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Docivyx
docetaxel
Black Box Warnings .
Mortality
treatment-related mortality incr. w/ abnormal liver function, at higher doses, and in patients w/ NSCLC and prior platinum-based tx if given docetaxel 100 mg/m^2 as monotherapy
Hepatic Impairment
do not use if bilirubin >ULN or AST and/or ALT >1.5x ULN w/ alk phos >2.5x ULN; incr. risk for severe neutropenia, febrile neutropenia, infections, severe thrombocytopenia, severe stomatitis, severe skin toxicity, and toxic death; higher rate of febrile neutropenia w/ isolated AST or ALT >1.5x ULN; monitor bilirubin, AST/ALT, and alk phos prior to each cycle
Neutropenia
do not use if ANC <1500 cells/mm^3; severe neutropenia w/ infection may occur; monitor CBC frequently
Severe Hypersensitivity Rxn
may incl. generalized rash/erythema, hypotension, bronchospasm, very rarely fatal anaphylaxis; reported in patients receiving dexamethasone premed; immediately D/C infusion, admin. appropriate tx if hypersensitivity rxns occur; do not use if severe hypersensitivity rxn history to docetaxel
Severe Fluid Retention
occurs in 6.5% of patients despite dexamethasone premed; may incl. one or more of the following: poorly tolerated peripheral edema, generalized edema, pleural effusion requiring urgent drainage, dyspnea at rest, cardiac tamponade, pronounced abdominal distension due to ascites
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments
breast CA
- [node-positive adjuvant tx]
- Dose: 75 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: give x6 cycles; part of multi-drug chemo regimen
- [locally advanced or metastatic disease, monotherapy]
- Dose: 60-100 mg/m^2/dose IV x1 on day 1 of 21-day cycle
- [metastatic disease, combo w/ capecitabine (off-label)]
- Dose: 75 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: for anthracycline-resistant disease
non-small cell lung CA, locally advanced or metastatic
- [75 mg/m^2/dose IV x1 on day 1 of 21-day cycle]
- Info: use w/ cisplatin for tx-naive patients or as monotherapy for platinum-resistant disease
prostate CA
- [metastatic castration-resistant disease]
- Dose: 75 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: give up to 10 cycles; use w/ prednisone 5 mg PO bid
- [metastatic castration-sensitive disease (off-label)]
- Dose: 75 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Start: w/in 6wk after starting darolutamide; Info: give x6 cycles; use w/ darolutamide; use w/ GnRH analog in patients w/o bilateral orchiectomy
- [metastatic castration-sensitive, high-volume disease (off-label)]
- Dose: 75 mg/m^2/dose IV x1 on day 1 of 21-day cycle; Info: for patients w/ de novo metastatic disease w/ at least 4 bone metastases or any visceral disease; give up to 6 cycles; use w/ abiraterone and steroid; use w/ GnRH analog in patients w/o bilateral orchiectomy
gastric CA, advanced
- [75 mg/m^2/dose IV x1 on day 1 of 21-day cycle]
- Info: part of multi-drug chemo regimen
squamous cell head/neck CA, locally advanced
- [75 mg/m^2/dose IV x1 on day 1 of 21-day cycle]
- Info: give x3-4 cycles; part of multi-drug chemo regimen
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin >ULN: avoid use; AST and/or ALT >1.5x ULN w/ alk phos >2.5x ULN: avoid use
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy 1st trimester
- ANC <1500
- Plt <100,000
- bilirubin elevated
- ALT or AST >1.5x ULN w/ alk phos >2.5x ULN
- avoid: breastfeeding during tx and x1wk after D/C
- caution: hypersensitivity to paclitaxel
- caution: alcohol use, concurrent
- caution: CNS depressant use, concurrent
- caution: pregnancy 2nd trimester
- caution: pregnancy 3rd trimester
- caution: patients of childbearing potential
- caution: male patients of reproductive potential
- caution: elderly patients
- caution: ALT or AST >1.5x ULN
- caution: neutropenia
- caution: tumor burden, high
Drug Interactions .
