Paclitaxel, Injection

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KEY POINTS

• This medicine is used to treat breast cancer, ovarian cancer, Kaposi's sarcoma, or non-small cell lung cancer.
• This medicine needs to be given on a regular schedule. Keep all appointments.
• You may get infections more easily while taking this medicine.
• Along with its needed effects, your medicine may cause some unwanted side effects. Tell your healthcare provider if you have any side effects that continue or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: paclitaxel, injection

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to treat:

• Advanced cancer of the ovaries
• AIDS-related Kaposi's sarcoma
• Breast cancer
• Non-small cell lung cancer

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or castor oil
• A bone marrow disorder or low blood cell counts
• Heart problems
• Liver disease
• Peripheral neuropathy (numbness, tingling, pain, or burning feelings in your feet or hands)
• Radiation therapy

Tell your healthcare provider if you have recently had an infection or been exposed to chickenpox or shingles (herpes zoster).

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

Men receiving this medicine should also use an effective birth control method during treatment with this medicine. Talk with your healthcare provider about this.

How do I use it?

Only healthcare providers experienced with this drug should prescribe it. It should only be given in a clinic or hospital where you can be monitored closely. These infusions are given by your healthcare provider.

Other medicines (by mouth and by injection) are given before this medicine to help prevent allergic reactions and stomach problems. Follow your healthcare provider's directions exactly for any medicines you may have to take by mouth. Take only the medicines approved by your healthcare provider.

What should I watch out for?

You need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

You may get infections more easily. Contact your healthcare provider right away if you have any signs of infection such as fever, chills, or sore throat. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

You may bleed more easily when taking this medicine. Be careful when shaving or brushing your teeth. This medicine needs to be given on a regular schedule. Be sure to keep all your appointments for your treatment.

Tell your healthcare provider if you have any numbness, tingling, or burning in the hands and feet while receiving this medicine. Your healthcare provider may interrupt treatment and restart at a lower dose after symptoms improve.

This medicine may cause mouth sores. Use a soft bristle brush or mouth swab to brush your teeth.

You may bleed more easily when taking this medicine. Be careful when shaving.

You may need to drink more water while receiving this medicine. Talk with your healthcare provider about this.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may increase the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

Hair loss is common during this treatment. Your hair will grow back after the treatments are stopped.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe tingling or burning in your hands or feet; black, tarry bowel movements; blood in urine or bowel movements; pinpoint red spots on skin; unusual bruising or bleeding; slow or irregular heartbeat; severe dizziness or fainting; chest pain; fever; flushing; chills; cough; shortness of breath; lower back or side pain; sore throat; painful mouth sores that keep you from drinking liquids; severe nausea or vomiting; severe diarrhea or stomach pain; yellowing of your skin or eyes; dark urine; trouble urinating; numbness, pain, or weakness in arms or legs; unexplained swelling; unusual tiredness or weakness; vision changes; seizures; injection site pain, redness, or swelling.

Other: Hair loss, decreased appetite, muscle or joint pain, nausea, vomiting, diarrhea, rash, itchy skin, headache, depression, tiredness, weakness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), and tamsulosin (Flomax)
• Antianxiety medicines such as alprazolam (Xanax), buspirone, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antidepressants such as duloxetine (Cymbalta), fluoxetine (Prozac), and nefazodone
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), olanzapine (Zyprexa), and thioridazine
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Antiviral medicines such as ombitasvir/paritaprevir/ritonavir (Technivie) and ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira)
• Arthritis medicines such as leflunomide (Arava) and tofacitinib (Xeljanz)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bosentan (Tracleer)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Celecoxib (Celebrex)
• Cholesterol-lowering medicines such as atorvastatin (Lipitor), gemfibrozil (Lopid), lovastatin (Altoprev), and simvastatin (Zocor)
• Cimetidine (Tagamet)
• Conivaptan (Vaprisol)
• Diabetes medicines such as pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• Echinacea
• Fingolimod (Gilenya)
• Heart or blood pressure medicines such as amiloride, amiodarone (Cordarone, Pacerone), benazepril (Lotensin), captopril, chlorthalidone, digoxin (Lanoxin), dronedarone (Multaq), hydrochlorothiazide (Microzide), irbesartan (Avapro), losartan (Cozaar), quinidine, ramipril (Altace), and valsartan (Diovan)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Lumacaftor/ivacaftor (Orkambi)
• Medicines to treat or prevent blood clots such as clopidogrel (Plavix), dipyridamole (Persantine), and warfarin (Coumadin)
• Mifepristone (Korlym, Mifeprex)
• Natalizumab (Tysabri)
• Natural remedies such as black cohosh, dong quai, gotu kola, kava, St. John's wort, and valerian
• Other cancer medicines such as abiraterone (Zytiga), carboplatin, ceritinib (Zykadia), cisplatin, doxorubicin (Doxil), enzalutamide (Xtandi), idelalisib (Zydelig), imatinib (Gleevec), mitotane (Lysodren), and sorafenib (Nexavar)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Vaccines

Ask your healthcare provider or pharmacist if you need to avoid products that contain grapefruit, Seville oranges, and tangelos while you are taking this medicine. These fruits and juices can affect the way this medicine works and may increase your risk of serious side effects.

Do not drink alcohol while you are receiving this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.