Paclitaxel Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 25, 2025.

Applies to paclitaxel: intravenous solution.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have a cough; dizziness; wheezing; trouble with breathing; chest or throat tightness; swelling in your face or hands; fever; chills; rash; itching or hives; skin redness; or lightheadedness or faintness while you are receiving this medicine.

While you are being treated with paclitaxel, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Paclitaxel may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Paclitaxel can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause peripheral neuropathy. Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet while using this medicine.

Cancer medicines can cause diarrhea, nausea, or vomiting in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these unwanted effects if you still have nausea or vomiting after receiving the medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of paclitaxel

Along with its needed effects, paclitaxel may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking paclitaxel:

Other side effects of paclitaxel

Some side effects of paclitaxel may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to paclitaxel: intravenous solution.

Cardiovascular adverse events

• Very common (10% or more): Hypotension
• Common (1% to 10%): Bradycardia
• Uncommon (0.1% to 1%): Cardiomyopathy, asymptomatic ventricular tachycardia, tachycardia with bigeminy, atrioventricular block and syncope, myocardial infarction, hypertension, thrombosis, thrombophlebitis
• Rare (0.01% to 0.1%): Cardiac failure
• Very rare (less than 0.01%): Atrial fibrillation, supraventricular tachycardia, shock
• Frequency not reported: Phlebitis^[Ref]

Dermatologic

• Very common (10% or more): Alopecia (90%), rash
• Common (1% to 10%): Transient and mild nail and skin changes, discoloration of the nail bed
• Rare (0.01% to 0.1%): Pruritus, rash, erythema
• Very rare (less than 0.01%): Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), erythema multiforme, exfoliative dermatitis, urticaria, onycholysis (patients on therapy should wear sun protection on hands and feet), scleroderma-like reaction^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (52%), mucositis (31%), vomiting, diarrhea mucosal inflammation
• Rare (less than 0.1%): Peritonitis, bowel obstruction, bowel perforation, ischemic colitis, pancreatitis
• Very rare (less than 0.01%): Pseudomembranous colitis, mesenteric thrombosis, neutropenic colitis, esophagitis, constipation, ascites^[Ref]

Hematologic

• Very common (10% or more): Myelosuppression, neutropenia (90%), anemia, thrombocytopenia, leucopenia, bleeding
• Rare (less than 0.1%): Febrile neutropenia^[Ref]

Hepatic

• Very common (10% or more): Elevated alkaline phosphatase (22%), elevated AST (SGOT) (19%)
• Common (1% to 10%): Elevated bilirubin
• Very rare (less than 0.01%): Hepatic necrosis, hepatic encephalopathy (both with reported cases of fatal outcome)^[Ref]

Hypersensitivity

• Very common (10% or more): Minor hypersensitivity reactions (mainly flushing and rash)
• Uncommon (0.1% to 1%): Significant hypersensitivity reactions requiring therapy (e.g., hypotension, angioneurotic edema, respiratory distress, generalized urticaria, chills, back pain, chest pain, tachycardia, abdominal pain, pain in extremity, diaphoresis, hypertension)
• Rare (less than 0.1%): Anaphylactic reactions
• Very rare (less than 0.01%): Anaphylactic shock^[Ref]

Immunologic

• Very common (10% or more): Infections (mainly urinary tract and upper respiratory tract infections), with reported cases of fatal outcome
• Uncommon (0.1% to 1%): Septic shock
• Rare (less than 0.1%): Sepsis, pseudomembranous colitis^[Ref]

Local

• Common (1% to 10%): Injection site reactions (including localized edema, pain, erythema, induration, on occasion extravasation can result in cellulitis, skin fibrosis and skin necrosis)
• Rare (less than 0.1%): Phlebitis^[Ref]

Musculoskeletal

• Very common (10% or more): Arthralgia/myalgia (44%)
• Frequency not reported: Systemic lupus erythematosus, scleroderma^[Ref]

Metabolic

• Common (1% to 10%): Severe elevation in aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase (SGOT)), severe elevation in alkaline phosphatase
• Uncommon (0.1% to 1%): Severe elevation in bilirubin
• Rare (0.01% to 0.1%): Dehydration, increased blood creatinine
• Very rare (less than 0.01%): Anorexia
• Frequency not reported: Tumor lysis syndrome^[Ref]

Nervous system

• Very common (10% or more): Neurotoxicity (mainly peripheral neuropathy)
• Rare (0.01% to 0.1%): Motor neuropathy (with resultant minor distal weakness)
• Very rare (less than 0.01%): Autonomic neuropathy (resulting in paralytic ileus and orthostatic hypotension), optic nerve disturbance, grand mal seizures, convulsions, encephalopathy, dizziness, headache, ataxia^[Ref]

Ocular

• Very rare (less than 0.01%): Optic nerve and/or visual disturbances (scintillating scotomata), particularly in patients who have received higher doses than recommended
• Frequency not reported: Macular edema, photopsia, vitreous floaters^[Ref]

Oncologic

• Very rare (less than 0.01%): Acute myeloid leukemia, myelodysplastic syndrome^[Ref]

Other

• Rare (0.01% to 0.1%): Asthenia, pyrexia, edema, malaise
• Very rare (less than 0.01%): Ototoxicity, hearing loss, tinnitus, vertigo^[Ref]

Psychiatric

• Very rare (less than 0.01%): Confusional state^[Ref]

Respiratory

• Rare (0.01% to 0.1%): Pneumonia, dyspnea, pleural effusion, interstitial pneumonia, lung fibrosis, pulmonary embolism, respiratory failure
• Frequency not reported: Bronchospasm
• Very rare (less than 0.01%): Cough^[Ref]

See also:

Frequently asked questions

• Why give Taxol (Paxel) before carboplatin?
• What is Paxel called in the USA?

Further information

Paclitaxel side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer