How does this medication work? What will it do for me?

Docetaxel belongs to the group of cancer-fighting medications known as antineoplastics, and specifically to the group of antineoplastics known as taxanes. Docetaxel kills cancer cells by interfering with the genetic material DNA, which is necessary for their growth and reproduction.

Docetaxel is used alone or in combination with other antineoplastic medications to treat cancers of the ovary, breast, prostate, or lung. It may also be used to treat head and neck cancer after a previous chemotherapy treatment has failed.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of sterile, non-pyrogenic, clear colourless to pale yellow solution contains docetaxel (anhydrous) 10 mg. Nonmedicinal ingredients: citric acid (anhydrous), ethanol anhydrous, polyethylene glycol 300, and polysorbate 80.

How should I use this medication?

The recommended dose and dosing schedule of docetaxel varies according to the specific type of cancer being treated, the response to therapy, and the other medications or treatments being used. The dose is also based on body size.

Docetaxel is usually injected into a vein through a site on the skin that has been prepared for this purpose. It is often scheduled to be given over a one-hour period once every 3 weeks.

Docetaxel is always given under the supervision of a doctor. Very careful handling of this medication is required. It is always administered in a hospital or similar setting with access to sterile equipment for preparation.

Before receiving your dose of docetaxel, you will be given some medication to reduce side effect symptoms. Keep track of any side effects and report them to your doctor as suggested below in the section, "What side effects are possible with this medication?"

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive your dose, contact your doctor.

This medication is stored at room temperature, protected from light, and kept out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use docetaxel if you:

  • are allergic to docetaxel, polysorbate 80, or any ingredients of the medication
  • are pregnant or breast-feeding
  • have a very low level of neutrophils (a type of white blood cell) in the blood
  • have severe liver disease

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changes in taste sensation
  • diarrhea
  • fatigue
  • fluid retention
  • hair loss
  • loosening or loss of fingernails or toenails, or change in their colour
  • loss of appetite
  • nausea
  • mild skin rash, redness, or itching
  • numbness, burning, or tingling in hands or feet
  • pain in joints or muscles
  • rash
  • redness, heat, irritation or pain, swelling, or lump at the site of injection
  • sores or ulcers in the mouth or on the lips or tongue
  • swelling at the injection site
  • tearing of the eyes
  • temporary loss of hair
  • vomiting
  • weakness in the arms, hands, legs, or feet

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • flushing of the face
  • fast or irregular heartbeat
  • increases in blood pressure sometimes with dizziness or headaches
  • persistent diarrhea or vomiting
  • reduction in blood pressure sometimes causing dizziness or fainting
  • severe red, scaly, swollen, or peeling areas of skin
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood,  bleeding gums, cuts that don't stop bleeding)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • swelling of abdomen, face, fingers, hands, feet, or lower legs
  • unusual tiredness or weakness
  • vision problems

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs of bleeding in the stomach (e.g., bloody, black, or  tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
  • signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
  • signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
  • chest pain
  • rash occurring during or shortly after your treatment

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reaction: Some people may experience an allergic reaction (flushing of the face, severe back pain, chest tightness, shortness of breath) within the first few minutes of receiving docetaxel. You will be asked to take some medication prior to treatment with docetaxel to reduce your chances of experiencing a reaction.

Blood clotting: Docetaxel can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won't stop bleeding.

Fluid retention: This medication can cause fluid retention, mainly involving the ankles and wrists. You will be prescribed medication to reduce your risk of experiencing fluid retention and your doctor will monitor you while you are receiving this medication.

Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who are sick, especially those who have contagious infections (e.g., colds, flu, chicken pox), and tell your doctor if you notice signs of an infection such as fever or chills.

Leukemia: This medication may rarely cause a form of leukemia. Talk to your doctor if you have any concerns.

Liver function: Liver disease or reduced liver function may cause increased side effects with this medication. If you have impaired liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may experience increased side effects from docetaxel.

Nerve pain: People usually experience a mild burning, tingling, numbing sensation of the fingers and toes while taking this medication. This side effect is rarely severe and usually goes away once you finish treatment with docetaxel.

Skin: This medication may rarely cause a severe skin reaction involving peeling, blistering, and redness of the skin. This usually appears on the hands and feet, but may also occur on the arms, face, or body. Contact your doctor if this reaction occurs.

Pregnancy: There are no adequate studies of use of this medication by pregnant women. This medication should not be taken during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if docetaxel passes into breast milk. Women should not breast-feed while using docetaxel.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may be at increased risk of side effects from this medication.

What other drugs could interact with this medication?

There may be an interaction between docetaxel and any of the following:

  • other cancer medications (e.g., cisplatin, doxorubicin, teniposide, etoposide, vincristine)
  • amiodarone
  • "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., phenobarbital, secobarbital)
  • boceprevir
  • bosentan
  • carbamazepine
  • carvedilol
  • clozapine
  • conivaptan
  • cyclosporine
  • deferasirox
  • desipramine
  • dexamethasone
  • diltiazem
  • echinacea
  • grapefruit juice
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • leflunomide
  • lomitapide
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • mefloquine
  • natalizumab
  • nefazodone
  • norfloxacin
  • phenytoin
  • pimecrolimus
  • primidone
  • progesterone
  • propranolol
  • quinidine
  • quinine
  • rifabutin
  • rifampin
  • "statin" cholesterol medications (e.g., atorvastatin, pravastatin, simvastatin)
  • tacrolimus
  • tamoxifen
  • telaprevir
  • tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib)
  • vaccines
  • verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.