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Generic Name: paclitaxel (PAK li TAK sel)

Brand Names: Onxol, Taxol

Form: Intravenous solution

Paclitaxel is a well-known anti-cancer chemotherapy drug. The generic is restricted as a "taxane", a "plant alkaloid," and an "antimicrotubule agent". Taxol is consumed to treat breast, ovarian, lung, bladder, prostate, melanoma, esophageal, as well as other types of solid tumor cancers. It has also been proved useful in Kaposi's sarcoma. The drug is formed out of needles of a specific type of ‘yew tree’. It does its working by stopping cancer cells splitting into two new cells, so hence it blocks the growth of the cancer. It is a treatment for various types of cancer.

Drug Description:

The injection is a purely clear, colorless to slightly yellow viscous solution. It is supplied as a nonaqueous(a homogeneous liquid preparation of any substance dissolved in water) solution intended for dilution with a suitable parenteral fluid before intravenous infusion. The medication is available in 30 mg (5 mL), 100 mg (16.7 mL), and 300 mg (50 mL) multidose vials. Each mL of antiseptic nonpyrogenic compound encompasses 49.7% (v/v) dehydrated alcohol, 6 mg paclitaxel and 527 mg of purified Cremophor EL (polyoxyethylated castor oil).

The solution is a natural commodity with antitumor activity. This solution is achieved by a emi-synthetic course from Taxus baccata. The chemical can be known as 5β,20-Epoxy-l,2α,4,7β,10β,13α - hexahydroxytax-l l-en-9-one 4,10-diacetate 2-benzoate 13-ester with (2R,3S)-N-benzoyl-3-phenylisoserine. Paclitaxel is a slight white to off-white crystalline crumb along the experimental formula C47H51NO14 and molecular weight as 853.9. The solution is eminently lipophilic, insoluble in water, and melts at around 216-217° C.

Indication:

The solution is mostly indicated for treatment of breast cancer post unsuccessful combination of chemotherapy with regard to different metastatic disease or weakening within 6 months of additional chemotherapy. Prior therapy one should have included an anthracycline unless clinically contraindicated. TAXOL, with combination of cisplatin, is subjected as startup or first-line treatment of non-small cell causing lung cancer in patients who are ideally non-candidates for potentially rescue surgery and/or other radiation therapy. The solution is also indicated for the second-line treatment of AIDS-related Kaposi's sarcoma.

Dosage:

Recommendations for dosing in patients with hepatic impairment on clinical trial data:

DEGREE OF HEPATIC IMPAIRMENT

TRANSAMINASE LEVELS

BILIRUBIN LEVELSB

RECOMMENDED TAXOL DOSEC

24-hour infusion

   < 2 x ULN

and

≤ 1.5 mg/dL

135 mg/m2

  2 to < 10xULN

and

≤ 1.5 mg/dL

100mg/m2

   < 10 x ULN

and

1. 6-7.5 mg/dL

50 mg/m2

   ≥ 10 x ULN

or

> 7.5 mg/dL

Not recommended

3-hour infusion

   < 10 x ULN

and

≤ 1.25xULN

175 mg/m2

   < 10 x ULN

and

1. 26-2.0 x ULN

135 mg/m2

   < 10 x ULN

and

2.01-5.0 x ULN

90 mg/m2

   ≥ 10 x ULN

or

> 5.0 x ULN

Not recommended

Over Dosage:

There is no known antidote for TAXOL (paclitaxel) in any case of over consumption. The primary and most simple way of anticipated complications of over dosage would subsist of bone marrow elimination, incidental neurotoxicity, and mucositis. Overdoses in pediatric patients may be correlated with acute ethanol.

Using Guide:

  • The solution is administered as an injection form through a needle placed into a vein. You will find this injection in a clinic or hospital setting. Taxol is suggested to be administered gently through an IV infusion, and can gradually consume taking it up to 24 hours.
  • It is usually given every 3 weeks. Before your injection, you may be given other medications to withhold serious allergic reaction got out of the solution.
  • If any of the solution or mixture gets in contact with your skin, wash the area with soap and warm water as soon as possible.
  • Breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while getting treated under this solution.
  • Heart rate may also be monitored time to time through electrocardiograph or ECG (also called an EKG). This machine measures electrical activity of the heart quicker.

Storage:

Store the vials in original cartons as bought in package between 20°-25° C (68°-77° F). the drug is suggested to be protect from light.

Side Effects:

The following side effects are common (occurring in greater than 30%) for patients taking Paclitaxel:

Decreased blood counts i.e. white, red blood cells and platelets may temporarily fall down. This action may put you at heightened risk for infection, anemia and/or bleeding. Hair loss may also be seen. Arthralgias and myalgias; are pain in the joints and muscles. Usually these side effects are temporary occurring for approx. 2 to 3 days after treatment, and resolve within a few days. Peripheral neuropathy; is numbness and tingling of the hands and feet.

Nausea and vomiting occurred are usually mild and does not stay for longer period of time. Diarrhea, Mouth sores. Hypersensitivity reactions are also part of side effects. Fever, facial flushing, chills, shortness of breath, or hives may be caused out of allergy. The majority of these reactions occur within the first 10 minutes of an infusion.

The following are less common side effects (occurring in 10-29%) for patients:

Swelling of the feet or ankles which are called as edema; Increases in blood tests with reference to liver function, these return to normal once treatment is discontinued; Low blood pressure generally which occurs during the first 3 hours of infusion; Darkening of the skin where previous radiation treatment has been given named as radiation recall; Nail changes with reference to discoloration of nail beds this is observed in very rare cases.

Precautions:

  • Avoid intake of aspirin, or products containing aspirin unless your doctor specifically permits this in combination of the solution.
  • Do not undergo any kind of immunization or vaccination without your doctor's approval.
  • For both men and women: be careful in conceiving a child (getting pregnant). Barrier methods of birth control, such as condoms, are recommended. Just after consulting your doctor, plan when you may safely become pregnant or conceive a child post therapy.
  • Drink at least two to three quarts of fluid every 24 hours for healthy and safe outcomes.
  • The drug will make you sensitive to sunlight. Wear sunglasses when outside, and avoid sun exposure is highly recommended. Wear protective clothing, and also wear SPF 15 (or higher) sun block.

In general, consuming alcoholic beverages should be kept to a minimum or avoided completely. Get plenty of rest. Maintain good nutrition.