Docetaxel (Intravenous)

Prescribed as a chemotherapy medicine, Docetaxel is used to treat various types of cancers, including stomach cancer, prostate cancer, non-small cell lung cancer, breast cancer and head and neck cancers.

Overview

As an antineoplastic drug, Docetaxel is used to target cancer cells within the patient's body. Although Docetaxel can be used to treat various types of cancers, it is most commonly prescribed to patients who are suffering from breast cancer, prostate cancer, stomach cancer, non-small cell lung cancer, as well as to individuals who have been diagnosed with cancer affecting the head and/or neck.

Delivered intravenously, Docetaxel is administered by injecting the medicine directly into the patient's vein. Although this means that the medicine is able to target cells quickly, injections are normally given fairly slowly and each treatment session may take a number of hours.

As Docetaxel is cytotoxic, it is able to destroy cells within the patient's body. This medication has been known to display increased cytotoxic activity on certain types of cells, such as colorectal, lung, breast, prostate, renal and gastric cancer cells. Due to this, Docetaxel is often used to treat these types of cancers.

As well as having cytotoxic effects on cells, Docetaxel inhibits mitotic cell division. This prevents cells from replicating and can, therefore, prevent more cancer cells from developing or spreading. While Docetaxel can halt the spread of the disease, it also enables the body to target existing cancer cells.

However, Docetaxel doesn't just affect cancer cells within the patient's body. Like most antineoplastic agents, Docetaxel can affect healthy cells too. Due to this, patients can experience mild, moderate or severe side effects while undergoing chemotherapy treatment.

Despite this, treatment with Docetaxel is often recommended as it can be a life-saving solution for patients with cancer. Although Docetaxel can be used alone, it is often used in conjunction with other chemotherapy medications. This enables physicians to target cells in various ways and may increase the efficacy of treatment.

Conditions Treated

Cancer, particularly:

  • Prostate cancer
  • Breast cancer
  • Stomach (gastric) cancer
  • Non-small cell lung cancer
  • Head and neck cancers

Type Of Medicine

  • Antineoplastic agent
  • Chemotherapy drug

Side Effects

Any type of medicine can cause patients to suffer from adverse effects but chemotherapy drugs are known to cause a wide-range of side-effects. Unfortunately, these are sometimes unavoidable but doctors may be able to provide additional medication to help patient's cope with the side-effects associated with Docetaxel.

The following side-effects may not require medical intervention but patients should always contact their physician if they are concerned about any adverse effects or if they are particularly severe:

  • Bloody nose
  • Change in color of toenails or fingernails
  • Body pain or aches
  • Hot, irritated, red or dry skin at injection site
  • Loss or loosening of toenails or fingernails, may be painful
  • Headache
  • Pain in muscles or joints
  • Hoarseness
  • Swelling, pain or a lump under the skin at injection site
  • Swollen, tender glands in neck
  • Runny nose
  • Changes to voice
  • Vomiting
  • Dry, itching or burning eyes
  • Burning stomach or upper abdominal pain
  • Difficulty having a bowel movement (stool)
  • Confusion
  • Excessive tearing
  • Discharge from eyes
  • Redness and pain on the skin at place of earlier radiation treatment
  • Sunken eyes
  • Rapid breathing
  • Swelling, redness or pain of the eyelid, eye or inner lining of the eyelid
  • Wrinkled skin
  • Tearing of eyes
  • Congestion
  • Soreness or dryness of the throat
  • Diarrhea
  • Nausea
  • Ulcers or sores on the tongue, lips or inside of the mouth
  • Skin redness or rash (mild)
  • Weakness in the legs, feet, hands or arms

As well as the side-effects listed above, patients may experience other adverse effects when they are being treated with Docetaxel. However, the following side-effects do require medical attention and patients should inform their doctor if they suffer from them:

  • Weight gain
  • Numbness, pain, tingling or burning in hands, arms, legs and/or feet
  • Swelling of the face, stomach, hands, fingers, lower legs or feet
  • Blood in stools or urine
  • Unusual weakness or tiredness
  • Tarry, black stools
  • Hoarseness or cough (accompanied by chills or fever)
  • Labored or difficulty breathing
  • Dizziness
  • Painful or difficult urination (accompanied by chills or fever)
  • Difficulty swallowing
  • Chills or fever
  • Fast heartbeat
  • Skin rash or hives
  • Puffiness, swelling or itching or the eyelids, face, tongue, lips or around the eyes
  • Pain in side or lower back (accompanied by chills or fever)
  • Rattling, noisy breathing
  • Scaly, red, peeling or swollen areas of skin (severe)
  • Red pinpoint spots on skin
  • Chest tightness
  • Unusual bruising and/or bleeding
  • Trouble breathing while at rest
  • Chest discomfort or pain
  • Irregular heartbeat
  • Decreased blood pressure
  • Increased blood pressure

If patients notice any other side-effects whilst they're being treated with Docetaxel, they should seek medical advice also.

