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Overview: Paclitaxel is an intravenous (IV) infusion given by a health care provider to treat cancer. Common side effects include hair loss, nausea, vomiting, diarrhea, and low blood pressure. Serious side effects are less common, but may include allergic reactions, blood disorders, nerve problems, or abnormal heart rhythms. Contact your health care provider right away if you have pain, burning, or tingling of your hands or feet, fever, trouble breathing, or chest pain.

Uses

What is paclitaxel used for?

Paclitaxel is commonly used to treat certain people with the following cancers. 

Paclitaxel may also be used for other conditions as determined by your health care provider.

Paclitaxel is also available in a form that is bound to a protein. See Paclitaxel Protein-Bound for more information.

How does paclitaxel work (mechanism of action)?

Paclitaxel is a type of medicine known as chemotherapy. It works by stopping certain cells from dividing and multiplying. This helps to slow or stop cancer tumors from growing. 

How is paclitaxel supplied (dosage forms)?

Brands and other names

  • Taxol

Paclitaxel is available in an injectable form that is given by a health care provider.

How should I store paclitaxel?

Paclitaxel is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of paclitaxel?

The most common side effects of paclitaxel are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Blood disorders (see below)
  • Infections
  • Bleeding
  • Allergic reactions (see below)
  • Low blood pressure
  • Slow heartbeat 
  • Heart rhythm changes (see below)
  • Nerve problems (see below)
  • Muscle and joint pain
  • Nausea and vomiting
  • Diarrhea
  • Swelling in your mouth and stomach
  • Hair loss
  • Changes in liver function tests
  • Pain, itching, swelling, or redness near the injection site (where the needle went in)

There may be other side effects of paclitaxel that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of paclitaxel?

While less common, the most serious side effects of paclitaxel are described below, along with what to do if they happen.

Severe Allergic Reactions. Paclitaxel may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Pale bumps on the skin called hives that can be red, pink, white, or brown, depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Disorders. Paclitaxel can cause blood disorders, such as low neutrophils (neutropenia), low red blood cell levels (anemia), low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia or neutropenia). Keep all appointments for bloodwork so your health care provider can monitor your blood cell counts. Get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Heart Rhythm Changes. Paclitaxel may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. In rare cases, this may cause the heart to suddenly stop beating (cardiac arrest) or require a pacemaker. Get emergency help if you have any of the following signs of heart rhythm changes.

  • Chest pain
  • Shortness of breath
  • Feeling dizzy, lightheaded, or fainting
  • Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat

Nerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy, can happen in people who are using paclitaxel. Call your health care provider if you have pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet.

Warnings & Precautions

Who should not use paclitaxel?

Allergies to Ingredients. People who are allergic to any of the following should not use paclitaxel.

  • Abraxane
  • Paclitaxel
  • Paclitaxel protein-bound
  • Polyoxyl 35 castor oil
  • Taxol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in paclitaxel.

Low White Blood Cell Levels. Paclitaxel may not be safe to use if you have certain types of cancer and low levels of a type of white blood cell called a neutrophil (neutropenia). Your health care provider may check your neutrophil level to see if it is safe for you to use paclitaxel.

What should I know about paclitaxel before using it?

Paclitaxel is usually given by a health care provider in a hospital or clinic. You will likely get medicine before paclitaxel to reduce your risk of an allergic reaction. These medicines often include one or all of the following.

  • A corticosteroid, such as dexamethasone, methylprednisolone, or prednisone 
  • An antihistamine, such as diphenhydramine (Benadryl)
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid, Zantac), or nizatidine (Axid)

Your health care provider will likely monitor your body’s response to paclitaxel with blood tests. Keep all appointments so your health care provider can make sure it is safe for you to start and continue to use paclitaxel. 

People who are 65 or older can be at greater risk of some side effects from paclitaxel. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using paclitaxel?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if paclitaxel is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems
  • Nerve problems
  • Liver problems
  • Kidney problems
  • Previous injection site reactions

Other Medicines and Supplements. Paclitaxel may interact with other medicines and supplements. Before using paclitaxel, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Paclitaxel may harm an unborn baby. If you can become pregnant, you should use effective birth control while using paclitaxel. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if paclitaxel passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop paclitaxel.

Interactions

Does paclitaxel interact with foods or drinks?

There are no known interactions between paclitaxel and foods or drinks.

It is unknown if drinking alcohol will affect paclitaxel.

Does paclitaxel interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using paclitaxel.

  • Buspirone (Buspar), which is a medication used for anxiety
  • Felodipine (Plendil), which is a medicine used to treat high blood pressure
  • Eletriptan (Relpax), which is a medicine commonly used to treat migraines
  • Sildenafil (Viagra, Revatio, and others), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)
  • Triazolam (Halcion), a medicine used to treat insomnia
  • A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Clarithromycin, which is a medicine used for bacterial infections
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Repaglinide (Prandin), which is a medicine for diabetes
  • A medicine for high cholesterol, such as fenofibrate (Tricor), fenofibric acid (Fibricor, Trilipix), gemfibrozil (Lopid), lovastatin, or simvastatin (Zocor)

Many other medicines may alter the blood levels of paclitaxel. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with paclitaxel. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much paclitaxel?

If you or someone else has used too much paclitaxel, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of paclitaxel?

Missing doses of paclitaxel can cause it to not work as well over time. So it is important not to miss or skip doses. Paclitaxel is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving paclitaxel as scheduled.

If you miss an appointment to get your paclitaxel dose, call to make another appointment as soon as possible.