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

Cabazitaxel belongs to the group of cancer-fighting medications known as antineoplastics. Specifically, it belongs to the group of antineoplastics known as taxanes. It works by slowing or stopping the growth of cancer cells in your body. Cabazitaxel is used along with prednisone or prednisolone to treat prostate cancer that has metastasized (spread), is resistant to hormone treatment and treatment with docetaxel 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 taking this medication, speak to your doctor. Do not stop taking 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 the clear yellow to brownish-yellow, oily concentrated sterile solution contains 40 mg cabazitaxel (anhydrous).  Nonmedicinal ingredients:  polysorbate 80. Diluent contains ethanol in water for injection.

How should I use this medication?

The recommended adult dose of cabazitaxel varies according to body size. It is generally calculated as 25 mg per metre squared of body surface area, a calculation based on body weight and height. Depending on how well this medication is tolerated, your doctor may reduce the dose to reduce the severity of side effects.

Cabazitaxel 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.

Cabazitaxel 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.

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 cabazitaxel, contact your doctor as soon as possible to reschedule your appointment.

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 take cabazitaxel if you:

  • are allergic to cabazitaxel or any ingredients of the medication
  • have low white blood cell counts
  • have decreased liver function
  • are currently receiving live vaccines

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.

  • change in sense of taste
  • constipation
  • dizziness
  • hair loss
  • headache
  • low blood pressure
  • tingling, burning, numbness, or pain in the hands, arms, feet, or legs
  • mouth sores
  • muscle spasms
  • nausea
  • tiredness
  • vomiting
  • weakness
  • weight loss

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:

  • extreme weakness or fatigue
  • persistent vomiting or diarrhea
  • signs of anemia (low red blood cells; e.g., dizziness,  pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of bleeding (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 kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
  • 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)
  • signs of gastrointestinal toxicity (e.g., abdominal pain, tenderness, fever, persistent constipation and diarrhea)
  • symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)

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

  • 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 serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

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.

Anemia: Cabazitaxel may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Birth Control: Men with partners who are or may become pregnant should use reliable birth control during treatment and for 6 months after the last dose, to avoid exposing the partner to cabazitaxel.

Bleeding:  Cabazitaxel may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

Drowsiness/reduced alertness: Cabazitaxel may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.

Heart rhythm: Cabazitaxel can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems (e.g., people with heart failure, angina, low potassium or magnesium levels), 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.

Infection: As well as killing cancer cells, cabazitaxel can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections.  Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Kidney function: If you have reduced kidney function or kidney disease, 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.

Liver function:  Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. It may also cause a decrease in liver function. If you have liver problems, 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. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Pregnancy: Cabazitaxel may be harmful to the unborn baby if this medication is used during pregnancy. For this reason, this medication should not be used during pregnancy and a reliable form of birth control should be used. . If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if cabazitaxel passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under the age of 16.

What other drugs could interact with this medication?

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

  • abiraterone acetate
  • amiodarone
  • amphotericin
  • anthracycline anti-cancer agents (e.g., daunorubicin, doxorubicin, idarubicin)
  • aprepitant
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., butalbital, phenobarbital)
  • BCG
  • bicalutamide
  • boceprevir
  • bosentan
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • chloramphenicol
  • cimetidine
  • clotrimazole (oral)
  • clozapine
  • conivaptan
  • cyclosporine (systemic)
  • dabrafenib
  • dasatinib
  • denosumab
  • desipramine
  • dexamethasone (systemic)
  • digoxin
  • echinacea
  • fosphenytoin
  • fusidic acid
  • grapefruit juice
  • haloperidol
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • imatinib
  • leflunomide
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • metronidazole
  • mifepristone
  • natalizumab
  • nefazodone
  • norfloxacin
  • oxcarbazepine
  • phenytoin
  • pimecrolimus
  • platinum derivative anti-cancer agents (e.g., carboplatin, cisplatin, oxaliplatin)
  • primidone
  • rifabutin
  • rifampin
  • roflumilast
  • St. Johns wort
  • sertraline
  • tacrolimus
  • tetracycline
  • tocilizumab
  • trastuzumab
  • vaccines
  • verapamil
  • warfarin

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.