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Docetaxel

    Brands

    DEA Class; Rx

    Common Brand Names; Taxotere

    • Antineoplastics, Antimicrotubular (Taxanes)

    A taxane microtubule inhibitor
    Used for certain types of breast cancer, non-small cell lung cancer, gastric cancer, prostate cancer, and head and neck cancer
    Oral corticosteroid premedication required prior to each dose to reduce the incidence and severity of hypersensitivity, fluid retention, and skin toxicity

    Indicated for the treatment of breast cancer.

    For the treatment of non-small cell lung cancer (NSCLC).
    For the treatment of metastatic prostate cancer.

    Hypersensitivity to docetaxel or polysorbate 80

    Solid tumor with baseline ANC<1500/mm3

    Varies according to indication and treatment regimen

    • Alopecia
    • Anemia
    • Leukopenia
    • Neutropenia
    • Asthenia
    • Fever
    • Infections
    • Fluid retention
    • Hypersensitivity
    • Skin reactions
    • Diarrhea
    • Nausea
    • Vomiting
    • Sensory neuropathy
    • Myalgia
    • Nail changes

    Treatment-related mortality higher in patients with hepatic impairment, those receiving higher doses, and in patients with NSCLC and history of prior platinum-based chemotherapy who receive docetaxel as monotherapy at 100 mg/m²

    Sepsis reported in breast cancer patients receiving therapy; half of them reported during first cycle of therapy

    Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated docetaxel

    Perform frequent blood cell counts on all patients; do not retreat until neutrophils recover to >1500 cells/mm3 and platelets to >100,000 cell/mm3 (see Dosage Modifications)

    Enterocolitis and neutropenic colitis (typhlitis) reported; caution for patients with neutropenia, who are particularly at risk for developing GI complications; enterocolitis and neutropenic enterocolitis may develop at any time, and could lead to death as early as the first day of symptom onset

    A 25% reduction in dose of recommended during subsequent cycles following severe neutropenia (<500 cells/mm3) lasting 7 days or more, febrile neutropenia, or a grade 4 infection in a treatment cycle

    Observed closely for hypersensitivity reactions, especially during the first and second infusions; severe hypersensitivity reactions characterized by generalized rash/erythema, hypotension and/or bronchospasm, or very rarely fatal anaphylaxis, have been reported in patients premedicated with 3 days of corticosteroids; severe hypersensitivity reactions require immediate discontinuation of the infusion and aggressive therapy; patients with history of severe hypersensitivity reactions should not be rechallenged; patients with history of paclitaxel hypersensitivity may develop a reaction to docetaxel

    Based on findings in animal reproduction studies and its mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; limited available human data are not sufficient to inform drug-associated risk during pregnancy

    There is no information regarding presence of docetaxel in human milk, or effects on milk production or the breast-fed child

    The suggested maximum tolerated dose (MTD) for docetaxel is dependent on performance status, other chemotherapy agents or radiation given in combination, and disease state. The optimal dose or infusion duration of docetaxel has not been determined. Therefore, dosing may vary from protocol to protocol. If questions arise, clinicians should consult the appropriate references to verify the dose.

    Adults

    100 mg/m2 IV over 1 hour every 3 weeks as a single agent; doses of 100 mg/m2 IV have been associated with toxic deaths in patients with breast and lung cancer (see Adverse Reactions). Doses up to 40 mg/m2 have been given on a weekly basis. The recommended dose of intraperitoneal docetaxel is 100 mg/m2 IP every 3 weeks.

    Elderly

    100 mg/m2 IV over 1 hour every 3 weeks as a single agent; doses of 100 mg/m2 IV have been associated with toxic deaths in patients with breast and lung cancer (see Adverse Reactions). Doses up to 40 mg/m2 have been given on a weekly basis. The recommended dose of intraperitoneal docetaxel is 100 mg/m2 IP every 3 weeks.

    Adolescents

    In a phase I study of children with refractory solid tumors, the MTD for heavily pretreated patients was 65 mg/m2 IV every 3 weeks and 125 mg/m2 IV over 1 hour in less heavily pretreated patients.

    Children

    In a phase I study of children with refractory solid tumors, the MTD for heavily pretreated patients was 65 mg/m2 IV every 3 weeks and 125 mg/m2 IV over 1 hour in less heavily pretreated patients.

    Docetaxel 

    injectable solution

    • 10mg/mL (2mL, 8mL, 16mL vials)
    • 20mg/mL (1mL, 4mL vials)

    alcohol-free solution for injection

    • 20mg/mL
    • 80mg/4mL
    • 160mg/8mL