Paclitaxel

Products

Paclitaxel is commercially available as an infusion concentrate (Taxol, generic). It has been approved in many countries since 1993. The active ingredient itself is also known as taxol. Protein-bound nab-paclitaxel (Abraxane) was approved in many countries in 2014.

Structure and properties

Paclitaxel (C₄₇H₅₁NO₁₄, M_r = 853.9 g/mol) is a complex tetracyclic diterpene. It exists as a white crystalline powder that is practically insoluble in water. It is a lipophilic natural product from the Pacific yew tree, which can now be produced by various methods, including semisynthetic production from ingredients of the European yew tree.

Effects

Paclitaxel (ATC L01CD01) has antitumor, cytostatic, and antimitotic properties. The effects are due to disruption of the microtubule network. This inhibits mitosis and cell division.

Indications

In many countries, paclitaxel is approved for the following indications:

• Ovarian cancer
• Non-small cell bronchial carcinoma
• Breast carcinoma

Dosage

According to the professional information. The drug is administered as an intravenous infusion.

Contraindications

• Severe hypersensitivity
• Neutropenia
• Pregnancy and lactation

Full precautions can be found in the drug label.

Interactions

Paclitaxel is metabolized by CYP2C8 and CYP3A4. Corresponding drug-drug interactions with CYP inhibitors have been described.

Adverse effects

The most common potential adverse effects include:

• Hair loss
• Muscle and joint pain
• ECG changes, low blood pressure
• Infectious diseases
• Nausea, vomiting, diarrhea, mucositis.
• Blood count disorders: Neutropenia, anemia, thrombocytopenia (bone marrow toxicity).
• Bleeding
• Mild hypersensitivity reactions
• Peripheral neuropathy, sensory disturbances.