Overview
docetaxel
taxane
- CYP3A4 substrate
- hyperuricemic effects
- immunosuppressive oncologic agent
- myelosuppressive oncologic agent
- ototoxicity
- peripheral neuropathy
- some formulations of docetaxel contain ethanol
ethanol (in some formulations)
alcohol
- alcohol dehydrogenase pathway substrate
- CNS depression
- hyperuricemic effects
- peripheral neuropathy
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- disulfiram
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- metronidazole
- metronidazole vaginal
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- topiramate
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- acitretin
- adagrasib
- amikacin
- amikacin inhaled
- amphetamine
- atazanavir
- butalbital
- carbidopa
- ceritinib
- chloramphenicol
- cladribine oral
- clarithromycin
- clonidine
- cobicistat
- codeine
- deferiprone
- dexrazoxane
- dextroamphetamine
- diazepam
- diltiazem
- diroximel fumarate
- doxylamine
- ethacrynic acid
- ethanol
- etrasimod
- fexinidazole
- flurazepam
- gabapentin enacarbil
- ganciclovir
- gentamicin
- hydrocodone
- idelalisib
- isocarboxazid
- itraconazole
- kava
- ketoconazole
- kratom
- lemborexant
- levodopa
- levoketoconazole
- lonafarnib
- lopinavir/ritonavir
- lorazepam
- metaxalone
- metoclopramide
- midazolam
- mifepristone
- morphine
- nefazodone
- nelfinavir
- neomycin
- nifurtimox
- oliceridine
- opium
- oxybate
- oxymorphone
- palifermin
- penicillamine
- phenelzine
- pimecrolimus topical
- plazomicin
- posaconazole
- primaquine
- procarbazine
- prochlorperazine
- promethazine
- rabies vaccine
- radium Ra 223 dichloride
- ribociclib
- ritonavir
- ropeginterferon alfa-2b
- secnidazole
- streptomycin
- tacrolimus
- tapentadol
- thalidomide
- tinidazole
- tiopronin
- tipranavir
- tobramycin
- tobramycin inhaled
- tranylcypromine
- triazolam
- tucatinib
- valganciclovir
- venlafaxine
- voriconazole
- zuranolone
Monitor/Modify Tx
- 5-HTP
- albendazole
- aldesleukin
- alemtuzumab
- alfentanil
- allopurinol
- alprazolam
- amantadine
- amiodarone
- amitriptyline
- amlodipine
- amoxapine
- anthrax vaccine
- anti-thymocyte globulin
- apomorphine
- apraclonidine ophthalmic
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- asciminib
- asenapine
- atidarsagene autotemcel
- atorvastatin
- auranofin
- avacopan
- azathioprine
- baclofen
- balsalazide
- baricitinib
- belumosudil
- benznidazole
- berberine
- berotralstat
- betibeglogene autotemcel
- bicalutamide
- brexpiprazole
- brimonidine topical
- brivaracetam
- bumetanide
- buprenorphine
- butorphanol
- cannabidiol
- cannabis
- capivasertib
- carbamazepine
- cariprazine
- carisoprodol
- cenobamate
- chamomile, German
- chikungunya vaccine
- chlophedianol
- chlordiazepoxide
- chlorpromazine
- chlorzoxazone
- cidofovir
- cilostazol
- cimetidine
- ciprofloxacin
- cisplatin
- citalopram
- clobazam
- clofazimine
- clomipramine
- clonazepam
- clorazepate
- clozapine
- colchicine
- conivaptan
- COVID-19 vaccine
- crizotinib
- cyclophosphamide
- cyclosporine
- danazol
- dapsone
- daridorexant
- darifenacin
- darunavir
- deferasirox
- deferoxamine
- desflurane
- desipramine
- desvenlafaxine
- deuruxolitinib
- deutetrabenazine
- dexbrompheniramine
- dexchlorpheniramine
- dexmedetomidine
- dexmedetomidine injection
- dichlorphenamide
- difelikefalin
- difenoxin
- dihydrocodeine
- diosmin
- diphenhydramine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- domperidone
- doxepin
- doxepin topical
- dronabinol
- dronedarone
- droperidol
- duloxetine
- duvelisib
- ebola vaccine, live
- efavirenz
- efbemalenograstim alfa
- eflapegrastim (G-CSF)
- eflornithine
- elivaldogene autotemcel
- entrectinib
- erythromycin
- escitalopram
- esketamine
- eslicarbazepine acetate
- estazolam
- eszopiclone
- ethinyl estradiol (contraceptive)
- ethosuximide
- etomidate
- everolimus
- exagamglogene autotemcel
- febuxostat
- fedratinib
- felbamate
- fenfluramine
- fentanyl
- fesoterodine
- filgrastim (G-CSF)
- finerenone
- flibanserin
- fluconazole
- flucytosine
- fluoxetine
- fluphenazine
- fluvoxamine
- fosamprenavir
- fosaprepitant
- foscarnet
- foslevodopa
- fostamatinib
- furosemide
- gabapentin
- ganaxolone
- gepotidacin
- ginkgo
- givinostat
- givosiran
- glecaprevir
