Docetaxel

Docetaxel Brand Names- Docefrez | Taxotere

What is Docetaxel

Docetaxel is a semisynthetic antineoplastic agent that is very similar to paclitaxel in structure, mechanism of action, and spectrum of antitumor activity.

Docetaxel differs structurally from paclitaxel at the C-10 position where it has a hydroxy group instead of an acetyl group and contains an OC(CH₃)₃ moiety on the C-13 side chain as opposed to a benzamide phenyl group.

Docetaxel was isolated in 1986 as a result of the National Cancer Institute screening program for natural cytotoxic products. It is synthesized from 10-deacetyl baccatin III, a noncytotoxic substance extracted from the needles of the European yew tree (Taxus baccata).

Nonhematologic toxicities differ between docetaxel and paclitaxel; fluid retention and skin lesions are more severe with docetaxel.

Docetaxel is FDA approved for the treatment of breast cancer, non-small cell lung cancer (NSCLC), castration-resistant prostate cancer, gastric cancer, and squamous cell cancer of the head and neck; it also has several off-label indications.

Treatment-related mortality is increased in patients with abnormal liver function, in patients receiving higher doses, and at a monotherapy dose of 100 mg/m², in patients with NSCLC and a history of prior treatment with platinum-based chemotherapy.

It should not be given to patients with increased liver function tests or in patients with neutrophil counts less than 1,500 cells/mm³.

All patients should be premedicated with oral corticosteroids prior to each dose of docetaxel to reduce the incidence and severity of hypersensitivity, fluid retention, and skin toxicity.

Indications

1. breast cancer
2. gastric cancer
3. head and neck cancer
4. malignant melanoma
5. non-small cell lung cancer (NSCLC)
6. ovarian cancer
7. prostate cancer

For the treatment of breast cancer

for locally advanced or metastatic breast cancer after failure of previous chemotherapy

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. acute respiratory distress syndrome (ARDS)
4. alopecia
5. amenorrhea
6. anaphylactic shock
7. anemia
8. angina
9. anorexia
10. arthralgia
11. ascites
12. asthenia
13. atrial fibrillation
14. atrial flutter
15. back pain
16. bleeding
17. bone marrow suppression
18. bronchospasm
19. bullous rash
20. cardiac tamponade
21. chest pain (unspecified)
22. chills
23. colitis
24. confusion
25. conjunctivitis
26. constipation
27. cough
28. dehydration
29. diarrhea
30. disseminated intravascular coagulation (DIC)
31. dizziness
32. dysesthesia
33. dysgeusia
34. dysosmia
35. dyspepsia
36. dysphagia
37. dyspnea
38. edema
39. elevated hepatic enzymes
40. enterocolitis
41. epiphora
42. epistaxis
43. erythema
44. erythema multiforme
45. esophagitis
46. ethanol intoxication
47. exfoliative dermatitis
48. fatigue
49. fever
50. fluid retention
51. flushing
52. GI bleeding
53. GI obstruction
54. GI perforation
55. hearing loss
56. heart failure
57. hepatitis
58. hepatotoxicity
59. hyperbilirubinemia
60. hypertension
61. hypocalcemia
62. hypokalemia
63. hypomagnesemia
64. hyponatremia
65. hypotension
66. ileus
67. infection
68. injection site reaction
69. ischemic colitis
70. lacrimation
71. lethargy
72. leukemia
73. leukopenia
74. lymphoma
75. macular edema
76. myalgia
77. myocardial infarction
78. nail discoloration
79. nausea
80. neurotoxicity
81. neutropenia
82. new primary malignancy
83. odynophagia
84. onycholysis
85. ototoxicity
86. palmar-plantar erythrodysesthesia (hand and foot syndrome)
87. paresthesias
88. peptic ulcer
89. peripheral edema
90. peripheral neuropathy
91. peripheral vasodilation
92. phlebitis
93. pleural effusion
94. pneumonitis
95. pruritus
96. pulmonary embolism
97. pulmonary fibrosis
98. radiation recall reaction
99. rash
100. renal failure (unspecified)
101. scotomata
102. seizures
103. serious hypersensitivity reactions or anaphylaxis
104. sinus tachycardia
105. skin hyperpigmentation
106. Stevens-Johnson syndrome
107. stomatitis
108. syncope
109. thrombocytopenia
110. thrombosis
111. toxic epidermal necrolysis
112. tumor lysis syndrome (TLS)
113. typhlitis
114. ventricular tachycardia
115. visual impairment
116. vomiting
117. weight gain
118. weight loss
119. xerosis

