1992, Paclitaxel (Taxol, Onxal ) was approved by the US Food and Drug Administration (FDA) to treat metastatic breast cancer.  

Indications: Paclitaxel is used to treat the following cancers:  

• breast cancer 
• ovarian cancer 
• bladder cancer 
• Prostate cancer
• Kaposi's sarcoma 
• head and neck cancer 
• lung cancer: non-small cell lung cancer and small cell lung cancer 
• melanoma (dangerous form of skin cancer) 
• Esophageal cancer (Cancer of the Esophagus).  

Paclitaxel is sometimes used to treat other medical conditions; talk to your physician or pharmacist for more information. 

Dosage form: Paclitaxel is given by injection into a vein  

Dosage: Basing on certain criteria such as your age, type of cancer being treated, and your body surface area (BSA) , your physician will prescribe you the most effective dose to combat the disease. Even after you start the treatment, your doctor may change the dosage depending on the response of your body to the medication.  

Usually, paclitaxel is injected into a vein (intravenous injection) by an oncologist or health care professional qualified and has experience in giving chemotherapy drugs. The drug should be administered in a hospital or health center equipped for its preparation. Paclitaxel is usually given once every 3 weeks over 3 hours.  

Overdose: paclitaxel is given in hospital by professionals; the risk of overdose is very difficult, but not impossible. Paclitaxel overdose may cause a decrease in the number of blood cells in your bone marrow, and lead to severe health problems and even death. Keep all appointments with your doctor before, during, and after treatment with paclitaxel; regular checkups can help detect abnormalities in early stage before they become serious health problems.   

Missing dose: the fact that paclitaxel is administered in hospital, it is difficult to miss a dose if you keep your doctor’s appointments. Therefore, be present at each appointment to take all doses of paclitaxel prescribed by your doctor. Misusing any chemotherapy drug can be fatal. If for some reasons you cannot be present for the treatment, contact your oncologist before the date of the treatment.  

Contraindication: Paclitaxel or is not recommended under the following conditions:  

·         pregnancy  

·         breast-feeding 

·         allergy to paclitaxel or one of its components 

·         Allergy to polyethoxylated castor oil.  

Mechanism of action (MOA):  Paclitaxel belongs to antineoplastics, a class of chemotherapy drugs that works by stabilizing the mitotic spindle (also called nuclear spindle, formation of protein fibers in the cytoplasm of a cell during cell division), which slows or stops the growth of cancer cells.  

Interactions:  if you are taking Paclitaxel, tell your doctor before taking prescription or non prescription medications such as aspirin, vitamins, nutritional supplements, and St. John's wort. Some medicines may interact with Paclitaxel and causes health problems. Tell your doctor or pharmacist if you are taking any of these medications:    

• cyclosporine 
• dexamethasone 
• diltiazem 
• estrogens 
• ketoconazole 
• montelukast 
• quercetin 
• quinidine 
• retinoic acid 
• testosterone  
• verapamil  
• Protease inhibitors.   

Side effects: In addition to attacking cancer cells, Paclitaxel may interfere with certain normal cells, causing a number of side effects in most patients:  

• hair loss 
• nausea and vomiting
• loss of appetite
• taste change
• constipation
• diarrhea
• nail or/and skin discoloration
• tingling in the hands or toes
• joint pain
• fatigue
• sleep disorders
• Mouth blistering.

If the side effects above persist for weeks, contact your oncologist. In addition, contact your doctor if you experience any of these symptoms:  

•  dizziness 
• shortness of breath
• severe exhaustion
• facial flushing
• chest pain
• persistent diarrhea or constipation
• unusual bruising or bleeding
• pain, redness, or swelling at the injection site
• Infection/allergy signs: skin rash, fever, chills, cough, sore throat, etc.
• Difficulty swallowing.