It is not particularly uncommon for patients to suffer with side-effects when they are being treated with chemotherapy medicines, such as Docetaxel. Often, patients will be prescribed an oral steroid tablet to take whilst receiving treatment as this can help to relieve the side-effects associated with Docetaxel.

Before commencing treatment, however, their physician should discuss ways in which patients can manage the adverse effects associated with the medicine. In addition to this, specialist cancer nurses are often available to provide advice and assistance regarding the management of side-effects throughout treatment cycles.

Dosage

When patients are treated with Docetaxel, their dose will depend on numerous factors. The type of cancer they've been diagnosed with, the severity of the condition, their current clinical presentation and their age and weight will all affect how much medication they're given. In addition to this, their dose of Docetaxel may depend on whether they're being treated with any other chemotherapy medications. As Docetaxel is available in various strengths, the patient's dose will also depend on the type of Docetaxel which is used.

As chemotherapy treatment is normally given in cycles, patients may be treated with Docetaxel at regular intervals. In many cases, a period of three weeks occurs between each cycle.

When patients are treated for breast cancer, a typical dose of Docetaxel may be 60mg per meter of body surface area, via intravenous injection over a one hour period, alongside other chemotherapy drugs. If necessary, this dose can be increased to 100mg per meter of body surface area. Generally, the patient will receive further treatment every three weeks until their treatment is complete. Typically, patients will be given an oral corticosteroid to take when they are being treated with prednisone. Patients are normally advised to take this one day before receiving treatment.

If patients are being treated for non-small cell lung cancer or gastric cancer, however, 75mg of Docetaxel per meter of body surface area may be administered over a one hour period, every three weeks. This is normally followed by the immediate administration of additional chemotherapy medications. Once again, patients are usually advised to take an oral corticosteroid one day before their treatment commences. A similar dosage strategy may be used in the treatment of head and neck cancers but may be modified if the patient is due to undergo radiation therapy and/or chemoradiotherapy after chemotherapy.

When treating patients with prostate cancer, a common treatment strategy is 75mg of prednisone per meter of body surface area, administered over a one hour period every three weeks. As well as taking corticosteroids prior to treatment, however, patients are often advised to take a corticosteroid, such as prednisone, continuously.

Although these are examples of standard treatment regimes, each patient will be given an individual treatment plan. Their dose of Docetaxel will, therefore, vary considerable, depending on the treatment they're receiving.

As Docetaxel is delivered via intravenous injection, patients will receive this medication in a clinical setting or a hospital. Doctors and/or nurses will administer the medication so patients will not have to calculate the correct dose or administer their own medication when they are being treated with Docetaxel.

However, if patients have forgotten to take their dose of corticosteroid, they should inform their doctor or nurse before treatment commences.

Potential Drug Interactions:

Generally, medications can interact with each other and this can affect the way they work. In some cases, an interaction between two medications can cause unwanted effects so may not be recommended.

Usually, Docetaxel is not prescribed for patients if they have recently taken or been treated with:

  • Measles Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Varicella Virus Vaccine
  • Rubella Virus Vaccine, Live

Treatment with Docetaxel may not be recommended if patients are taking any of the following medications. However, treatment with both medicines may be appropriate in some cases. If so, doctors may modify the patient's dose to try and prevent interactions from occurring. These medications include:

  • Adenovirus Vaccine
  • Smallpox Vaccine
  • Aprepitant
  • Nefazodone
  • Atazanavir
  • Indinavir
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Fluconazole
  • Ceritinib
  • Indinavir
  • Cholera Vaccine, Live
  • Idelalisib
  • Clarithromycin
  • Nelfinavir
  • Cobicistat
  • Itraconazole
  • Conivaptan
  • Fosaprepitant
  • Dronedarone
  • Ketoconazole
  • Influenza Virus Vaccine, Live
  • Nefazodone
  • Ritonavir
  • Pitolisant
  • St John's Wort
  • Telithromycin
  • Poliovirus Vaccine, Live
  • Thalidomide
  • Saquinavir
  • Yellow Fever Vaccine
  • Typhoid Vaccine
  • Smallpox Vaccine
  • Voriconazole

If patients are treated with Docetaxel when they are taking any of the following medicines, it may increase the risk of side-effects occurring:

  • Cisplatin
  • Sorafenib
  • Quinupristin
  • Dalfopristin

Due to this, doctors may change the way patients take their medication or alter the dose to minimize the side-effects which occur.

Patients should also notify their doctor if they are using any over-the-counter medicines, supplements or vitamins as these could also interact with Docetaxel. Furthermore, patients should seek medical advice before using any of these medicines, supplements or vitamins once they are receiving treatment with Docetaxel.

In some cases, certain types of food and drink can also interact with medications. When receiving treatment with Docetaxel, patients should not consume grapefruit, grapefruit juice and/or grapefruit derivatives.