Monitoring Parameters

• CBC with differential
• LFTs
• pregnancy testing
• serum creatinine/BUN
• serum uric acid

Contraindications

• acute bronchospasm
• alcoholism
• ascites
• biliary tract disease
• breast-feeding
• cardiac tamponade
• children
• colitis
• contraception requirements
• driving or operating machinery
• edema
• ethanol ingestion
• ethanol intoxication
• fluid retention
• geriatric
• hepatic disease
• hyperuricemia
• hypotension
• infants
• infection
• infertility
• male-mediated teratogenicity
• mortality
• neurotoxicity
• neutropenia
• new primary malignancy
• ocular disease
• peripheral edema
• pleural effusion
• polysorbate 80 hypersensitivity
• pregnancy
• pregnancy testing
• renal impairment
• reproductive risk
• serious hypersensitivity reactions or anaphylaxis
• serious rash
• taxane hypersensitivity
• thrombocytopenia
• tumor lysis syndrome (TLS)

Interactions

• Amlodipine; Celecoxib
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amprenavir
• Apalutamide
• Aprepitant, Fosaprepitant
• Atazanavir
• Atazanavir; Cobicistat
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Boceprevir
• Bortezomib
• Bosentan
• Brigatinib
• Cabozantinib
• Carbamazepine
• Carvedilol
• Celecoxib
• Ceritinib
• Chloramphenicol
• Ciprofloxacin
• Clarithromycin
• Cobicistat
• Conivaptan
• Cyclosporine
• Daclatasvir
• Dalfopristin; Quinupristin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Delavirdine
• Diclofenac
• Diclofenac; Misoprostol
• Diflunisal
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Doxorubicin
• Dronedarone
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Elbasvir; Grazoprevir
• Elexacaftor; tezacaftor; ivacaftor
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Enzalutamide
• Epirubicin
• Erlotinib
• Erythromycin
• Erythromycin; Sulfisoxazole
• Esomeprazole; Naproxen
• Etodolac
• Etravirine
• Famotidine; Ibuprofen
• Fenoprofen
• Filgrastim, G-CSF
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Flurbiprofen
• Fluvoxamine
• Fosamprenavir
• Fosphenytoin
• Glecaprevir; Pibrentasvir
• grapefruit juice
• Hydrocodone; Ibuprofen
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Idelalisib
• Ifosfamide
• Imatinib
• Indinavir
• Indomethacin
• Isavuconazonium
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ixabepilone
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lansoprazole; Naproxen
• Ledipasvir; Sofosbuvir
• Letermovir
• Live Vaccines
• Lopinavir; Ritonavir
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Meclofenamate Sodium
• Mefenamic Acid
• Meloxicam
• Mephobarbital
• Mifepristone
• Mitotane
• Nabumetone
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nefazodone
• Nelfinavir
• Netupitant, Fosnetupitant; Palonosetron
• Nevirapine
• Nilotinib
• Nonsteroidal antiinflammatory drugs
• Ombitasvir; Paritaprevir; Ritonavir
• Oritavancin
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• Penicillamine
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• Phenytoin
• Piroxicam
• Posaconazole
• Primidone
• Ribociclib
• Ribociclib; Letrozole
• Rifampin
• Ritonavir
• Rofecoxib
• Rolapitant
• Rufinamide
• Sapropterin
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• Simeprevir
• Sofosbuvir; Velpatasvir; Voxilaprevir
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Sulindac
• Tbo-Filgrastim
• Telaprevir
• Telithromycin
• Telotristat Ethyl
• Thalidomide
• Tipranavir
• Tolmetin
• Tolvaptan
• Tuberculin Purified Protein Derivative, PPD
• Tucatinib
• Valdecoxib
• Vemurafenib
• Voriconazole
• Zonisamide