Abraxane Side Effects
Generic Name: paclitaxel protein-bound
Note: This page contains information about the side effects of paclitaxel protein-bound. Some of the dosage forms included on this document may not apply to the brand name Abraxane.
Common side effects of Abraxane include: infection, severe peripheral sensory neuropathy, neutropenia, bone marrow depression, alopecia, anemia, and peripheral sensory neuropathy. Other side effects include: hypersensitivity reaction. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to paclitaxel protein-bound: intravenous powder for suspension
In addition to its needed effects, some unwanted effects may be caused by paclitaxel protein-bound (the active ingredient contained in Abraxane). In the event that any of these side effects do occur, they may require medical attention.
If any of the following side effects occur while taking paclitaxel protein-bound, check with your doctor or nurse immediately:More common:
- Black, tarry stools
- bloating or swelling of the face, arms, hands, lower legs, or feet
- blurred or double vision
- chest pain
- loss of taste
- lower back or side pain
- painful or difficult urination
- pale skin
- rapid weight gain
- sore mouth, tongue, or throat
- tightness in the chest
- tingling of the hands or feet
- troubled breathing with exertion
- ulcers, sores, or white spots in the mouth
- unusual bleeding or bruising
- unusual weight gain or loss
- unusual tiredness or weakness
- blood in the urine or stools
- burning, tingling, numbness or pain in the hands, arms, feet, or legs
- difficulty with swallowing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, pounding, slow, or irregular heartbeat or pulse
- general feeling of discomfort or illness
- inability to move the arms, legs, or facial muscles
- inability to speak
- pain in the chest, groin, or legs, especially the calves
- pinpoint red spots on the skin
- rapid, shallow breathing
- sensation of pins and needles
- severe, sudden headache
- skin itching, rash, or redness
- slurred or slow speech
- stabbing pain
- sudden loss of coordination
- sudden, severe weakness or numbness in the arms or legs
- sudden, unexplained shortness of breath
- swelling of the face, throat, or tongue
- thickening of bronchial secretions
- trouble thinking or walking
Minor Side Effects
Some of the side effects that can occur with paclitaxel protein-bound may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:More common:
- Cracked lips
- decreased appetite
- difficulty with moving
- lack or loss of strength
- loss of hair
- muscle pain or stiffness
- pain in the joints
- Bleeding, blistering, burning, coldness, discoloration of the skin, a feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- Nail changes
For Healthcare Professionals
Applies to paclitaxel protein-bound: intravenous powder for injection
Dermatologic side effects including alopecia (90%) have been reported. Skin abnormalities including generalized rash, maculopapular rash, erythema, pruritus, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely as part of the continuing surveillance of paclitaxel injection and may occur following therapy with paclitaxel protein-bound (the active ingredient contained in Abraxane) particles. Additionally, there have been case reports of photosensitivity reactions, radiation recall phenomenon, and in some patients previously exposed to capecitabine, reports of palmar-plantar erythrodysesthesia.[Ref]
Hematologic side effects have been reported including neutropenia less than 2.0 x 10(9)/L (80%) and less than 0.5 x 10(9)/L (9%), anemia less than 11 g/L (33%) and less than 8 g/L (1%), and thrombocytopenia less than 100 x 10(9)/L (2%) and less than 50 x 10(9)/L (less than 1%). Febrile neutropenia (2%) and bleeding (2%) have also been reported.[Ref]
Myelosuppression has been dose related and reversible.[Ref]
Nervous system side effects have been reported such as any symptoms of sensory neuropathy (71%) including severe symptoms of sensory neuropathy (10%). Cranial nerve palsies, vocal cord paresis, and autonomic neuropathy resulting in paralytic ileus have been reported during postmarketing surveillance.[Ref]
Sensory neuropathy has been dose related. The frequency and severity of neurologic manifestations were also influenced by prior and/or concomitant therapy with neurotoxic agents.[Ref]
The most frequently reported ECG modifications were nonspecific repolarization abnormalities, sinus bradycardia, and sinus tachycardia.[Ref]
Cardiovascular side effects have been reported such as abnormal ECG (60%) including abnormal ECG in patients with a normal baseline (35%). Hypotension (5%), severe cardiovascular events (3%), and bradycardia (less than 1%) have also been reported. The severe cardiovascular events included chest pain, cardiac arrest, supraventricular tachycardia, edema, thrombosis, pulmonary thromboembolism, pulmonary emboli, and hypertension. Cases of stroke and transient ischemic attacks have been reported rarely. Postmarketing reports have included congestive heart failure, left ventricular dysfunction and atrioventricular block.[Ref]
General side effects have been reported such as any symptoms of asthenia (47%) including severe asthenia (8%) and fluid retention/edema (10%). Pyrexia and dehydration have also been reported.[Ref]
Symptoms of myalgia/arthralgia were usually transient, occurred two or three days after the administration of paclitaxel protein-bound (the active ingredient contained in Abraxane) particles, and resolved within a few days.[Ref]
Musculoskeletal side effects have been reported such as any symptoms of myalgia/arthralgia (44%) including severe symptoms of myalgia/arthralgia (8%).[Ref]
Hepatic side effects including AST (SGOT) elevations (39%), alkaline phosphatase elevations (36%), and bilirubin elevations (7%) have been reported. Grade 3 or 4 elevations in gamma-glutamyl transpeptidase (GGT) were reported in 14% of patients.