- glofitamab
- glycopyrrolate
- goldenseal
- grazoprevir
- guanfacine
- Haemophilus b vaccine
- haloperidol
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydromorphone
- hydroxychloroquine
- hydroxyurea
- hydroxyzine
- ifosfamide
- iloperidone
- imatinib
- influenza H5N1 vaccine
- influenza vaccine
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- isavuconazonium
- isoflurane
- isoniazid
- istradefylline
- ivacaftor
- Japanese encephalitis vaccine
- ketamine
- lacosamide
- lamotrigine
- lapatinib
- larotrectinib
- lasmiditan
- lazertinib
- lefamulin
- leflunomide
- lenacapavir
- letermovir
- levetiracetam
- levorphanol
- linezolid
- linvoseltamab
- lofexidine
- lomitapide
- lovastatin
- lovotibeglogene autotemcel
- lumateperone
- lurasidone
- lymphocyte immune globulin, anti-thymocyte globulin
- maribavir
- mavorixafor
- melatonin
- meningococcal vaccine
- meperidine
- mercaptopurine
- mesalamine
- mesalamine rectal
- methadone
- methocarbamol
- methohexital
- methotrexate
- methsuximide
- methyldopa
- metyrapone
- mirtazapine
- mitotane
- molindone
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nalbuphine
- naltrexone
- nelarabine
- netupitant
- nicardipine
- nilotinib
- nirogacestat
- olanzapine
- olsalazine
- opicapone
- orphenadrine
- osilodrostat
- oxaliplatin
- oxazepam
- oxcarbazepine
- oxybutynin
- oxycodone
- palbociclib
- paliperidone
- paromomycin
- paroxetine
- passion flower
- pazopanib
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- pegloticase
- pentamidine
- pentazocine
- pentobarbital
- peppermint
- perampanel
- perphenazine
- phenobarbital
- phenytoin
- pibrentasvir
- pimozide
- pirtobrutinib
- pneumococcal vaccine
- poliovirus vaccine
- pramipexole
- pregabalin
- primidone
- probenecid
- proguanil
- propofol
- pyrimethamine
- quazepam
- quercetin
- quetiapine
- ranolazine
- rasagiline
- rasburicase
- remdesivir
- remifentanil
- remimazolam
- repotrectinib
- respiratory syncytial virus vaccine
- resveratrol
- ribavirin
- rifabutin
- rifamycin
- rilzabrutinib
- risperidone
- ritlecitinib
- rituximab
- rizatriptan
- ropinirole
- rucaparib
- rufinamide
- ruxolitinib topical
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- scopolamine
- selegiline transdermal
- selinexor
- selpercatinib
- sertraline
- sevoflurane
- sipuleucel-T
- sirolimus
- smallpox/mpox vaccine, live
- solifenacin
- spironolactone
- stiripentol
- succimer
- sufentanil
- sulfasalazine
- sumatriptan
- suvorexant
- temazepam
- teplizumab
- teprotumumab
- teriflunomide
- thioridazine
- thiotepa
- thiothixene
- tiagabine
- ticagrelor
- tick-borne encephalitis vaccine
- tizanidine
- tocilizumab
- tofacitinib
- tolcapone
- tolterodine
- tolvaptan
- tramadol
- trazodone
- treosulfan
- trihexyphenidyl
- trimethoprim
- trospium
- typhoid vaccine
- upadacitinib
- valbenazine
- valerian
- valproic acid
- vancomycin
- verapamil
- vigabatrin
- vilazodone
- viloxazine
- vonoprazan
- zaleplon
- ziconotide
- zidovudine
- zileuton
- ziprasidone
- zolpidem
- zonisamide
Caution Advised
- abatacept
- abrocitinib
- adalimumab
- ado-trastuzumab emtansine
- almotriptan
- amphotericin
- anakinra
- anifrolumab
- avanafil
- baclofen intrathecal
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- betamethasone
- bimekizumab
- bortezomib
- brentuximab vedotin
- brimonidine ophthalmic
- brodalumab
- bromocriptine
- brompheniramine
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- buspirone
- cabazitaxel
- canakinumab
- carbinoxamine
- carboplatin
- cefotetan
- certolizumab pegol
- cetirizine
- chloroquine
- chlorpheniramine
- ciltacabtagene autoleucel
- clemastine
- clobetasol ophthalmic
- coccidioides immitis skin test antigen
- corticotropin
- cortisone
- crovalimab
- cyclobenzaprine
- cyproheptadine
- danicopan
- dantrolene
- daptomycin
- deflazacort
- delafloxacin
- delgocitinib topical
- deucravacitinib
- dexamethasone
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dimenhydrinate
- dimethyl fumarate
- dinutuximab
- diphenoxylate
- docetaxel
- dupilumab
- eculizumab
- efgartigimod alfa
- eletriptan
- elranatamab
- emapalumab
- enfortumab vedotin
- entacapone
- eribulin
- erlotinib
- etanercept
- ethanol (in some formulations)
- fenoprofen
- fidanacogene elaparvovec
- fingolimod
- fludarabine
- fludrocortisone
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosphenytoin
- frovatriptan
- golimumab
- guselkumab
- hydrocortisone
- hydrocortisone ophthalmic
- hyoscyamine
- imipramine
- inebilizumab
- infliximab
- iptacopan
- isotretinoin
- ixabepilone
- ixazomib
- ixekizumab
- lebrikizumab
- levocetirizine
- levofloxacin
- levomilnacipran
- loteprednol ophthalmic
- loxapine
- meclizine
- meprobamate
- methylprednisolone
- metyrosine
- miglustat
- milnacipran
- mirikizumab
- mirvetuximab soravtansine
- mitoxantrone
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- moxifloxacin
- nadofaragene firadenovec intravesical
- naproxen
- naratriptan
- natalizumab
- naxitamab
- neomycin otic
- nipocalimab
- nortriptyline
- ocrelizumab
- ofatumumab
- ofloxacin
- ozanimod
- paclitaxel
- pegcetacoplan
- pheniramine
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- pozelimab
- prednisolone
- prednisolone ophthalmic
- prednisone
- protriptyline
- pyrilamine
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- ramelteon
- ravulizumab
- rilonacept
- risankizumab
- rotigotine transdermal
- rozanolixizumab
- safinamide
- secukinumab
- selegiline
- siltuximab
- spesolimab
- sutimlimab
- tadalafil
- talquetamab
- tasimelteon
- teclistamab
- telisotuzumab vedotin
- tildrakizumab
- tisagenlecleucel
- tisotumab vedotin
- torsemide
- tralokinumab
- triamcinolone
- trifluoperazine
- trimethobenzamide
- trimipramine
- triprolidine
- tuberculin purified protein derivative
- ustekinumab
- vamorolone
- vedolizumab
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- zilucoplan
- zolmitriptan
Adverse Reactions .
Serious Reactions
- hepatotoxicity
- anemia
- thrombocytopenia
- leukopenia
- neutropenia
- febrile neutropenia
- infection, severe
- sepsis
- enterocolitis
- neutropenic colitis
- GI bleeding
- stomatitis, severe
- hypersensitivity rxn, severe
- anaphylaxis
- skin toxicity, severe
- Stevens-Johnson syndrome
- acute generalized exanthematous pustulosis
- hand-foot syndrome
- toxic epidermal necrolysis
- erythema multiforme
- cutaneous lupus erythematosus
- sensory neuropathy, severe
- pulmonary toxicity
- fluid retention, severe
- CHF
- arrhythmia
- secondary malignancy
- asthenia
- cystoid macular edema
- amenorrhea
- ototoxicity
- tumor lysis syndrome
- myositis
Common Reactions
- neutropenia
- leukopenia
- anemia
- alopecia
- asthenia
- fluid retention
- fatigue
- nausea
- diarrhea
- sensory neuropathy
- infection
- nail changes
- stomatitis
- pharyngitis
- taste changes
- hyperbilirubinemia
- ALT or AST elevated
- vomiting
- anorexia
- dyspnea
- arthralgia
- myalgia
- cough
- lacrimation
- rash
- desquamation
- hypersensitivity rxn
- thrombocytopenia
- constipation
- pain
- amenorrhea
- intoxication symptoms
Safety/Monitoring .
Monitoring Parameters
pregnancy test, Cr at baseline; CBC w/ diff at baseline, then continue frequently during tx; LFTs prior to each cycle; ophthalmic exam if change or loss of vision
Ethanol Content
contains 4 g ethanol per 200 mg dose; avoid or minimize alcohol use, caution advised w/ concomitant CNS depressant use; CNS depression and/or intoxication symptoms may occur
Look/Sound-Alike Drug Names
DOCEtaxel confused with: PACLitaxel; Taxol
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use in 1st trimester, weigh risk/benefit in 2nd and 3rd trimesters w/ alcohol-containing forms; possible risk of fetal harm in 1st trimester based on drug's mechanism of action; risk of fetal harm low in 2nd and 3rd trimesters based on limited human data
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x2mo after D/C in patients of childbearing potential and during tx and x4mo after D/C in male patients
Lactation
Clinical Summary
avoid breastfeeding during tx and x1wk after D/C; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver extensively; CYP450: 3A4 substrate
Excretion: feces 75% (<8% unchanged), urine 6%; Half-life: 116h
Subclass: Mitosis Inhibitors, Antimicrotubule Agents ; Mitosis Inhibitors, Taxanes
Mechanism of Action
promotes formation and inhibits disassembly of stable microtubules, inhibiting mitosis
Formulary .
No Formulary Selected
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