Classifications: antineoplastic agent; taxane agent; Therapeutic: antineoplastic
Pregnancy Category: D
20 mg, 80 mg injection
Docetaxel is a semisynthetic analog of paclitaxel. Potential advantages over paclitaxel are greater antitumor activity and
lower toxicity potential. Docetaxel, like paclitaxel, binds to the microtubule network essential for interphase and mitosis
of the cell cycle.
Docetaxel stabilizes the microtubules involved in cell division and prevents their normal functioning; this results in inhibiting
mitosis in cancer cells.
Metastatic breast cancer, metastatic prostate cancer, non-small cell lung cancer.
Hypersensitivity to docetaxel or other drugs formulated with polysorbate 80, paclitaxel, neutrophil count <1500 cells/mm3, biliary tract disease, hepatic disease, jaundice, neutropenia, intramuscular injections, thrombocytopenia, lactation,
pregnancy (category D), acute infection.
Bone marrow suppression, bone marrow transplant patients; CHF, ascites, peripheral edema, pleural effusion; radiation therapy;
pulmonary disorders, acute bronchospasm; cardiac tamponade; dental disease, dental work, herpes infection; hypotension,
elderly; infection. Safety and effectiveness in children <16 y are not established.
Route & Dosage
Adult: IV 60100 mg/m2 every 3 wk (premedicate patients with dexamethasone 8 mg b.i.d. x 5 d, starting 1 d prior to docetaxel)
Adult: IV 75 mg/m2 every 21 d plus prednisone (5 mg PO twice daily) for 10 cycles (premedicate patients with dexamethasone 8 mg q12h, 3h,
and 1h prior to starting docetaxel infusion)
Non-Small Cell Lung Cancer
Adult: IV 75 mg/m2 every 3 wk
- Note: If drug contacts skin during preparation, wash immediately with soap and water.
PREPARE: IV Infusion: ??Bring vials to room temperature for 5 min; add provided diluent, gently rotate for 45 sec; let stand until surface foam
dissipates.??Inject required amount of diluted solution into a 250-mL, or larger, bag of NS or D5W; the final concentration should be
between 0.30.74 mg/mL. Mix completely by manual rotation.??Use glass or polypropylene bottles or polypropylene or polyolefin plastic bags and administer through polyethylene-lined
administration sets. Do not use PVC administration sets or containers. ??Mix completely by manual rotation.??Use within 4 h (including the 1 h infusion time).
ADMINISTER: IV Infusion: ??Give at a constant rate over 1 h. Administer ONLY after premedication with corticosteroids to prevent hypersensitivity.??Reduce dose by 25% following severe neutropenia (<500 cells/mm3) for 7 d or longer for febrile neutropenia, severe cutaneous reactions, or severe peripheral neuropathy.
INCOMPATIBILITIES Y-site: Amphotericin B, doxorubicin, methylprednisolone, nalbuphone.
- Refrigerate vials at 2°8° C (36°46° F). Protect from light. Do not store in PVC bags. Store
diluted solutions in refrigerator or at room temperature for 8 h.
Adverse Effects (≥1%)CNS:
Paresthesia, pain, burning sensation, weakness, confusion. CV:
Hypotension, fluid retention (peripheral edema, weight gain),
pleural effusion. GI: Nausea, vomiting, diarrhea, stomatitis,
abdominal pain; increased liver function tests (AST or ALT). Hematologic: Neutropenia, leukopenia, thrombocytopenia, anemia,
febrile neutropenia. Skin:
Rash, localized eruptions, desquamation, alopecia,
nail changes (hyper/hypopigmentation, onycholysis). Body as a Whole: Hypersensitivity reactions,
infusion site reactions (hyperpigmentation, inflammation, redness, dryness, phlebitis, extravasation).
Possibility of interacting with other drugs metabolized by CYP3A4.
97% protein bound. Metabolism:
In liver by CYP3A4. Elimination:
80% in feces, 20% renally. Half-Life:
Assessment & Drug Effects
- Lab tests: Monitor bilirubin, AST or ALT, and alkaline phosphatase prior to each drug cycle. Generally, do not give to patients
with elevations of bilirubin or with significant elevations of transaminases concurrent with elevations of alkaline phosphatase.
Monitor frequently CBCs with differential. Withhold drug if platelets <100,000 or neutrophils <1500 cells/mm3.
- Monitor for S&S of hypersensitivity (see Appendix F), which may develop within a few minutes of initiation of infusion.
It is usually not necessary to discontinue infusion for minor reactions (i.e., flushing or local skin reaction).
- Assess throughout therapy and report cardiovascular dysfunction, respiratory distress; fluid retention; development of neurosensory
symptoms; severe, cutaneous eruptions on feet, hands, arms, face, or thorax; and S&S of infection.
Patient & Family Education
- Learn common adverse effects and measures to control or minimize them when possible. Report immediately any distressing
- Note: It is extremely important to comply with corticosteroid therapy and monitoring of lab values.
- Avoid pregnancy during therapy.