Hepatic necrosis and hepatic encephalopathy leading to death have been reported rarely as part of the continuing surveillance of paclitaxel injection and may occur following therapy with paclitaxel protein-bound (the active ingredient contained in Abraxane) particles.[Ref]
Gastrointestinal side effects have been reported such as any symptoms of nausea (30%) including severe nausea (3%), any diarrhea (26%) including severe diarrhea (less than 1%), any vomiting (18%) including severe vomiting (4%), and any mucositis (7%) including severe mucositis (less than 1%). Oral candidiasis has also been reported.
Intestinal obstruction, intestinal perforation, pancreatitis, ischemic colitis, and neutropenic enterocolitis have been reported rarely as part of the continuing surveillance of paclitaxel injection and may occur following therapy with paclitaxel protein-bound (the active ingredient contained in Abraxane) particles.[Ref]
Other side effects including infections (24%), sepsis, and neutropenic sepsis have been reported. Nail changes (changes in pigmentation or discoloration of the nail bed) were uncommon.[Ref]
Respiratory side effects including dyspnea (12%), cough (6%), respiratory tract infections, and pneumonia have been reported. Pneumothorax has been reported rarely.
Postmarketing reports have included pneumonitis, interstitial pneumonia, pulmonary embolism and radiation pneumonitis.
Lung fibrosis has been reported as part of the continuing surveillance of paclitaxel injection and may occur following therapy with paclitaxel protein-bound (the active ingredient contained in Abraxane) [Ref]
The use of paclitaxel protein-bound (the active ingredient contained in Abraxane) particles in patients previously exhibiting hypersensitivity to paclitaxel injection or human albumin has not been studied. Patients who experience a severe hypersensitivity reaction to paclitaxel protein-bound particles should not be rechallenged with the drug.[Ref]
Hypersensitivity side effects including hypersensitivity reactions (4%) which consisted of dyspnea, flushing, hypotension, chest pain, and arrhythmia have been reported.
During postmarketing surveillance, rare occurrences of severe hypersensitivity reactions have been reported with paclitaxel protein-bound particles.[Ref]
Local side effects have included mild injection site reactions (1%). The recurrence of skin reactions at a site of previous extravasation following administration of paclitaxel injection at a different site (recall) has been reported rarely.
Phlebitis, cellulitis, induration, skin exfoliation, necrosis, and fibrosis have been reported rarely as part of the continuing surveillance of paclitaxel injection.[Ref]
Because of the possibility of extravasation, close monitoring of the infusion site for possible infiltration during drug administration is recommended.[Ref]
Ocular side effects have been reported such as ocular/visual disturbances (13%) including severe ocular/visual disturbances (1%). The severe cases (keratitis and blurred vision) were reported in patients who received higher doses in a single arm study than the doses currently recommended.
Conjunctivitis, increased lacrimation and cystoid macular edema have been reported as part of the continuing surveillance of paclitaxel injection and may occur following therapy with paclitaxel protein-bound (the active ingredient contained in Abraxane) particles.[Ref]
Renal side effects have been reported such as elevated creatinine levels (11%) including severely elevated creatinine levels (1%).[Ref]
1. "Product Information. Abraxane (paclitaxel protein-bound)." American Pharmaceutical Partners, Schaumberg, IL.
Not all side effects for Abraxane may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
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