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Paclitaxel Disease Interactions

There are 5 disease interactions with paclitaxel:

Major

Antineoplastics (Includes Paclitaxel) ↔ Infections

Severe Potential Hazard, High plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
View all 31 references
Major

Paclitaxel (Includes Paclitaxel) ↔ Conduction Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: Arrhythmias

Severe conduction abnormalities, some requiring pacemaker placement, have been reported during paclitaxel therapy. Therapy with paclitaxel should be administered cautiously in patients with or predisposed to conduction disorders. Clinical monitoring of cardiac function is recommended during subsequent paclitaxel therapy.

References

  1. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  2. Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC "Clinical toxicities encountered with paclitaxel (Taxol)." Semin Oncol 20(4 Suppl) (1993): 1-15
Major

Paclitaxel (Includes Paclitaxel) ↔ Hepatic Dysfunction

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Paclitaxel is extensively metabolized by the liver. Patients with moderate to severe hepatic impairment may be at increased risk for hepatotoxicity. Additionally, myelotoxicity of paclitaxel may be exacerbated in patients with serum total bilirubin >2 times ULN. Therapy with paclitaxel should be administered cautiously and at a reduced dosage in patients with compromised hepatic function.

References

  1. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
Major

Paclitaxel (Includes Paclitaxel) ↔ Myelosuppression

Severe Potential Hazard, High plausibility

Applies to: Bone Marrow Depression/Low Blood Counts, Fever, Bleeding, Neutropenia

Paclitaxel induces dose-dependent myelosuppression, primarily affecting neutrophils. Anemia characterized as a red blood cell count <11 g/dl has been reported in 78% of patients administered paclitaxel. Thrombocytopenia is uncommon and rarely severe. Therapy with paclitaxel should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld when neutrophil counts fall below 1500/mm3 and/or platelet counts fall below 100,000/mm3. Paclitaxel injection should not be used in patients with solid tumors with baseline neutrophil counts less than 1500/mm3 or in patients with AIDS-related Kaposi's sarcoma with baseline neutrophil counts of less than 1000/mm3. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  2. Reed E, Kohn EC, Sarosy G, Christian M, Goldspiel B, Davis P, Jacob J, Maher M "The incidence of severe side effects from dose intense paclitaxel, administered at one institution (Meeting abstract)." Proc Annu Meet Am Assoc Cancer Res 36 (1995): a14291995
  3. Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC "Clinical toxicities encountered with paclitaxel (Taxol)." Semin Oncol 20(4 Suppl) (1993): 1-15
Major

Paclitaxel (Includes Paclitaxel) ↔ Peripheral Neuropathy

Severe Potential Hazard, Moderate plausibility

Applies to: Peripheral Neuropathy

Dose-dependent peripheral neuropathy has been reported in 60% of patients during paclitaxel therapy. Severe peripheral neuropathy is rare and requires a 20% reduction in dosage of paclitaxel. Therapy with paclitaxel should be administered cautiously in patients with or predisposed to peripheral neuropathy.

References

  1. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  2. Rowinsky EK, Eisenhauer EA, Chaudhry V, Arbuck SG, Donehower RC "Clinical toxicities encountered with paclitaxel (Taxol)." Semin Oncol 20(4 Suppl) (1993): 1-15
  3. Liu JM, Chen YM, Chao Y, Liu TW, Chou CM, Chen LT, Yu WL, Whangpeng J "Paclitaxel-induced severe neuropathy in patients with previous radiotherapy to the head and neck region." J Natl Cancer Inst 88 (1996): 1000-2

paclitaxel drug Interactions

There are 356 drug interactions with paclitaxel

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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