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Paclitaxel and docetaxel
Thursday, July 21, 2011 Posted by Piscean


Paclitaxel and docetaxel
Antineoplastic drugs are used to treat metastatic ovarian and breast cancer after chemotherapy has failed. They include:
  • paclitaxel
  • docetaxel.
Pharmacokinetics
After I.V. administration, paclitaxel is highly bound to plasma proteins. Docetaxel is administered I.V. with a rapid onset of action.
Metabolism and excretion
Paclitaxel is metabolized primarily in the liver with a small amount excreted unchanged in urine. Docetaxel is excreted primarily in stool.
Pharmacodynamics
Paclitaxel and docetaxel exert their chemotherapeutic effect by disrupting the microtubule network essential for mitosis and other vital cellular functions.
Pharmacotherapeutics
Paclitaxel is used when first-line or subsequent chemotherapy has failed in treating metastatic ovarian cancer as well as metastatic breast cancer.

Head, neck, and below
The taxanes may also be used for treating head and neck cancer, prostate cancer, and non’small-cell lung cancer
Drug interactions
Taxanes may interact with other drugs.
  • Concomitant use of paclitaxel and cisplatin may cause additive myelosuppressive effects.
  • Cyclosporine, ketoconazole, erythromycin, and troleandomycin may modify the metabolism of docetaxel.

  • Phenytoin may decrease paclitaxel serum level, leading to a loss of efficacy.
  • Quinupristin/dalfopristin may increase paclitaxel serum levels, increasing the risk of toxicity.

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