Paclib Dosage/Direction for Use

5 mL & 16.67 mL: Premedication Regimen: Premedicate all patients with oral dexamethasone (20 mg) approximately 12 and 6 hours before paclitaxel administration, IV diphenhydramine or its equivalent (50 mg) 30 to 60 minutes before paclitaxel, and either IV cimetidine (300 mg) or IV ranitidine (50 mg) 30 to 60 minutes before paclitaxel in order to reduce the incidence of hypersensitivity reactions.
Patients with HIV infection may follow the same premedication regimen with the exception of a reduced dose of oral dexamethasone (10 mg).
Paclitaxel Injection must be diluted prior to intravenous infusion. (See Table 1.)

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General Dosing Information: Monitor vital signs regularly, particularly during the first hour of administration. Cardiac monitoring is not required except in patients with preexisting cardiac abnormalities.
Closely monitor the infusion site for possible infiltration during drug administration particularly during longer periods of infusion (e.g., 24 hours). Local reactions may appear 7 to 10 days after completion of paclitaxel infusion.
Dose Adjustments: For patients with solid tumors (ovary, breast, NSCLC): Paclitaxel courses should not be repeated until the patient's neutrophil count is at least 1500 cells/mm³ and platelet count is at least 100,000 cells/mm³.
Reduce dose by 20% for subsequent courses of paclitaxel in patients who experience severe neutropenia (neutrophil <500 cells/mm³ for a week or longer) or severe peripheral neuropathy during paclitaxel therapy.
For AIDS-related Kaposi's Sarcoma: Initiate or repeat treatment only if the neutrophil count is at least 1000 cells/mm³.
Reduce dose by 20% for subsequent courses of paclitaxel in patients who experience severe neutropenia (neutrophil <500 cells/mm³ for a week or longer).
Initiate concomitant hematopoietic growth factor (G-CSF) as clinically needed.
Dosing in Patients with Hepatic Impairment: See Table 2.

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43.4 mL: Primary treatment of ovarian carcinoma: A combination regimen consisting of Paclitaxel (Paclib) 135 mg/m² administered over 24 hours, followed by Cisplatin 75 mg, every 3 weeks. Paclitaxel (Paclib) should be administered before Cisplatin.
Secondary treatment of ovarian carcinoma: Paclitaxel (Paclib) at a dose of 175 mg/m² administered intravenously over 3 hours every 3 weeks has been shown to be effective in patients with metastatic carcinoma of the ovary or breast after the failure of first line or subsequent chemotherapy.
Palliative treatment of advanced non-small cell lung carcinoma: The recommended dose of Paclitaxel (Paclib) is 175 mg/m² administered over a period of 3 hours; followed by a platinum compound, with a 3 week interval between courses.
Paclitaxel (Paclib) should not be re-administered until the neutrophil count is at least 1500/mm³ and the platelet count is at least 100,000/mm³.
Patients who experience severe neutropenia (neutrophil count <500/mm³) or moderate to severe peripheral neuropathy should receive a dose reduction of 20% for subsequent courses. The incidence and severity of neurotoxicity and haematologic toxicity increases with dose. All patients must be premedicated with corticosteroids, antihistamines, and H₂ antagonists prior to Paclitaxel (Paclib) administration, e.g. Dexamethasone 20 mg orally approximately 12 and 6 hours before Paclitaxel (Paclib), promethazine 25 IV 30 to 60 minutes before Paclitaxel (Paclib).
Paclitaxel (Paclib) should be administered through an in-line filter with a microporous membrane not greater than 0.22 micron. Or as prescribed by the physician.