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Paclitaxel (Taxol)

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This page tells you about the chemotherapy drug paclitaxel (Taxol) and its possible side effects. There is information about

 

What paclitaxel is

Paclitaxel is a chemotherapy drug. It also known by its original brand name, Taxol. The drug is made from the needles of a particular type of yew tree. It works by stopping cancer cells separating into two new cells, so it blocks the growth of the cancer. It is a treatment for various types of cancer, including

Sometimes it is combined with other anti cancer drugs.

One type of paclitaxel is combined with a protein called albumin to form a drug called Abraxane. Doctors also call it nab-paclitaxel. This drug tends to cause fewer side effects than other types of paclitaxel. It treats breast cancer that has spread and pancreatic cancer that has spread.

 

How you have paclitaxel

You usually have paclitaxel as an injection into a vein. It can cause an allergic reaction. To try to prevent this, you have a steroid injection and tablets before the paclitaxel drip. You also have an antihistamine (such as chlorphenamine) into a vein about an hour before your treatment. You will also have a medicine to prevent heartburn, such as ranitidine or cimetidine. Abraxane does not usually cause an allergic reaction so you don't need the anti allergy drugs with abraxane.

You can have paclitaxel through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for paclitaxel depends on which cancer you have. You can find out about how doctors plan chemotherapy in the chemotherapy section.

Paclitaxel side effects are listed below. You can use the underlined links to find out more about each side effect. Where there is no link, use the search box at the top of the page or go to our cancer drugs side effects section.

 

Common side effects

More than 10 in every 100 people have one or more of the side effects listed below.

  • An Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
  • Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
  • Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
  • Numbness or tingling in fingers and toes affects between 3 to 8 out of 10 people (30 to 80%) depending on the dose – it can be severe in 3 to 15 out of 100 people (3 to 15%) and can cause difficulty with fiddly things such as doing up buttons. It starts after a few days or weeks and usually goes within a few months of finishing treatment
  • Aching joints (arthralgia) and muscles (myalgia) happen in about 6 out of 10 people (60%) – this may start a couple of days after treatment and last for about 5 days
  • Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment ends
  • Mild allergic reactions occur in more than 3 out of 10 people (34%) – this usually shows as a rash or a red face
  • Feeling or being sick is generally very well controlled with anti sickness injections and tablets – tell your doctor or nurse if you still have sickness so that they can give you other anti sickness medicines
  • Hair loss (alopecia) may be complete and includes all body hair but your hair will grow back after your treatment ends – a cold cap may help to stop you losing your hair. Cold caps are not suitable for all types of cancer, so talk to your doctor or nurse about whether it may help you
  • Low blood pressure during the treatment – your nurse will check your blood pressure regularly
  • Mouth sores and ulcers
  • Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or lasts more than a couple of days because you could get dehydrated
  • You may feel a bit tipsy because the paclitaxel drip contains alcohol to help dissolve the drug – it is the equivalent of a large glass of wine or a pint of beer
 

Occasional side effects

Between 1 and 10 in every 100 people have one or more of these.

  • Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
  • A slow heart rate
  • Mild skin rashes or nail changes
  • Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished, but you will have regular blood tests to check how well your liver is working
  • Women may stop having periods (amenorrhoea) but this may only be temporary
  • Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
 

Rare side effects

Fewer than 1 in 100 people have these.

  • An immediate severe allergic reaction during the paclitaxel drip – your nurse will give you steroids and other medicines before treatment to try to stop this happening but let your nurse know if you feel hot or have any skin rashes, itching, dizziness, headaches, shivering, breathlessness, anxiety, flushing of the face, or a sudden need to pass urine
  • Abdominal pain
  • High blood pressure – your nurse will check your blood pressure regularly during treatment
  • Blood clots – let your doctor or nurse know straight away if you have any redness, swelling or pain in your legs, or any chest pain or breathlessness
  • Damage to heart muscle, which is usually temporary but for a small number of people may be permanent – your doctor will check your heart before and after your treatment
  • High bilirubin levels
  • Muscle weakness in arms and hands, and legs
  • Itching
  • A high temperature (fever)
  • Changes in lung tissue may lead to a cough or breathlessness
  • Build up of fluid, leading to swelling in arms and legs
  • Red, hot, sore skin in areas previously treated with radiotherapy
  • Headaches
  • Hearing or sight (visual) disturbances
  • Dizziness or fits (seizures)
  • Loss of appetite
  • Severe skin reactions – the manufacturers recommend that you wear sun protection on hands and feet during your course of treatment
  • Change in colour and shape or loss of finger or toenails
 

Important points to remember

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on

  • How many times you've had the drug before
  • Your general health
  • The amount of the drug you have (the dose)
  • Other drugs you are having

Coping with side effects

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Other medicines

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Do not breastfeed during this treatment because the drug may come through in the breast milk.

 

Immunisations and chemotherapy

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).

You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.

 

More information on paclitaxel

This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.

If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.

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Updated: 12 February 2014