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Taxotere
Last reviewed: 23.04.2024
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The drug is based on docetaxel, one of the many antitumour agents, alkaloid Taxotere is a concentrated liquid for intravenous infusions. Often, this drug is used for second-line chemotherapy, with various cancer processes in the body.
Taxotere is released in pharmacies only if there is a prescription from the doctor.
Indications Taxotere
Taxotere can be prescribed in the following situations:
- as an adjuvant treatment for a cancerous process in the mammary gland, involving the nearest lymph nodes in the process. Treatment is supplemented with preparations of Doxorubicin and Cyclophosphamide;
- with a localized cancer process in the mammary gland, with metastasis, in combination with the Doxorubicin preparation and as the initial chemotherapeutic regimen. Possible chemotherapy, both first and second line. A unilateral treatment regimen can be performed in conjunction with capecitabine, if the initial therapy consisted of anthracyclines and alkylating medications and was found to be ineffective;
- as the initial chemotherapeutic regimen for breast cancer tumors with metastases and onco-expression of HER2 in conjunction with the drug Trastuzumab;
- with a localized or metastatic non-small cell lung cancer (in combination with Cisplatin and Carboplatin), as an initial chemotherapeutic regimen or re-treatment in the absence of the effect of a previous scheme involving platinum-based medications;
- with a metastatic cancer process in the ovaries, if the previous form of chemotherapy was found to be ineffective;
- with an inoperable localized squamous cancer process in the head and cervical region, in combination with Cisplatin and 5-fluorouracil, as initial treatment;
- with a metastatic squamous cancer process in the head and cervical region as a second-line chemotherapeutic regimen;
- at a metastatic hormone-dependent malignant process in combination with medications Prednisolone and Prednisone;
- at a metastatic malignant tumor process in the stomach (including the cardiac department), in the form of initial treatment in conjunction with medications Cisplatinum and 5-fluorouracil.
[1]
Release form
Taxotere is a concentrated substance provided for the manufacture of infusion fluid.
Taxotere consists of the active ingredient of docetaxel and an additional ingredient of polysorbate 80. The kit contains a liquid-solvent in the form of 13% of ethyl alcohol diluted with water for injection.
The drug has the form of a colorless oily liquid, the color of which varies, from yellowish to brownish hue. Concentrated medicine is bottled:
- 20 mg / 0.5 ml;
- 80 mg / 2 ml.
Vials are glass, transparent. A rubber stopper with aluminum protection and a plastic lid of green or red color.
One package contains 1 bottle of concentrated medicine and 1 bottle with a dissolving liquid. Cellular packaging sealed with polyethylene. In addition, the package contains an information annotation to the medication.
The name of the analogues of Taxotere
According to the active ingredient docetaxel, the following analogues of the drug Taxotere were selected:
- Vizdok is an infusion drug;
- Dozemeda - concentrated medicine for the preparation of infusion solution;
- Dozet - concentrated medicine;
- Docetax is a concentrated medication for preparing an infusion solution;
- Docetaxel (Ebove, Amaxa, Vista, Pharmstandard-Biolek, Teva, Pharmex);
- Doctetactin is an infusion concentrated preparation;
- Dotserera - concentrated medication;
- Dozet-Health - infusion solution;
- Taxolite is a concentrated medication.
Pharmacodynamics
Taxotere is an antitumor chemotherapeutic agent on a natural basis (taxoid group). The effect of the drug is due to the stimulation of tubulin accumulation in resistant microtubules, as well as to prevent their decomposition, which leads to a decrease in the amount of freely existing tubulin. The connection of the active component and microtubules does not affect the number of protofilaments.
Laboratory tests indicate that Taxotere changes the microtubular network, which is of great importance in the cellular phase of mitosis and interphase.
The drug shows toxicity in relation to various malignant cells. In this case, the Taxotere effect may not depend on the frequency of application of the agent and manifest itself in a vast spectrum of anticancer activity.
Pharmacokinetics
The kinetic properties of Taxotere depend on the amount of the drug administered. The association with plasma proteins is more than 95%.
During the week, active metabolite is excreted with urinary fluid and calves (approximately 6% and 75%, respectively). Most of the drug, which is excreted with the feces, can be detected for 2 days in the form of an inactive product.
With small functional disorders of the liver, the overall clearance is reduced by 27%, compared with the averaged index.
The clearance of the active ingredient of the drug does not change with a small accumulation of fluid in the body.
Dosing and administration
To prevent allergic processes and fluid accumulation in tissues, all patients (excluding patients with prostate adenocarcinoma) undergo premedication with glucocorticosteroids prior to chemotherapy. Example of a premedication scheme:
- Dexamethasone orally in an amount of 8 mg twice a day, for 3 days;
- the initial dose of the drug should be taken one day before the start of chemotherapy.
In prostate adenocarcinoma, prednisolone (or prednisone) is premedicated with Dexamethasone in a dosage of 8 mg for 12 hours, 3 hours and 60 minutes before chemotherapy.
To reduce the risk of complications from the blood, a preventive administration of G-CSF can be prescribed.
Taxotere injected intravenously-drip, for one hour, once every 21 days.
- In the adjuvant treatment of the cancerous process in the mammary gland, the standard dosage of Taxotere can be 75 mg / m² 60 minutes after the administration of Doxorubicin (50 mg / m²) and Cyclophosphamide (500 mg / m²), once every 21 days. Treatment includes 6 injections.
As an independent treatment, Taxotere is administered in an amount of 100 mg / m² once every 21 days. In combination with preparations of Doxorubicin (50 mg / m²) and Capecitabine (1250 mg / m²) Taxotere is administered in an amount of 75 mg / m² once every 21 days.
