Paclitaxel (Taxol)

Paclitaxel is a chemotherapy drug. It is also known by its brand name, Taxol. 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 various types of cancer, including

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

Sometimes it is combined with other anti cancer drugs.

One type of paclitaxel is combined with albumin to form a drug called Abraxane. This tends to cause fewer side effects than other types of paclitaxel.

You usually have paclitaxel as an injection into a vein. It can cause an allergic reaction. To try to prevent this, you have a cortico steroid injection, and anti histamine (chlorpheniramine) into a vein about an hour before your treatment. You may also have a drug called ranitidine to prevent heartburn. Abraxane does not usually cause an allergic reaction so you don't need the anti allergy drugs with abraxane.

You can have paclitaxel through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

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. Where there is no link, click on 'search' at the top of the page or go to our cancer drugs side effects section.

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)

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 during and after treatment – 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 or nurse if you are still having sickness – they can give you 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 or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons – this starts within a few days or weeks and usually goes within a few months of finishing treatment
• 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 that 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
• Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• 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 having a baby is important to you
• 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

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 give 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 them.

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.

You should not have immunisations with live vaccines while you are having this treatment 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.

It is 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 not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.