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GENERIC NAME: docetaxel

BRAND NAME: Taxotere

DRUG CLASS AND MECHANISM: Docetaxel is a cancer drug that is used for treating breast cancer . Docetaxel works by attacking cancer cells. Different medications attack cancer cells in different ways. Every cell in your body contains a supporting structure (almost like a skeleton) called the microtubular network. If this "skeleton" is changed or damaged, the cell can't grow or reproduce. Taxotere makes the "skeleton" in cancer cells unnaturally stiff, so that these cells can no longer grow.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Concentrate liquid for intravenous injection. The concentrate requires dilution prior to administration

STORAGE: Store refrigerated, 2° to 8°C (36° to 46°F). Retain in the original package to protect from bright light.

PRESCRIBED FOR: Docetaxel (Taxotere) for Injection Concentrate is indicated for the treatment of patients with locally advanced or metastatic breast cancer after failure of prior chemotherapy . Docetaxel (Taxotere) has recently been approved for the 2nd-line treatment of patients with locally advanced or metastatic non-small cell lung cancer after failure of prior platinum-based chemotherapy.

DOSING: Docetaxel (Taxotere) for Injection Concentrate is given intravenously (by a needle that is put into your vein) every 3 weeks. Each treatment takes about 1 hour. Again, every patient is different. Your doctor will determine what dose of Taxotere is right for you and how often you should receive it.

DRUG INTERACTIONS: Some medications should not be taken because they can interact with docetaxel (Taxotere). Interactions can cause side effects and they may keep your medications from working. Take only medications that your doctor prescribes for you.

Caution should be exercised with cyclosporine, terfenadine , ketoconazole , erythromycin , and troleandomycin when treating patients receiving docetaxel (Taxotere) as there is a potential for a significant interaction.

Be sure that the doctor who is giving you docetaxel (Taxotere) knows about all other medications you are taking, including nonprescription drugs and those prescribed by other doctors. Likewise, make sure any other doctors who treat you know you are receiving chemotherapy.

PREGNANCY: Docetaxel (Taxotere) can cause fetal harm when administered to pregnant women. If docetaxel (Taxotere) is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus or potential risk for loss of the pregnancy. Women of childbearing potential should be advised to avoid becoming pregnant during therapy with docetaxel (Taxotere).

NURSING MOTHERS: It is not known whether docetaxel (Taxotere) is excreted in human milk. Because many drugs are excreted in human milk, and because of the potential for serious adverse reactions in nursing infants from docetaxel (Taxotere), mothers should discontinue nursing prior to taking the drug.

SIDE EFFECTS: Following are some of the common side effects associated with docetaxel (Taxotere) for Injection Concentrate. If you have these or any other side effects, be sure to tell your doctor or nurse.

Low White Blood Cell Count
Usually, you will not feel it if you have a low white blood cell count, since there are no specific symptoms associated with this side effect unless an infection develops. Your nurse or doctor will check your blood count if he or she thinks it is necessary. Your white blood cells protect your body against infection. Like many agents used to treat cancer, docetaxel (Taxotere) may cause a temporary drop in the number of white blood cells (a condition known as neutropenia ) and may increase the risk of infection. However, most people receiving docetaxel (Taxotere) don't develop infections, even when their white blood cell count is low.

Fever
Fever is one of the most common and earliest signs of infection. If you have a fever over 100°F, make sure to call your doctor or nurse immediately. You should also tell your doctor about other symptoms of infection, such as a sore throat or cough or a burning sensation while urinating.

Allergic Reactions
This type of reaction, which occurs during the infusion of docetaxel (Taxotere), is infrequent. If you feel a warm sensation, difficulty in breathing, or itching during or shortly after your treatment, tell your doctor or nurse immediately. If you have a mild allergic reaction to the first few infusions of docetaxel (Taxotere), such as flushing or a rash, notify the nurse. The doctor will generally stop treatment for a few minutes and then restart the infusion.

Fluid Retention
Fluid retention is a term used to describe an accumulation of fluid in body tissues and/or body cavities. It is important for you to let your doctor or nurse know if you have any signs of fluid retention. Watch for shortness of breath, swelling of your feet or hands, or unexplained weight gain.

In severe cases, shortness of breath may develop due to fluid accumulation in body cavities such as the area surrounding your lungs, the space around your heart, or in your abdomen.

Dexamethasone is used to prevent or reduce fluid retention in patients taking docetaxel (Taxotere). It is important that you take your dexamethasone exactly as your doctor or nurse advises you. If you forget to take your dexamethasone, it is very important that you tell your doctor or nurse before you receive your docetaxel (Taxotere) treatment.

Hair Loss
Loss of hair (including the hair on your head, underarm hair, pubic hair, eyebrows, and eyelashes), which is known as alopecia, occurs in most patients taking docetaxel (Taxotere). For some people, this is a very difficult side effect to experience. However, your hair should grow back once you stop treatment. Meanwhile, your doctor or nurse can refer you to a specialty store that carries wigs, hairpieces, and turbans specifically for patients with cancer. You can also call the American Cancer Society for more information (1-800-ACS-2345).

Fatigue and Muscle Discomfort
Many patients receiving docetaxel (Taxotere) for Injection Concentrate feel tired at some time during their treatment. Even if you are only slightly tired, make sure you get enough rest during your treatment. Muscle pain happens about 20% of the time, but is rarely severe. You may feel pain in your muscles or joints. Tell your doctor or nurse if this happens. They may suggest ways to make you more comfortable.

Rash
Patients on docetaxel (Taxotere) may develop a red, blotchy rash. This usually occurs on the feet and hands, but may also appear on the arms, face, or body. If it occurs, the rash generally appears within a week after docetaxel (Taxotere) treatment and usually disappears after a week or two.

Numbness
Some patients receiving docetaxel (Taxotere) experience numbness, tingling, burning, or weakness in their hands and feet.

Nail Changes
Changes in the color of your fingernails or toenails may occur while you are taking docetaxel (Taxotere). Occasionally, nails become soft and tender. In more extreme but rare cases, nails may fall off. After you have finished docetaxel (Taxotere) treatment, your nails will generally grow back. Keeping your nails clean and trimmed while being treated with docetaxel (Taxotere) may help prevent nail problems.

Nausea, Vomiting, and Diarrhea
Nausea, vomiting, and diarrhea may occur but generally are not severe with Taxotere.

Other Possible Side Effects
The side effects listed here include those that occur most frequently in patients receiving docetaxel (Taxotere), but they are not the only ones that may occur. Make sure to report any symptoms to your doctor or nurse.

As part of your treatment plan, your doctor may prescribe other medications, including dexamethasone, which is used to help lessen some of the side effects you may have during treatment. Dexamethasone may prevent fluid retention (holding extra water in the body), and may also lessen any allergic reactions to docetaxel (Taxotere). Patients generally begin taking dexamethasone 1 day before their docetaxel (Taxotere) treatment and usually continue for a total of 3 days. However, you should always follow your doctor's or nurse's instructions on how to take your medications and for how many days.

Use of a short course of dexamethasone, a corticosteroid, can cause side effects, although they are generally mild in nature. These side effects can include flushing, upset stomach, and nausea. If you have previously had side effects while taking corticosteroids, alert your physician or nurse before receiving treatment with docetaxel (Taxotere).

If you forget to take your dexamethasone as directed, make sure to tell your doctor or nurse before you receive your docetaxel (Taxotere) treatment. Call your doctor or nurse if you have any problems taking your dexamethasone.


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