Paclitaxel Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Ovarian Cancer

For previously untreated patients with cancer of the ovary:
175 mg/m2 intravenously over 3 hours every 3 weeks followed by cisplatin or
135 mg/m2 intravenously over 24 hours every 3 weeks followed by cisplatin

For patients previously treated for cancer of the ovary:
175 mg/m2 intravenously over 3 hours every 3 weeks or
135 mg/m2 intravenously over 3 hours every 3 weeks

Usual Adult Dose for Kaposi's Sarcoma

For patients with AIDS-Related Kaposi's Sarcoma:
135 mg/m2 intravenously over 3 hours every 3 weeks or
100 mg/m2 intravenously over 3 hours every 2 weeks

Note: In patients with advanced HIV disease:
1) reduce the dose of dexamethasone as one of the three premedication drugs to 10 mg (instead of 20 mg orally)
2) Initiate or repeat treatment with paclitaxel only if the neutrophil count is at least 1000 cells/mm3
3) Reduce the dose of subsequent courses of paclitaxel by 20% for patients who experience severe neutropenia (a neutrophi count <500 cells/mm3 for a week or longer)
4) Initiate concomitant hematopoietic growth factor (G-CSF) as clinically indicated.

Usual Adult Dose for Breast Cancer - Adjuvant

For adjuvant treatment of node-positive:
175 mg/m2 intravenously over 3 hours every 3 weeks for four courses administered sequentially to doxorubicin-containing chemotherapy.

Usual Adult Dose for Breast Cancer

After failure of initial chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy:
175 mg/m2 intravenously over 3 hours every 3 weeks

Usual Adult Dose for Non-Small Cell Lung Cancer

135 mg/m2 intravenously over 24 hours followed by cisplatin every 3 weeks

Usual Pediatric Dose for Wilms' Tumor

Recurrent Wilms' tumor: 250-350 mg/m2/dose over 24 hours every 3 weeks

Liver Dose Adjustments

Bilirubin <= 1.5: < 135 mg/m² IV.
Bilirubin 1.6-3: <=75 mg/m² IV.
Bilirubin >=3.1: 50 mg/m² IV.

Dose Adjustments

Patients who experience severe neutropenia (< 500 cells/mm³ for a week or longer), or severe peripheral neuropathy during therapy should have the dose reduced by 20% for subsequent courses of therapy.

Precautions

Therapy should not be administered to patients with baseline neutrophil counts < 1,500 cells/mm³. Courses of therapy should not be repeated until the neutrophil count is at least 1,500 cells/mm³ and platelet count is at least 100,000 cells/mm³. Paclitaxel should be immediately discontinued in patients developing severe reactions including hypotension requiring treatment, dyspnea requiring bronchodilators, angioedema or generalized urticaria. Patients developing severe hypersensitivity reactions should not be rechallanged.

Other Comments

Peripheral blood cell counts should be performed on all patients. All patients should be premedicated to prevent severe hypersensitivity. Dexamethasone 20 mg orally at 12 and 6 hours, or 20 mg IV at 45 minutes, prior to paclitaxel, diphenhydramine 50 mg IV at 30-60 minutes prior to paclitaxel, cimetidine 300 mg IV, or ranitidine 50 mg IV at 30-60 minutes prior to paclitaxel. Frequent vital sign monitoring, particularly during the first hour of infusion is recommended.

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