What is Docetaxel?

Docetaxel ampoule is a chemotherapy drug known by the brand name Taxotere. This drug is used to treat some cancers, including breast cancer, head and neck cancers, stomach cancer, prostate cancer, and lung cancer (non-small cell type) alone or in combination with other chemotherapy drugs. Docetaxel ampoule can be used as an intravenous injection (intravenous) with a doctor’s order in clinics. In this article, we will review the concept of docetaxel, its development history, mechanism of action, indications, side effects, and its importance in cancer management.

Docetaxel dosage forms

Chemical and herbal medicines available in pharmacies are produced in pharmaceutical forms such as serum, tablets, capsules, syrups, etc. The doctor prescribes the best forms of medicine according to the patient’s age (adults, elderly and children), medical records and type of disease. Docetaxel dosage forms include 10 mg/ml injectable solution (2 ml, 8 ml, 16 ml vials), 20 mg/ml (1 ml, 4 ml vials) and alcohol-free injectable solution. It is available in sizes of 20 mg/ml, 80 mg/4 ml and 160 mg/8 ml.

Docetaxel uses

This drug is used to treat cancer (such as breast, lung, prostate, stomach, and head or neck cancer). Docetaxel is a member of a family of drugs called taxanes that work by slowing cell growth. The most important uses of this product include breast cancer (locally advanced or metastatic), non-small cell lung cancer, stomach cancer, head and neck cancer, prostate cancer, kidney disorder, and liver disorder.

Uses of docetaxel ampoule in adults

1. Breast Cancer
2. Non-small cell lung cancer
3. gastric cancer
4. Head and neck cancer
5. Prostate Cancer
6. Kidney disorder and liver disorder

Pharmacological effects and mechanism of action of docetaxel drug

Semi-synthetic taxane prevents the polymerization of cellular microtubules, which leads to inhibition of DNA, RNA and protein synthesis. The bound protein of this drug is 94-97% and it is metabolized through the liver (CYP3A4). 75% excretion of the drug from feces; Urine is 6%.

Dosage of docetaxel

Read the Patient Information Leaflet, if available from your pharmacist, before you start receiving docetaxel and each time you receive treatment. This medicine is given by a healthcare professional through an injection into a vein. It is usually prescribed over 1 hour every 3 weeks as prescribed by the doctor. Dosage and frequency are based on medical condition, body weight and response to treatment. If you forget a dose, inject or take it as soon as you remember. If the missed dose is close to the next dose, skip the dose.

Dosage of docetaxel for breast cancer

1. It is used for locally advanced or metastatic breast cancer after failure of previous chemotherapy. The recommended dose for monotherapy is 60-100 mg/m2 1 hour every 3 weeks and adjunctive combination therapy 75 mg/m2 1 hour after doxorubicin and cyclophosphamide in 3 weeks.
2. For dose modification (adjuvant therapy) in patients with febrile neutropenia treated with G-CSF or severe, cumulative skin or nerve sensory reactions, reduce to 60 mg/m2.
3. For combination therapy (with doxorubicin and cyclophosphamide) febrile neutropenia generally give G-CSF, if persistent, reduce to 60 mg/m2 and continue G-CSF.
4. In case of stomatitis grade 3.4, consumption is accompanied by a reduction of 60 mg per square meter.
5. In the direction of severe or cumulative skin reactions, the median sensory nerve S/S is reduced to 60 mg/m2. Also, discontinue use if adverse effects persist.

Dosage of docetaxel for non-small cell lung cancer

1. It is recommended for treatment (as monotherapy) in patients with locally advanced or metastatic NSCLC after failure of prior platinum-based chemotherapy.
2. It is also indicated in combination with cisplatin for the treatment of unresectable, locally advanced, or metastatic NSCLC in chemotherapy-naïve patients.
3. The recommended dose is 75 mg every 1 hour for 3 weeks.

Dosage of docetaxel for stomach cancer

1. It is used in combination with cisplatin and fluorouracil for advanced gastric adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, in patients who have not previously received chemotherapy for advanced disease.
2. The amount used on the first day is 75 mg/m2 IV infusion over 1 hour and then 75 mg/m2 cisplatin as a 1-3 hour infusion.
3. After cisplatin, fluorouracil 750 mg/m2 per day is administered as a continuous 24-hour infusion for 5 days.

Dosage of docetaxel for prostate cancer

1. It is prescribed in combination with prednisone for hormone-resistant metastatic prostate cancer.
2. The recommended dose for this disease is 75 mg every 1 hour for 3 weeks with daily prednisone 5 mg every 12 hours.

Time to take docetaxel ampoule

At the time of the doctor’s visit, he may prescribe premedications (such as corticosteroids such as dexamethasone) to prevent side effects such as swelling (fluid retention or edema) and allergic reactions. These usually start 1 day before treatment and last a total of 3 days. Follow your doctor’s instructions carefully to prepare for your treatment. If you forget to take a pre-medication or do not take it as scheduled, tell your doctor or nurse before receiving docetaxel treatment.

