Paclitaxel and docetaxel
Antineoplastic drugs are used to treat metastatic ovarian
andbreast cancer after chemotherapy has failed. They include:
After I.V. administration, paclitaxel is highly
bound to plasma pro-teins. Docetaxel is administered I.V. with a rapid onset of
Paclitaxel is metabolized primarily in the liver
with a small amount excreted unchanged in urine. Docetaxel is excreted
pri-marily in stool.
Paclitaxel and docetaxel exert their
chemotherapeutic effect by disrupting the microtubule network essential for
mitosis and oth-er vital cellular functions.
Paclitaxel is used when first-line or subsequent
chemotherapy has failed in treating metastatic ovarian cancer as well as
metastatic breast cancer.
The taxanes may also be used for treating head and
neck cancer, prostate cancer, and non–small-cell lung cancer. (See Culturalconsiderations with docetaxel use.)
Taxanes may interact with other drugs.
Concomitant use of paclitaxel and cisplatin may cause additive
Cyclosporine, ketoconazole, erythromycin, and troleandomycin may modify
the metabolism of docetaxel.
Phenytoin may decrease paclitaxel serum level, leading to a loss of
Quinupristin/dalfopristin may increase paclitaxel serum levels,
increasing the risk of toxicity. (See Adverse
reactions to paclitax-el and docetaxel.)