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Docetaxel should be administered under supervision of a physician experienced in the use of cancer chemotherapeutic agents. Since significant hypersensitivity reactions may occur, appropriate management of complications is possible only when adequate diagnostic and treatment facilities are readily available. During the infusion, it is recommended that vital functions should be closely monitored.
In order to reduce fluid retention all the patients should be premedicated with oral corticosteroids like Dexamethasone 16 mg per day for 4-5 days beginning 1 day prior to Docetaxel administration.
Patient should be treated with Docetaxel only when baseline neutrophil count is > 1500/mm3. Frequent monitoring of complete blood count should be performed regularly during Docetaxel therapy. The subsequent dose of docetaxel should be
reduced in case of Grade IV neutropenia (neutrophil Count < 500/mm3) lasting for 7 days or more.
Hypersensitivity reactions (HSR) may occur within a few minutes following the initiation of the infusion of Docetaxel. Minor HSR may manifest as mild flushing or localized skin reactions however, interruption of therapy is not required in such cases. Severe HSRs such as hypotension or bronchospasm or generalized rashes require immediate cessation of infusion and aggressive symptomatic therapy. Patients who have developed severe HSRs should not be rechallenged with Docetaxel.
Peripheral neuropathy may be observed in a few patients during Docetaxel therapy. Subsequent dose reductions is suggested in case of peripheral neuropathy.
Safety of Docetaxel has not been established in children; hence, a cautious use is suggested utilizing risk vs. benefit ratio.
Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated with Docetaxel. There is a higher risk of developing severe adverse reactions such as toxic deaths including sepsis and gastrointestinal haemorrhage which can be fetal, febrile neutropenia, infections, thrombocytopenia, stomatitis and asthenia.
Skin reactions such as localized skin erythema of the extremities (palm of the hand and sole of the feet) with oedema followed by desquamation have been reported with Docetaxel therapy. This type of toxicity can lead to interruption or discontinuation of therapy.
Effects on Ability to Drive and Use Machines: No studies of the effects on the ability to drive and use machines have been performed. The amount of alcohol in this medicinal product may impair the patients ability to drive or use machines.
