Uses
Breast Cancer
Treatment of locally advanced or metastatic breast cancer after failure of prior chemotherapy.
Non-small Cell Lung Carcinoma
Monotherapy of locally advanced or metastatic non-small cell lung cancer after failure of prior platinum-based chemotherapy.
In combination with cisplatin for treatment of unresectable locally advanced or metastatic non-small cell lung cancer in patients who have not previously received chemotherapy for this condition; also used in combination with carboplatin.
Dosage and Administration
General
- All patients should be premedicated before docetaxel administration to prevent severe hypersensitivity reactions and to reduce the incidence and severity of fluid retention.
- Oral dexamethasone 8 mg twice daily for 3 days, starting 1 day prior to docetaxel administration, can be given.
- Consult specialized references for procedures for proper handling and disposal of antineoplastics.
Administration
IV Administration
For solution and drug compatibility information, see Compatibility under Stability.
Administer by IV infusion.
Handle cautiously (by trained nonpregnant personnel); use protective equipment (e.g., gloves) and wash hands after removal of the gloves.
Immediately treat accidental contact with skin by thoroughly washing with soap and water; immediately treat accidental contact with mucous membranes by thoroughly washing with water.
Administer through polyethylene-lined administration sets. Use of inline filters is neither required nor recommended.
Dilution
Docetaxel for injection concentrate requires 2 dilutions prior to administration.
Remove vials from refrigerator and allow to stand at room temperature for approximately 5 minutes. Add the contents of the diluent vial to the vial of docetaxel for injection concentrate, to give a solution containing docetaxel 10 mg/mL.
Mix this solution by repeated inversions for at least 45 seconds; do not shake. If foaming occurs, allow solution to stand for a few minutes to allow foam to dissipate; all foam does not have to dissipate to continue preparation.
Withdraw the appropriate dose with a calibrated syringe and inject into 250 mL of either 0.9% sodium chloride injection or 5% dextrose injection to produce a final docetaxel concentration of 0.3–0.74 mg/mL.
If doses larger than 200 mg of docetaxel are required, increase volume of IV solution accordingly so that a docetaxel concentration of 0.74 mg/mL is not exceeded.
Rate of Administration
Administer over 1 hour.
Dosage
Adults
Breast Cancer
IV
60–100 mg/m2 in repeated 3-week cycles.
Dosage adjustment during treatment may be necessary. In patients initially dosed at 100 mg/m2 who experience febrile neutropenia, neutrophil count <500/mm3 for more than 1 week, severe or cumulative cutaneous reactions, or peripheral neuropathy, reduce dose by 25% (e.g., from 100 to 75 mg/m2) for subsequent courses of therapy. If the patient continues to experience these reactions, reduce dosage from 75 to 55 mg/m2 or discontinue. Discontinue entirely if >grade 3 peripheral neuropathy develops.
Higher doses may be tolerated by patients who are dosed initially at 60 mg/m2 and who do not experience febrile neutropenia, neutrophil count <500/mm3 for more than 1 week, severe or cumulative cutaneous reactions, or peripheral neuropathy.
Non-small Cell Lung Carcinoma
IV
Treatment after failure of platinum-based chemotherapy: 75 mg/m2 in repeated 3-week cycles. Higher doses (i.e., 100 mg/m2) associated with increased hematologic toxicity, infection, and treatment-related mortality.
Chemotherapy-naive patients: 75 mg/m2 immediately followed by cisplatin in repeated 3-week cycles.
Dosage adjustment during treatment may be necessary. In patients who are dosed initially at 75 mg/m2 after failure of platinum-based chemotherapy who experience febrile neutropenia, neutrophil count <500/mm3 for more than 1 week, severe or cumulative cutaneous reactions, or other grade 3/4 nonhematologic toxicities, withhold until toxicity resolves and then resume at 55 mg/m2. Discontinue entirely if >grade 3 peripheral neuropathy develops.
In chemotherapy-naive patients who are dosed initially at 75 mg/m2 in conjunction with cisplatin whose nadir platelet count during the previous course is <25,000/mm3, or who experience febrile neutropenia or serious nonhematologic toxicities, reduce dose to 65 mg/m2 for subsequent cycles. In patients who need further dose reduction, a dose of 50 mg/m2 is recommended.
Prescribing Limits
Adults
Breast Cancer
IV
100 mg/m2.
Special Populations
Dosage in Hepatic Impairment
Not recommended in patients with hepatic impairment. (See Hepatic Impairment under Boxed Warning.)
Dosage in Renal Impairment
Dosage adjustment does not appear to be necessary.
Geriatric Patients
Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and potential for concomitant disease and drug therapy.
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