Paclitaxel (Taxol)

• What paclitaxel is
• How you have treatment
• Common side effects
• Occasional side effects
• Important points to remember
• Immunisations and chemotherapy

Paclitaxel is a chemotherapy drug. It is also known by its brand names, Taxol and Abraxane. The drug comes from the bark of one particular type of yew tree. It works by stopping cancer cells separating into two new cells, so it blocks the growth of the cancer. It is a treatment for

• Ovarian cancer
• Breast cancer
• Non small cell lung cancer.

You may have it combined with other anti-cancer drugs.

You usually have paclitaxel as an injection into a vein. It can cause an allergic reaction. To try to prevent this, you may have a steroid injection into a vein about an hour before your treatment.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for paclitaxel depends on which cancer you are having it for. There is more about how doctors plan chemotherapy in CancerHelp UK.

Paclitaxel side effects are listed below. You can use the links to find out more about each side effect or click on 'search' at the top of the page.

With this drug, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells - it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) - you may need a blood transfusion
• Bruising more easily due to a drop in platelets - you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

These effects on your bone marrow can begin about 7 days after each treatment and usually go back to normal after about 21 to 28 days. Some of these side effects can be life threatening, particularly infections.  You should contact your doctor if you have any of these side effects.  Your doctor will check your blood counts regularly to see how well your bone marrow is working

Other common side effects include

• Fatigue may be the most disruptive side effect of all - it often carries on after treatment has ended but most people find their energy levels are back to normal from 6 months to a year after their treatment finishes
• Feeling or being sick is generally very well controlled with anti-sickness injections and tablets, so tell your doctor if you are still having sickness - you can try other anti-sickness medicines
• Hair loss (alopecia) may be complete and includes all body hair but is only temporary and your hair will grow back after your treatment ends - a cold cap may help to stop you losing your hair, but is not suitable for all types of cancer, so talk to your doctor about whether it may help you
• Numbness and tingling in the hands and feet (peripheral neuropathy).
• Aching joints (arthralgia) and muscles (myalgia) affects about 6 out of 10 people (60%) - it may start a couple of days after treatment and last for about 5 days
• Mouth sores and ulcers
• Diarrhoea - drink plenty of fluids and if this becomes severe or lasts more than a couple of days, tell your doctor as you could get dehydrated
• This drug may harm a baby developing in the womb so it is not advisable to become pregnant or father a child when having paclitaxel - talk to your doctor about contraception before you start treatment if there is any chance you or your partner could become pregnant
• Mild allergic reactions occur in about 1 in 5 people (20%) - this usually shows as a rash or a red face
• You should not breast feed while having this drug as it may come through in the breast milk

Some people have the following side effects

• An immediate severe allergic reaction (doctors usually give steroids and other medicines routinely to try to stop this happening)
• Low blood pressure
• Slowing down of the heart rate (bradycardia)
• Abdominal pain
• Temporary taste alterations
• Headaches
• Liver changes that are very mild and you are unlikely to notice any symptoms - the liver will almost certainly go back to normal when treatment is finished, but your doctor will check your liver with blood tests
• While you are having the chemotherapy, paclitaxel may leak from the drip or injection site and damage the body tissues in that area. It is important to tell the nurse or doctor if you have any stinging or burning around the site, leaking fluid, redness or swelling around the site after treatment ends
• Loss of fertility - you may not be able to get pregnant or father a child after treatment with this drug so it is important to talk to your doctor before starting treatment if you are concerned
• Women may stop having periods (amenorrhoea) but this may only be temporary

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Some side effects are inconvenient or upsetting but not damaging to your health.

Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - some drugs can react together.

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them.

Your chemotherapy nurse, clinic or ward nurse will have given you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call.

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.