Details About Generic Salt ::  Paclitaxel 

Main Medicine Class:: Anti Neoplastic Agents   Sub Medicine Class ::  Anti Neoplastic Agents

18A. ANTI-NEOPLASTIC AGENTS in 18. ANTI-NEOPLASTIC AGENTS
PACLITAXEL
ANTI-NEOPLASTIC
PK: D: Extensive M: Hepatic E: Feces (~70%, 5% as unchanged drug), urine (14%)

Indications & Dose: ADVANCED OVARIAN EPITHELIAL CANCER Mono therapy/Second-line therapy IV Adult 135/175mg/m2 over 3h q3wk in patients with metastatic carcinoma who failed to respond to first-line therapy | First-line therapy IV Adult 175mg/m2 over 3h q3wk or 135mg/m2 over 24h q3wk, followed by cisplatin (IV, 75mg/m2) | AIDS-RELATED KAPOSI’S SARCOMA IV Adult 135mg/m2 over 3h q3wk or 100mg/m2 over 3h q2wk | METASTATIC BREAST CANCER Second-line therapy IV Adult Refractory to initial chemotherapy/breast cancer that has relapsed after 6 months of adjuvant therapy:175mg/m2 over 3h q3wk | NODE-POSITIVE BREAST CANCER First-line therapy IV Adult 175mg/m2 as inf over 3h q3wk for 4 courses given sequentially with doxorubicin combination chemotherapy | NON-SMALL-CELL LUNG CANCER Combination therapy IV Adult 135mg/m2 over 24h q3wk, followed by cisplatin (IV, 75mg/m2), may be repeated q3wk

Contra: Hypersensitivity, absolute neutrophil count <1500 cells/mm3, acute infect

Precautions: Hepatic dysfunction, elderly, children, debilitated patients, depressed bone marrow from radiotherapy/therapy with other anti-neoplastics

ADR: Serious: Flushing, ECG abnormal, edema, hypotension, peripheral neuropathy, arthralgia/myalgia, creatinine increased, hypersensitivity reaction, infect, bradycardia, tachycardia, HTN, syncope, venous thrombosis, blood disorders, bleeding, AST/alkaline phosphatase increased, febrile neutropenia, bilirubin increased, Others: dyspnea, Inj site reaction, nail changes, alopecia, rash, nausea, vomiting, diarrhea, mucositis, stomatitis, abdominal pain

DDI: Serious Verapamil (high-dose) reduces drug clearance & increases the incidence of hematological toxicity, Epirubicin/Doxorubicin causes cardiotoxicity, Carboplatin causes neurotoxicity, Cisplatin causes severe myelosuppression if cisplatin is given first, Warfarin effects increases (bleeding), Phenobarbital/Carbamazepine/Phenytoin increases drug clearance & increase its maximum tolerated dose, Gemfibrozil/Ciclosporin increases drug level, HIV protease inhibitors leads to life-threatening hematological toxicities, Cyclophosphamide leads to toxicity

Monitor: CBC with differential, monitor for hypersensitivity reactions, vital signs (frequently during first hour of Inf), continuous cardiac monitoring (patients with conduction abnormalities)

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