Paclitaxel is a chemotherapy drug. It is a treatment for many different types of cancer. It is also called Taxol.
How paclitaxel works
Paclitaxel works by stopping cancer cells from separating into two new cells. This blocks the growth of the cancer.
How you have it
You usually have paclitaxel as cycles of treatment. You might have it on its own or with other chemotherapy drugs.
You have paclitaxel as a drip into your bloodstream (intravenously). Each treatment takes either 1 hour, 3 hours or 24 hours.
Into your bloodstream
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
When you have treatment
You might have paclitaxel every week or every 2 or 3 weeks.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
Common side effects
These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:
Risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising and bleeding
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
You might have a mild allergic reaction during or shortly after your treatment. This could be a rash, itching or a red face.
You will usually be given medication just before treatment to prevent or reduce risk of an allergic reaction.
Numbness and tingling in hands and feet
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your doctor if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
Low blood pressure (hypotension)
Tell your doctor or nurse if you feel light headed or dizzy. You have your blood pressure checked regularly.
Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Muscle and joint pain
You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:
- slow heart rate
- nail and skin changes - these are usually mild and return to normal after treatment is finished
- pain, swelling, redness at the injection site
- changes to the way the liver works - usually mild and doesn't cause symptoms
Rare side effects
These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:
- an allergic reaction needing treatment signs include change in blood pressure, shortness of breath, hives, pain, high heart rate, chills
- changes to the heart including heart attack
- inflammation of the blood vessels
- high blood pressure
- blood clots that can be life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung.
- changes to the lung tissue that can cause cough and breathlessness. Rarely this can be life threatening
Contact your advice line or doctor straight away if you have any symptoms of these side effects.
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else should I know?
Other medicines, food and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Some brands of this drug contain alcohol (equal to half a glass of wine or half a pint of beer) and may make you drowsy or dizzy, especially if you have drunk alcohol. Don't operate machinery or drive if you feel drowsy.
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 might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
Pregnancy and contraception
It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment.
Talk to your doctor or nurse about effective contraception you can use during treatment. Ask how long you should use it before starting treatment and after treatment has finished.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
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