Cabazitaxel Dosage
Medically reviewed by Drugs.com. Last updated on Jan 15, 2025.
Applies to the following strengths: 60 mg/1.5 mL
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Prostate Cancer
20 mg/m2 IV over one-hour every three weeks
- Some patients may received a dose of 25 mg/m2 every three weeks
Comments:
- In selected patients, the dose may be increased to 25 mg/m2; primary prophylaxis with G-CSF is recommended in these patients.
- Use in combination with oral prednisone 10 mg once a day.
- Dose is based on calculation of the Body Surface Area (BSA).
- Give premedication regimen at least 30 minutes prior to each administration, including antiemetics prophylaxis as needed.
- Ensure adequate hydration throughout treatment.
Use: In combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer previously treated with a docetaxel-containing treatment regimen
Renal Dose Adjustments
CrCl 15 mL/min to less than 90 mL/min not requiring hemodialysis: No adjustment necessary
End stage renal dysfunction (CrCl less than 15 mL/min): Use with caution and monitor carefully during treatment.
Liver Dose Adjustments
Mild hepatic dysfunction (total bilirubin greater than 1 to 1.5 times upper limit of normal [x ULN] or AST greater than 1.5 x ULN): Maximum dose 20 mg/m2
Moderate hepatic dysfunction (total bilirubin greater than 1.5 to 3 x ULN and any AST): Maximum tolerated dose 15 mg/m2; however, efficacy of this dose is unknown
Severe hepatic dysfunction (total bilirubin greater than 3 x ULN): Contraindicated
Dose Adjustments
Dose modifications:
- Patients at a 20 mg/m2 dose who require dose reduction should decrease dosage to 15 mg/m2
- Patients at a 25 mg/m2 dose who require dose reduction should decrease dosage to 20 mg/m2
- One additional dose reduction to 15 mg/m2 may be considered
Adjust dosage for the following adverse events:
- Prolonged (more than 1 week) Grade 3 or higher neutropenia despite appropriate medication including G-CSF: Delay treatment until neutrophil count is greater than 1,500 cells/mm3, then reduce dose by one dose level. Use G-CSF for secondary prophylaxis.
- Febrile neutropenia or neutropenic infection: Delay treatment until improvement or resolution, and neutrophil count is greater than 1,500 cells/mm3, then reduce dose by one dose level.
- Grade 3 or higher, or persisting diarrhea despite appropriate medication, fluid, and electrolytes replacement: Delay treatment until improvement or resolution, then reduce dose by one dose level.
- Grade 2 peripheral neuropathy: Delay treatment until improvement or resolution, then reduce dose by one dose level.
- Grade 3 or higher peripheral neuropathy: Discontinue treatment.
Adjust dosage for use with strong CYP450 3A inhibitors:
- Avoid the coadministration of strong inhibitors of CYP450 3A drugs.
- If concomitant use of strong inhibitors of CYP450 3A drugs is inevitable, consider a cabazitaxel 25% dose reduction.
Precautions
US BOXED WARNINGS:
NEUTROPENIA:
- Neutropenic deaths have been reported.
- Monitor for neutropenia with frequent blood cell counts.
- Do not give this drug to patients with neutrophil counts of 1500 cells/mm3 or less.
- Primary prophylaxis with G-CSF is recommended in patients with high-risk clinical features.
- Consider primary prophylaxis with G-CSF in all patients receiving a dose of 25 mg/m2.
HYPERSENSITIVITY:
- Severe hypersensitivity reactions can occur and may include generalized rash/erythema, hypotension and bronchospasm.
- Severe hypersensitivity reactions require immediate discontinuation of the infusion and administration of appropriate therapy.
- Patients should receive premedication.
- Do not give this drug to patients who have a history of severe hypersensitivity reactions to this drug or to other drugs formulated with polysorbate 80.
CONTRAINDICATIONS:
- Neutrophil counts of 1500/mm3 or less
- History of severe hypersensitivity reactions to this drug or to other drugs formulated with polysorbate 80
- Severe hepatic impairment (total bilirubin greater than 3 times ULN)
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Administer this drug as a one-hour IV infusion.
- This drug requires two dilutions prior to administration.
- Do not use PVC infusion containers for preparation or infusion.
- Do not use polyurethane infusion sets for administration.
- Use an in-line 0.22 micrometer filter during administration.
Storage requirements:
- Unopened: Store at room temperature; do not refrigerate
- Reconstituted solutions: Use within 8 hours at room temperature OR 24 hours under refrigeration; includes the 1-hour infusion time
Reconstitution/preparation techniques: The manufacturer product information should be consulted.
IV compatibility: Do not mix with other medications.
General:
- Administer under the supervision of a physician experienced in the use of antineoplastics.
- Facilities and equipment for the treatment of serious hypersensitivity reactions, like hypotension and bronchospasm, must be available.
Monitoring:
- Hematologic: Neutropenia with frequent blood cell counts
- Genitourinary: Monitor of cystitis
- Pulmonary: Monitor for new or worsening pulmonary symptoms
Patient advice:
- Educate patients about risk of hypersensitivity and to immediately report signs of hypersensitivity reactions.
- Explain the importance of routine blood cell counts.
- Have patients monitor their temperature frequently and immediately report fever.
- Explain the importance of taking corticosteroids as instructed.
- Inform patients of infection, dehydration, and renal failure risk; instruct patients to immediately report fever, significant vomiting or diarrhea, decreased urinary output, and hematuria.
More about cabazitaxel
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