Warnings

If patients have any existing medical conditions, it may affect their treatment with Docetaxel. The following conditions are particularly relevant if patients are due to be treated with Docetaxel:

  • Liver disease
  • Allergy to polysorbate 80
  • Current infection
  • Vision problems
  • Low white blood cell count (Neutropenia)
  • Muscle weakness (Asthenia)
  • Low platelet counts (Thrombocytopenia)
  • Edema (Fluid retention)
  • Peripheral neuropathy (Tingling or numbness in the legs, toes, arms and/or fingers)

Before commencing treatment, patients should discuss their medical history with their physician, as well as any current diagnosed or suspected health problems.

If patients have existing liver, kidney or heart problems, if may affect their body's ability to process medicines. Due to this, patients may require a lower dose of Docetaxel. This is particularly relevant to older patients as they have an increased risk of age-related heart, kidney and/or liver disease.

When patients are being treated with Docetaxel, the number of white blood cells in their body can be reduced. As a result, patients may be more prone to illnesses and infections. In order to prevent additional illnesses occurring, patients should wash their hands regularly and refrain from contact with infected individuals. If patients suspect they are becoming unwell or are exhibiting an infection, they should seek medical help straight away.

Docetaxel can also reduce the patient's platelet count and this can lead to increased instances of bleeding and/or bruising. With a reduced number of platelets, the patient's blood will not clot as it normally would and extensive bleeding may occur. Patients should, therefore, be particularly cautious and prevent cuts and lacerations from occurring whenever possible. In addition to this, patients may need to alter their oral hygiene routine to reduce the risk of their gums bleeding.

If patients consult any medical professionals, including dentists, they should inform them that they are being treated with Docetaxel. Patients will need to undergo regular check-ups with their physician and/or oncologist. In addition to this, regular blood tests will be carried out to ensure the medication is working properly and that no harmful effects are taking place.

Docetaxel may increase the risk of the patient developing acute myeloid leukemia and/or blood cell problems. This increased risk may occur for years after treatment has ceased. Patients should discuss this, along with any other concerns, with their doctor before beginning treatment.

When being treated with Docetaxel, patients may experience fluid retention (edema). Symptoms of edema can include:

  • Shortness of breath
  • Rapid increase in weight
  • Chest discomfort or pain
  • Irregular heartrate or breathing
  • Swelling of the ankles, feet, hands or wrists
  • Extreme weakness and/or tiredness

If patients exhibit these symptoms, they should seek medical help straight away. Treatment with diuretics can be extremely effective in reducing fluid retention and should ease the patient's symptoms.

Docetaxel is associated with skin problems and changes to vision. If patients experience blistering of the skin, peeling or a red rash on the skin following treatment, they should access medical help. Similarly, patients will need to seek medical advice if they has difficulty reading, eye pain and/or blurred vision. These symptoms may indicate that the patient is suffering from cystoid macular edema so treatment should be obtained quickly.

Patients may experience drowsiness and a lack of alertness when being treated with Docetaxel. Due to this, patients should not drive, operate heavy machinery or carry out tasks which require them to be fully alert if they are suffering from these side-effects.

Treatment with Docetaxel can harm an unborn fetus if the patient is pregnant. Patients should use effective forms of birth control during and following treatment. If patients become pregnant when being treated with Docetaxel, they should contact their physician for medical advice.

If patients breastfeed whilst receiving treatment with Docetaxel, the risks to the infant are unknown. Due to this, patients are often advised to refrain from breastfeeding during and immediately following treatment. Patients should discuss this with their physician before breastfeeding, even if their treatment has finished.

Before being treated, patients should notify their doctor if they have an known allergies. In some cases, an allergic reaction and anaphylaxis may occur during or following treatment with Docetaxel. Symptoms may include:

  • Difficulty breathing
  • Swelling of the lips, throat, tongue and/or face
  • Wheezing
  • Hives
  • Chills or fever
  • Irregular or increased heartrate
  • Difficulty swallowing
  • Rash on the skin

Anaphylaxis is a life-threatening emergency and patients should seek immediate medical assistance if they display these symptoms.

Storage

Unless the manufacturer advises otherwise, Docetaxel vials should be stored in a controlled environment, between temperatures of 2-25°C (36-77°F). Vials should also be stored in their original packaging until use and should be kept away from bright lights.

As patients are given Docetaxel in a clinical setting, they should not be required to store, manage or prepare this medication at home.

Summary

Similar to most chemotherapy medicines, Docetaxel is associated with a number of side-effects. Although this can have short and long-term effects on patients, the benefits associated with treatment generally outweigh any risks associated with the drug.

By preventing cancer cells from spreading and enabling the destruction of existing cancer cells, Docetaxel can effectively treat patients and is known to be a life-saving form of medicine. Although Docetaxel can be used in isolation, it may be even more effective when patients are treated with additional chemotherapy medications. When used as part of combination therapy, Docetaxel can help patients to overcome cancer and ensure that cancer cells are eradicated from their system.