Precautions

If you are allergic to docetaxel or to similar drugs (taxane-type drugs such as paclitaxel and cabazitaxel), avoid using this drug. This product may contain inactive ingredients (such as polysorbate 80) that can cause allergic reactions or other problems. Also, if you have medical records of liver problems, lung problems (such as pulmonary effusion), heart problems (such as heart failure), weak immune system (such as neutropenia), blood problems (such as anemia, thrombocytopenia), blood pressure problems, etc., with caution be consumed

1. The risk of treatment-related mortality is higher in patients with hepatic impairment, those receiving higher doses, and in patients with NSCLC and a history of platinum-based chemotherapy receiving docetaxel 100 mg/m2 as monotherapy. .
2. Sepsis has been reported in breast cancer patients undergoing treatment.
3. Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated with docetaxel.
4. Repeated blood cell count in all patients; Do not withdraw until neutrophils are greater than 1,500 cells/mm3 and platelets are greater than 100,000 cells/mm3 (see Dose Modifications).
5. Enterocolitis and neutropenic colitis (typhllitis) have been reported. Use with caution in patients with neutropenia who are particularly at risk of gastrointestinal complications. Enterocolitis and neutropenic enterocolitis may develop at any time and lead to death within the first day of symptom onset.
6. Second reported primary malignancies, particularly acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), non-Hodgkin’s lymphoma (NHL), and kidney cancer, may occur several months or years after docetaxel treatment.
7. Localized erythema of the limbs with edema followed by scaling has been observed. Adjust dose for severe skin toxicity.
8. Severe neurological symptoms (eg, paresthesia, dysesthesia, pain) were observed. If symptoms persist, readjust the dose or discontinue treatment.
9. Cystoid macular edema (CME) has been reported. If you experience vision problems, schedule a comprehensive eye exam right away. If CME is detected, discontinue docetaxel.

Docetaxel contraindications

Pharmaceutical companies have stated medicinal information on all their chemical and herbal products, such as indications for use, precautions, how to use, contraindications, etc. Patients should read the precautions and contraindications before taking any medicine so that the doctor can change their medicine if necessary. Pregnant women, the elderly, children, and nursing mothers are at greater risk for side effects and contraindications for this drug. This group of people did not take any medicine (including docetaxel) without consulting a doctor to avoid serious side effects.

1. Allergy to docetaxel or polysorbate 80
2. Solid tumor with baseline ANC <1500/mm3
3. During pregnancy and breastfeeding

Docetaxel side effects

Pain or swelling at the injection site, nausea, vomiting, diarrhea, excessive tearing, fatigue, dizziness, drowsiness, drunkenness, constipation and loss of appetite are some of the side effects of docetaxel. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help reduce some of these effects. Also, some serious side effects of this product include unusual fatigue and weakness, swelling of hands and feet, weight gain without reason, numbness or tingling of arms and legs, etc.

1. alopecia
2. Anemia
3. Leukopenia
4. Neutropenia
5. asthenia
6. Fever and infection
7. Fluid retention
8. Hypersensitivity
9. Skin reactions
10. Diarrhea, nausea and vomiting
11. Sensory neuropathy
12. myalgia
13. Nail change

Docetaxel drug interactions

Drug interactions may change how your medications work or increase your risk of serious side effects. Do not start, stop, or change any medication without your doctor’s approval. Azole antifungal drugs (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), ritonavir, HIV drugs (such as atazanavir), milk thistle, disulfiram, metronidazole, tinidazole, etc. cause drug interactions with docetaxel. This drug causes drowsiness in patients, avoid using marijuana (cannabis), narcotic pain relievers or cough relievers (such as codeine, hydrocodone), sleep or anxiety medications after use.

Use of docetaxel during pregnancy and breastfeeding

Based on the findings of animal reproduction studies and its mechanism of action, the treatment can cause fetal harm if administered to a pregnant woman. The limited human data available are insufficient to inform the risks associated with the drug during pregnancy. Before starting treatment, check the pregnancy status of potentially fertile women. Also, there is no information about the presence of docetaxel in human milk or its effect on the milk production of nursing mothers. Because of the potential for serious adverse effects in a nursing infant from exposure to docetaxel, including toxic death, hepatotoxicity, neutropenia, and acute myeloid leukemia, women are advised not to breastfeed during treatment.

Docetaxel ampoule storage conditions

This product is kept only in clinics and hospitals, and its storage conditions are not available at home.

The last word about Docetaxel

Docetaxel works by slowing down the growth of cancer cells, as we said in this article from the Green Positive Online Pharmacy magazine. This drug works by binding to microtubules, which are the building blocks of the cell’s skeleton. Microtubules are essential for cell division, so by binding to them, docetaxel can prevent cancer cells from dividing. The common side effects of this product include nausea and vomiting, hair loss, reduction in the number of blood cells, fatigue, muscle pain, digestive problems, infection, etc. Before starting treatment with docetaxel, you should talk to your doctor about the risks and benefits of this drug.

Site source: Medscape