In combination with the drug Trastuzumab, the amount of Taxotere is 100 mg / m² once every 21 days.
- With a non-small cell lung cancer process, Taxotere is used in an amount of 75 mg / m², both with unilateral therapy and in combination with platinum-based medications, once every 21 days.
- In metastatic ovarian cancer, Taxotere is used in a dosage of 100 mg / m² once every 21 days.
- In a locally localized squamous cell tumor, the head and cervical regions of Taxotere are administered in an amount of 75 mg / m². In one day, with the medication, Cisplatin is administered in an amount of 75 mg / m² for 60 minutes, with further dropping of 5-fluorouracil 750 mg / m² per day for five days. This scheme is applied once in 21 days and can be repeated up to 4 times.
- In the metastatic squamous cell process of the head and cervical region, Taxotere is administered in an amount of 100 mg / m² once every 21 days.
- With a metastatic hormone-independent cancer process in the prostate, Taxotere is administered in an amount of 75 mg / m² once every 21 days. Prednisolone is taken orally 5 mg twice a day for the entire course of chemotherapy.
- When metastatic cancer process in the stomach (including in the cardiac department) Taxotere is administered in an amount of 75 mg / m² once every 21 days. On the same day, Cisplatinum should be administered in a dose of 75 mg / m², for 1 to 3 hours infusion, with further administration of 5-fluorouracil in an amount of 750 mg / m² (daily infusion over 5 days).
The concentrated substance is preliminarily diluted in the dissolving liquid that comes with the preparation.
Before you dilute the drug, it must be brought to room temperature. When stirring, the vial is not shaken, but inverted and held for 45 seconds, then left for 5 minutes until completely dissolved.
Before starting the infusion it is necessary to make sure that the preparation is clean and does not contain turbidity and sediment.
Use Taxotere during pregnancy
The antitumor agent Taxotere is prohibited for prescribing to pregnant and lactating patients.
Before and during treatment, medications should use contraceptives, which are also used 3 months after the end of chemotherapy.
If a woman becomes pregnant during the period of chemotherapy, then she is obliged to immediately notify the attending doctor.
Clinical trials have shown that Taxotere has a genotoxic effect and can even worsen the quality of male sperm. Therefore, both women and men, during the treatment with the drug and within six months after the therapeutic course, it is necessary to take measures to prevent the possible conception of the child. Sometimes, if in the future the couple plans to have children, it is advisable to carry out cryopreservation of the sperm before the chemotherapy begins.
Contraindications
With some diseases and conditions, treatment with Taxotere can be considered impossible:
- at a neutrophil level in the peripheral blood stream of less than 1500 per μL;
- with significant functional disorders of the liver;
- in the period of gestation and breastfeeding of the baby;
- in children and adolescents under 18;
- at a high probability of an allergic reaction with respect to the ingredients of the medicament.
When carrying out combined treatment with the use of additional drugs, it is necessary to take into account also other contraindications, which concern auxiliary drugs.
[15]
Side effects Taxotere
Like all chemotherapy, Taxotere has a large number of side effects:
- marked transient neutropenia, occurring against the background of fever, septic complications and pneumonia;
- thrombocytopenia with a probability of bleeding, anemia;
- allergic manifestations (reddening of the skin, itching, shortness of breath, bronchospasm, rash);
- loss of hair, skin rashes, pigmentation of nail plates, onycholysis;
- swelling of the extremities, accumulation of fluid in the abdominal cavity, generalized edema;
- dyspepsia, changes in taste sensations, inflammation of the mucosa of the esophagus, stomach, intestines;
- ulcers of the digestive tract, bleeding;
- numbness of the limbs, peripheral neuropathy, convulsive syndrome;
- arrhythmias, changes in blood pressure, increased thrombosis, pre-infarction and infarction;
- hepatitis, pneumonia, development of pulmonary fibrosis;
- pain in the joints and muscles, myasthenia gravis;
- conjunctivitis, tearing, transient visual impairment;
- deterioration of the skin, increased pigmentation, pinpoint hemorrhages on the skin, inflammatory lesions of veins;
- pain in the chest, redness of the palms and feet, the phenomenon of dehydration.
Overdose
The phenomenon of overdose is considered unlikely, since such cases are single, since the dosage is calculated individually for each patient.
Signs of the use of an excess dose for the body can be considered:
- oppressed function of hematopoiesis;
- generalized inflammation of mucous tissues;
- peripheral neuropathy.
At the moment, the drug neutralizing the action of Taxotere has not been determined. If a patient is suspected of overdose, they are referred for inpatient treatment with the use of symptomatic drugs and constant monitoring of the basic vital functions of the body. The use of colony-stimulating factors (G-CSF) is shown.
[18],
Interactions with other drugs
According to the studies, it was found that the biological transformation of Taxotere can change with the combined use of drugs that affect the cytochrome system P450-3A (cyclosporins, ketoconazole, oleandomycin, erythromycin). Given this, one should be careful with the simultaneous administration of such medications.
The use of Taxotere and Doxorubicin: Taxotere clearance rates may increase, which does not affect the effectiveness of the drug.
There were no other clinically important drug interactions and Taxotere.
Storage conditions
Taxotere recommended to keep at a temperature range of +2 ° C to + 25 ° C, in a darkened place, out of reach for children. Shelf life is indicated on the medicine package.
[22]
Attention!
To simplify the perception of information, this instruction for use of the drug "Taxotere" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.