📋 Indications & Clinical Dosage
*Treatment of ovarian cancer in combination with Cisplatin:*
BY IV INJ: Adults: 175 mg/m2 over 3 hr or 135 mg/m2 over 24 hr every 3 week.
*Treatment ofmetastatic ovarian cancer where platinum-containing therapy has failed:*
BY IV INJ: Adults: 135-175 mg/m2 over 3 hr every 3 week.
*Treatment of locally advanced or metastatic breast cancer (in combination or alone), Adjuvant treatment of node-positive breast cancer following treatment with anthracycline and cyclophosphamid:*
BY IV INJ: Adults: 175 mg/m2 over 3 hr every 3 week.
*Treatment of non-small cell lung cancer (in combination with cisplatin) when surgery or radiotherapy not appropriate:*
BY IV INJ: Adults: 135 mg/m2 over 24 hr every 3 week.
*Treatment of advanced AIDS-related Kaposis sarcoma where liposomal anthracycline therapy has failed, First-line treatment of metastatic adenocarcinoma of the pancreas (in combination with gemcitabine):*
BY IV INJ: Adults: 135 mg/m2 over 3 hr every 3 week or 100 mg/m2 over 3 hr every 2 week.
Children: Not applicable.
💊 Mode of Administration
The concentrate must be diluted to a final Paclitaxel cone of 0.3 to 1.2 mg/ml in D5W, NS, D5NS. Administration over 3 hours is often recommended.
⛔ Contraindications
Acute porphyrias, Neutrophils less than 1.5x109 per litre, severe hepatic impairment.
⚠️ Precautions & Warnings
Patients aged over 75 years with metastatic adenocarcinoma of the pancreas. Monitor blood counts, Cardiac conduction abnormalities, peripheral neuropathy, renal or hepatic failure. Ensure resuscitation equipment available.
⚠️ Adverse Reactions / Side Effects
Arrhythmia, arthralgia, febrileneutropenia, GI disorders, myalgia, peripheral neuropathy, sensory neuropathy, tachycardia, alopecia, hypotension, bone marrow suppression, bradycardia, cardiac conduction defects, extravasation, hypersensitivity reactions, hyperuricaemia, muscle pain, myelosuppression, nausea, neutropenia, oral mucositis, pneumonitis, Stevens-Johnson syndrome, thromboembolism, toxic epidermal necrolysis, tumourlysis syndrome, vomiting. Rare: Bradycardia, cardiac arrest, congestive heart failure, left ventricular dysfunction
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindication in pregnancy
Lactation / Breastfeeding:
Contraindicated. Discontinue breast-feeding
🧪 Compatibility & Storage Stability
Compatibility: Stable in D5LR, D5NS, NS. Incompatible with amphotericin B, amphotericin B cholesteryl sulphate complex, chlorpromazine, doxorubicin liposome, hydroxyzine, methylprednisolone sodium succinate, mitoxantrone. Stability: Store intact vials at room temperature of 20C (68F-77F). Reconstituted solution is stable for up to 27 hours at room temperature (25C) and ambient light con-ditions. Solutions in D5W, NS, D5NS, and D5LR are stable for up to 48 hours at room temperature (25C).
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.