Paclitaxel

TAXOL

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What it isTaxane chemotherapy that stabilizes microtubules and arrests mitosis; used across breast, ovarian, lung, and other cancers.

Why this oneAlbumin-bound paclitaxel avoids the Cremophor vehicle and its premedication burden.

What limits itBone-marrow suppression and cumulative peripheral neuropathy limit treatment; solvent-based infusion can cause severe hypersensitivity.

FDA-approved for

cancer (1992)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Severe myelosuppression — do not administer to patients with baseline neutrophil count <1,500 cells/mm3

FDA dosing	Population	Start	Target
Metastatic breast cancer	Adults	260 mg/m2 IV over 30 min q3wk	260 mg/m2 q3wk
NSCLC (+ carboplatin)	Adults	100 mg/m2 IV over 30 min days 1, 8, 15 of each 21-day cycle	same
Pancreatic adenocarcinoma (+ gemcitabine)	Adults	125 mg/m2 IV over 30-40 min days 1, 8, 15 of each 28-day cycle	same

Renal No starting-dose adjustment required for renal impairment

Hepatic No adjustment for mild; reduce starting dose for moderate-severe; not recommended if AST >10x ULN or bilirubin >5x ULN

Instructions

Do not substitute for other paclitaxel products
Closely monitor infusion site for extravasation/infiltration

Contraindications

Baseline neutrophil count <1,500 cells/mm3

Cautions

Severe myelosuppression / neutropenia
Sensory neuropathy
Sepsis (with gemcitabine)
Pneumonitis
Severe hypersensitivity reactions
Increased toxicity in hepatic impairment
Embryo-fetal toxicity

Adverse reactions

Alopecia
Neutropenia
Sensory neuropathy
Abnormal ECG
Fatigue/asthenia
Myalgia/arthralgia
AST and alkaline phosphatase elevation
Anemia
Nausea
Infections
Diarrhea

Pregnancy Can cause fetal harm based on mechanism and animal findings

Lactation Undefined

⚠ BOXED WARNINGS

Severe hypersensitivity reactions
Bone marrow suppression

Cost, est. cash$50–$10,000/month or cycle

Generic entry2002

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk3 / 4

Legacy pregnancy categoryD

Defining liabilityMyelosuppression and agent-specific hepatic, cardiac, pulmonary, neurologic or reproductive toxicity require oncology monitoring.