Cabazitaxel Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Prostate Cancer

Initial dose: 25 mg/m2 IV every 3 weeks in combination with prednisone 10 mg orally once daily.

Renal Dose Adjustments

CrCl less than 30 mL/min or end-stage renal disease: No specific dose adjustment guidelines have been suggested; however, caution is recommended.

Liver Dose Adjustments

Liver dysfunction (total bilirubin greater than or equal to ULN, or AST and/or ALT greater than or equal to 1.5 times ULN): Use is not recommended.

Dose Adjustments

In patients with prolonged grade 3 or greater neutropenia (more than 1 week) despite treatment with granulocyte colony stimulating factor therapy, treatment should be delayed until the neutrophil count is greater than 1,500 cells/mm3, then the dose of cabazitaxel should be reduced to 20 mg/m2. Granulocyte colony stimulating factor should be used for secondary prophylaxis. Cabazitaxel should be discontinued if the patient continues to experience this reaction at a dose of 20 mg/m2.

In patients with febrile neutropenia, treatment should be delayed until improvement or resolution, and until the neutrophil count is greater than 1,500 cells/mm3, then the dose of cabazitaxel should be reduced to 20 mg/m2. Granulocyte colony stimulating factor should be used for secondary prophylaxis. Cabazitaxel should be discontinued if the patient continues to experience this reaction at a dose of 20 mg/m2.

In patients with grade 3 or greater diarrhea or persistent diarrhea despite appropriate management, treatment should be delayed until improvement or resolution, then the dose of cabazitaxel should be reduced to 20 mg/m2. Cabazitaxel should be discontinued if the patient continues to experience this reaction at a dose of 20 mg/m2.

Precautions

Cabazitaxel should not be administered to patients with a neutrophil count of less than or equal to 1,500 cells/mm3. Treatment may be restarted when the neutrophil count is greater than 1,500 cells/mm3. A complete blood count is recommended on a weekly basis during cycle 1 and prior to each treatment cycle thereafter.

Cabazitaxel should be discontinued in patients who develop a severe hypersensitivity reaction (hypotension, bronchospasm). These patients should not be rechallenged with cabazitaxel.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Cabazitaxel should be administered by a healthcare provider experienced in the use of antineoplastic agents.

Cabazitaxel should be administered as a one-hour intravenous infusion. During administration, use of an in-line filter of 0.22 micrometer nominal pore size is recommended.

Patients should be premedicated to prevent severe hypersensitivity reactions. Intravenous administration of an antihistamine (dexchlorpheniramine 5 mg, or diphenhydramine 25 mg or equivalent antihistamine), a corticosteroid (dexamethasone 8 mg or equivalent steroid), and an H2 antagonist (ranitidine 50 mg or equivalent H2 antagonist) at least 30 minutes prior to each dose of cabazitaxel is recommended. Prophylactic administration of an antiemetic is also recommended and may be given orally or intravenously.

PVC infusion containers or polyurethane infusion sets should not be used for preparation and administration of cabazitaxel.

Cabazitaxel requires 2 dilutions prior to administration. Both the cabazitaxel injection and the diluent vials contain an overfill to ensure that after dilution, the initial diluted solution contains 10 mg/mL of cabazitaxel. The manufacturer's instructions should be consulted and carefully followed in order to complete the first and second (final) dilutions.

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