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Docetaxel (Taxotere)

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This page tells you about the chemotherapy drug docetaxel and its possible side effects. There are sections about

 

What docetaxel is

Docetaxel is one of the taxane type drugs that were originally developed from the yew tree. Docetaxel is a man made drug that was first made from yew tree needles. It is also known by its brand name, Taxotere. It works by stopping the cancer cells from separating into 2 new cells, so it blocks the growth of cancer. It is a treatment for

You may also have it as part of trials for other types of cancer such as ovarian cancer and bladder cancers.

 

How you have docetaxel treatment

Docetaxel is a liquid that you have through a drip (infusion) into a vein (intravenously). Each infusion takes about an hour and you have one every 1 to 3 weeks, depending on the type of cancer you have. 

You can have it 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. There is detailed information about planning chemotherapy in the main chemotherapy section.

Docetaxel can cause an allergic reaction. To try to prevent this, your doctor or nurse will give you steroid tablets to take, usually for 3 days, starting the day before each treatment. For prostate cancer your steroid treatment usually starts 12 hours before your chemotherapy. You will then have 2 further doses at 3 hours before treatment, and 1 hour before treatment.

The side effects associated with docetaxel are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, see the cancer drug side effects section or click on 'search' at the top of the page.

 

Common side effects

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

A temporary drop in the number of blood cells made by the bone marrow, causing

  • 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, sore throat, pain passing urine or feel cold and shivery
  • 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)

Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

  • Fatigue (tiredness) during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment finishes
  • Hair loss – your hair normally falls out completely and this affects 8 out of 10 people treated. A cold cap may help to stop your hair falling out, but you need to talk to your doctor about whether this is advisable with your type of cancer
  • Fluid retention occurs in about 5 out of 10 people – you may have swelling of the hands and feet, breathlessness, and weight gain. The steroids you have with the drug can help to prevent this side effect
  • A rash, which may be itchy, in about 5 out of 10 people
  • Discoloured fingernails but they will go back to normal a few months after the treatment ends
  • Soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome), which may cause tingling, numbness, pain and dryness
  • A sore mouth in about 4 out of every 10 people
  • Diarrhoea in about 4 out of every 10 people
  • Numbness and tingling in hands and feet – you may have a change in how things feel when you touch them, which can make doing fiddly things difficult (for example doing up buttons)
  • An allergic reaction during the infusion – more than 2 out of 10 people have an allergic reaction to docetaxel. This nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely
  • Watery eyes – let your doctor or nurse know if you have watery eyes as they may be able to prescribe medicines to help
 

Occasional side effects

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

  • Feeling or being sick is usually mild and lasts for only a short time after each treatment
  • Women may stop having periods (amenorrhoea) but this may only be temporary
  • Loss of fertility – this drug can stop men being able to father children and may cause an early menopause in some women. It is important to talk to your doctor before starting treatment if having a baby is important to you
  • Aching muscles and joints
  • A high temperature (fever)
  • Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your doctor or chemotherapy nurse immediately
  • Changes in eyesight – docetaxel can make fluid to build up at the back of the eye (called cystoid macular oedema). If you have blurred vision or a black area in the middle of your vision, let your doctor or nurse know
 

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 that they can help you manage them. Your nurse will give you a contact number to ring if you have any questions or problems. 

Other medicines, foods and drink

Docetaxel can interact with some other medicines and herbal products. Tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over the counter remedies.

Do not eat grapefruit or drink grapefruit juice while having treatment with docetaxel as it can make the side effects worse. 

Pregnancy and contraception

Docetaxel may have a harmful effect on a baby developing in the womb. You should not become pregnant or father a child whilst taking this drug. Discuss contraception with your doctor before you start your treatment if there is any possibility that you or your partner could become pregnant. Men need to continue using contraception for 6 months after treatment ends.

Breastfeeding

Breastfeeding is not advisable during docetaxel 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 about docetaxel

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 November 2012