Dangerous Drug: Docetaxel(dohs eh tax’ ell)
Docefrez, Taxotere
PREGNANCY CATEGORY D
Drug Classes
Antineoplastic (taxoid)
Therapeutic Actions
Inhibits the normal dynamic reorganization of the microtubule network that is essential for dividing cells; leads to cell death in rapidly dividing cells.
Indications
Treatment of patients with locally advanced or metastatic breast cancer after failure of prior chemotherapy
Treatment of non–small-cell lung cancer after failure with platinum-based chemotherapy, with metastases
First-line treatment of unresectable, locally advanced, or metastatic non–small-cell lung cancer in patients who have not received prior chemotherapy when used in combination with cisplatin
Treatment of androgen-independent metastatic prostate cancer with prednisone
Adjuvant post-surgery treatment of patients with operable node-positive breast cancer in combination with doxorubicin and cyclophosphamide
Induction treatment of patients with locally advanced squamous cell carcinoma of the head and neck, in combination with cisplatin and 5-FU, before the patient undergoes chemoradiotherapy or radiotherapy
Treatment of advanced gastric adenocarcinoma in patients who have not received chemotherapy for advanced disease with cisplatin and 5-FU
Unlabeled uses: Esophageal, ovarian, small-cell lung, urothelial cancers
Contraindications and Cautions
Contraindicated with hypersensitivity to docetaxel or drugs using polysorbate 80; bone marrow depression with neutrophil counts less than 1,500 cells/mm2, lactation, pregnancy.
Use cautiously with hepatic impairment, history of treatment with platinum-based chemotherapy.
Available Forms
Injection—10 mg/mL, 20 mg/0.5 mL, 20 mg/mL, 20 mg/2 mL, 40 mg/mL, 80 mg/4 mL
Dosages
Adults
Breast cancer: 60–100 mg/m2 IV infused over 1 hr every 3 wk.
Non–small-cell lung cancer: 75 mg/m2 IV over 1 hr every 3 wk.
First-line treatment of non–small-cell lung cancer: 75 mg/m2 of Taxotere given over 1 hr followed by 75 mg/m2 cisplatin IV given over 30–60 min every 3 wk.
Androgen-independent metastatic prostate cancer: 75 mg/m2 IV every 3 wk as a 1-hr infusion with 5 mg prednisone PO bid constantly throughout therapy. Premedicate with dexamethasone 8 mg PO 12 hr, 3 hr, and 1 hr before docetaxel infusion. Reduce dosage to 60 mg/m2 if febrile neutropenia, severe or cumulative cutaneous reactions, moderate neurosensory signs or symptoms, or neutrophil count less than 500 mm3 occurs for longer than 1 wk. Stop therapy if reactions continue with reduced dose.
Operable node-positive breast cancer: 75 mg/m2 IV given 1 hr after doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 every 3 wk for 6 courses. Adjust dosage based on neutrophil count.
Induction for squamous cell cancer of the head and neck before radiotherapy (Taxotere): 75 mg/m2 as a 1-hr IV infusion followed by cisplatin 75 mg/m2 IV over 1 hr on day 1, followed by 5-FU 750 mg/m2/day IV for 5 days. Repeat every 3 wk for four cycles before radiotherapy starts.
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