Fluid retention docetaxel

Docetaxel, another taxane, binds to tubulin to promote microtubule assembly. The pharmacokinetics of docetaxel are best described by a three-compartment model, with an a half-life of 0.08 hours, a 3 half-life of 1.6 to 1.8 hours, and a terminal half-life of 65 to 73 hours.14 Docetaxel has activity in the treatment of breast, non-small cell lung, prostate, bladder, esophageal, stomach, ovary, and head and neck cancers. Dexamethasone, 8 mg twice daily for 3 days starting the day before treatment, is used to prevent the fluid retention syndrome associated with docetaxel and possible hypersensitivity reactions. The fluid... 

Docetaxel Myelosuppression, severe fluid retention Alopecia, fatigue, stomatitis, nausea, vomiting, diarrhea, peripheral neuropathy, nail disorder, skin reactions, hypersensitivity reactions... 

Docetaxel Neutropenia (DLT), hyperlacrimation, fluid retention, nail disorders, myelosuppression Use with caution in liver dysfunction. Do not give if biliary tract is obstructed. Premedicate dexamethasone. 

Docetaxel -semisynthetic taxane stabilizes tubulin polymers leading to death of mitotic cells -bone marrow suppression -nausea and vomiting -mucocutaneous effects (mucositis, stomatitis, diarrhea) -hypersensitivity reactions -fluid retention syndrome -fatigue -myalgias -alopecia (universal)... 

Docetaxel, 75 mg/m2 every 3 weeks, combined with prednisone, 5 mg twice daily, has been shown to prolong survival in hormone-refractory metastatic prostate cancer. The most common adverse events were nausea, alopecia, and myelosuppression. Docetaxel can also cause fluid retention and peripheral neuropathy. 

Docetaxel Inhibits mitosis Breast cancer, non-small cell lung cancer, prostate cancer, gastric cancer, head and neck cancer, ovarian cancer, bladder cancer Hypersensitivity Neurotoxicity, fluid retention, myelosuppression with neutropenia... 

Generic Name Docetaxel Trade Name Taxotere Primary Antineoplastic Indication(s) Breast cancer Common Adverse Effects Blood disorders (anemia, leukopenia, neutropenia] fever fluid retention paresthesias/dysthesias skin rash-es/itching stomatitis Gl distress (nausea, diarrhea] ... 

Docetaxel 100 mg/m2 IV over 1 hour every 3 weeks Hypersensitivity, rash Neurotoxicity, fluid retention, neutropenia... 

Docetaxel Nausea and vomiting hypersensitivity reactions Bone marrow depression fluid retention peripheral neuropathy alopecia arthralgias myalgias cardiac coxiciiy mild Gl disturbances mucositis... 

Fluid retention has previously been reported with docetaxel. Some believe that this effect depends on the dose and the duration of infusion (3,4) and that high concentrations of M4, the cyclized oxazolidinedione metabolite of docetaxel, cause more pronounced fluid retention. 

Both paditaxel and docetaxel may result in anaphylactoid or severe hypersensitivity reactions manifested by dyspnea, bronchospasm, angioedema, hypotension (occasionally HTN), and urticarial skin reactions. The reaction may be due to the active drug itself or to the vehicle (Cremophor or polysorbate 80). Additionally, patients receiving docetaxel may experience serious or life-threatening fluid retention. This syndrome is characterized by poorly tolerated peripheral or generalized edema, pleural effusion, dyspnea, ascites, and cardiac tamponade. 

It is recommended that all patients receiving paditaxel receive pretreatment with corticosteroids (such as dexa-methasone) and antihistamines, both H, (diphenydramine) and Hj (cimetidine or ranitidine) antagonists. All patients must be premedicated with corticosteroids prior to receiving each cycle of docetaxel to reduce the incidence and severity of hypersensitivity reactions or fluid retention. Patients who experience severe hypersensitivity reactions should not be rechallenged. 

Metabolism/elimination Hepatic metabolism Adverse reactions Alopeda, nausea/vomiting/diarrhea, myelosuppression (dose-limiting, granulocytopenia, and thrombocytopenia), hepatic toxidty, peripheral neuropathy, hypersensitivity reactions, myalgias/arthralgias, rare cardiovascular events, fluid retention/pulmonary edema (docetaxel). 

Precautions Doses may be modified or therapy delayed for toxicity (myelosuppression). Adjust dose for hepatic impairment. Avoid use of docetaxel in patients with elevated bilirubin. Corticosteroids and antihistamines (i.e., cimetidine and diphenhydramine) are recommended to lessen risk for anaphylactoid reactions with paditaxel. Pretreatment with steroids is required for docetaxel to minimize risk for fluid retention and hypersensitivity. 

Dexamethasone 8 mg orally twice daily for 3 days (starting 1 day prior to docetaxel) is recommended to lower risk of fluid retention syndrome shorter dexamethasone regimens used for weekly docetaxel dosing Requires dose reduction for liver dysfunction (elevated total bilirubin, elevated transaminases and/or alkaline phosphatase)... 

On May 19, 2004, docetaxel was approved for the treatment of metastatic prostate cancer. The approval was based on the TAX327 study, a randomized, multicenter global clinical trial enrolling over 1000 men with metastatic, hormone-refractory prostate cancer. The study compared docetaxel 75 mg/m every 3 weeks and prednisone 5 mg twice a day with docetaxel 35 mg/m weekly five out of six weeks and prednisone 5 mg twice a day and mitoxantrone 75 ng/m every 3 weeks and prednisone 5 mg twice a day. Docetaxel, in combination with prednisone, given every 3 weeks showed a survival advantage of approximately 2.5 months over the control group in the trial p =. 009). The most common adverse events reported were nausea, alopecia, and bone marrow suppression. In addition, fluid retention and peripheral neuropathy, known effects of docetaxel, were... 

Paclitaxel has very limited solubility and must be administered in a vehicle of 50% ethanol and 50% polyethoxylated castor oil (CREMOPHOR EL), a formation likely responsible for a high rate of hypersensitivity reactions. Patients receiving this formulation are protected by pretreatment with a histamine Hj receptor antagonist such as diphenhydramine, an receptor antagonist such as cimetidine fsee Chapter 24), and a glucocorticoid such as dexamethasone (see Chapter 59). Docetaxel, which is somewhat more soluble, is administered in polysorbate 80 and causes a lower incidence of hypersensitivity reactions. Pretreatment with dexamethasone is required to prevent progressive, and often disabling, fluid retention. 

Mitotic inhibitors Docetaxel An+, D+, M++, N+ Severe fluid retention in 6% of patients. 

The recommended dose of docetaxel is generally 75—100 mg/m, administered intravenously over 1 hour once every 3 weeks. Premedication with dexamethasone is generally given for example, dexamethasone 8 mg bd for 3 days, starting the day before treatment with docetaxel. This helps to reduce fluid retention, as well as hypersensitivity reactions. 

Fluid balance Fluid retention has been reported in up to 50% of patients treated with docetaxel, usually after cumulative doses. This commonly manifests as peripheral edema, but pleural effusions and ascites have also been reported [130 ]. As a result. 

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