Docetaxel

Indications
Intravenous
Breast cancer
Adult: As a single agent: Initially, 60-100 mg/m2 BSA by infusion once every 3 wk. In combination therapy: 75 mg/m2 once every 3 wk.
Hepatic impairment: ALT and/or AST >1.5 times the upper limit of normal (ULN), and alkaline phosphatase >2.5 times the ULN: Reduce dose from 100 mg/m2 to 75 mg/m2. Avoid in severe impairment.
Intravenous
Head and neck cancer
Adult: 75 mg/m2 BSA once every 3 wk. For gastric adenocarcinoma: Dose is given before cisplatin and fluorouracil. For head and neck cancer: Treatment is given for 3 cycles followed by chemoradiotherapy or 4 wk followed by radiotherapy alone. For prostatic cancer: May be given with oral prednisolone 5 mg bid continuously during treatment.
Hepatic impairment: ALT and/or AST >1.5 times the upper limit of normal (ULN), and alkaline phosphatase >2.5 times the ULN: : Reduce dose from 100 mg/m2 to 75 mg/m2. Avoid in severe impairment.
Intravenous
Prostate cancer
Adult: 75 mg/m2 BSA once every 3 wk. For gastric adenocarcinoma: Dose is given before cisplatin and fluorouracil. For head and neck cancer: Treatment is given for 3 cycles followed by chemoradiotherapy or 4 wk followed by radiotherapy alone. For prostatic cancer: May be given with oral prednisolone 5 mg bid continuously during treatment.
Hepatic impairment: ALT and/or AST >1.5 times the upper limit of normal (ULN), and alkaline phosphatase >2.5 times the ULN: : Reduce dose from 100 mg/m2 to 75 mg/m2. Avoid in severe impairment.
Intravenous
Non-small cell lung cancer
Adult: 75 mg/m2 BSA once every 3 wk. For gastric adenocarcinoma: Dose is given before cisplatin and fluorouracil. For head and neck cancer: Treatment is given for 3 cycles followed by chemoradiotherapy or 4 wk followed by radiotherapy alone. For prostatic cancer: May be given with oral prednisolone 5 mg bid continuously during treatment.
Hepatic impairment: ALT and/or AST >1.5 times the upper limit of normal (ULN), and alkaline phosphatase >2.5 times the ULN: : Reduce dose from 100 mg/m2 to 75 mg/m2. Avoid in severe impairment.
Intravenous
Gastric adenocarcinoma
Adult: 75 mg/m2 BSA once every 3 wk. For gastric adenocarcinoma: Dose is given before cisplatin and fluorouracil. For head and neck cancer: Treatment is given for 3 cycles followed by chemoradiotherapy or 4 wk followed by radiotherapy alone. For prostatic cancer: May be given with oral prednisolone 5 mg bid continuously during treatment.
Hepatic impairment: ALT and/or AST >1.5 times the upper limit of normal (ULN), and alkaline phosphatase >2.5 times the ULN: : Reduce dose from 100 mg/m2 to 75 mg/m2. Avoid in severe impairment.

Special Populations: Reduce initial dose by 25% in monotherapy of patients with moderate hepatic impairment.
Contraindications
Previous severe hypersensitivity reaction to docetaxel, the solvent or polysorbate 80. Severe neutropenia; pregnancy, severe liver impairment.
Warnings / Precautions
Lactation. Hepatic impairment. Monitor liver blood function and blood counts regularly. Premedication with oral dexamethsaone at 16 mg daily for 3 days, starting one day before docetaxel treatment is recommended.
Adverse Reactions
Erythematous patches, eruptions, scleroderma, onycholysis, alopoecia, nausea, vomiting, diarrhoea, stomatitis; increases in hepatic transaminases, bilirubin and alkaline phosphatase; mucositis, asthenia, arthralgia, myalgia, paroxysmal atrial tachycardia, atrial flutter, dysrrhythmia, hypertension and heart failure.
Potentially Fatal: Neutropenia; fluid retention syndrome; anaemia.
Drug Interactions
Co-admin of drugs that induce, inhibit, or metabolised by cytochrome P-450 isoenzyme may affect the metabolism of docetaxel.
Potentially Fatal: Caution should be exercised during concomitant therapy with ciclosporin, terfenadine, ketoconazole, erythromycin and troleandomycin.
See Below for More docetaxel Drug Interactions
Mechanism of Actions
Docetaxel disrupts the microtubular network in cells that is essential for vital mitotic and interphase cellular functions. It binds to the free tubulin and promotes the assembly of tubulin into stable microtubules while simultaneously inhibiting their disassembly, resulting in inhibition of mitosis.
Distribution: Rapidly distributed throughout body tissues. Protein-binding: >95%
Metabolism: Extensively hepatic.
Excretion: Faeces (as metabolites), urine; 11 hr (elimination half-life).
Storage Conditions
Intravenous: Store at 2-25°C.
ATC Classification
L01CD02 - docetaxel ; Belongs to the class of plant alkaloids and other natural products, taxanes. Used in the treatment of cancer.
Storage
Intravenous: Store at 2-25°C.
Available As
  • Docetaxel 120 mg
  • Docetaxel 20 mg
  • Docetaxel 80 mg
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