Paclitaxel - Instructions For Use, Reviews, Price, Side Effects

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Paclitaxel

Paclitaxel: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. For violations of liver function
12. 12. Drug interactions
13. 13. Analogs
14. 14. Terms and conditions of storage
15. 15. Terms of dispensing from pharmacies
16. 16. Reviews
17. 17. Price in pharmacies

Latin name: Paclitaxel

ATX code: L01CD01

Active ingredient: paclitaxel (Paclitaxel)

Producer: RUE Belmedpreparaty (Republic of Belarus); Novalek Pharmaceutical Pvt. Ltd. (Novalek Pharmaceutical Pvt. Ltd.) (India); PJSC Pharmstandard-Biolek (Ukraine); LLC "Onco Generics" (Ukraine)

Description and photo update: 2019-31-10

Paclitaxel is an antineoplastic agent.

Release form and composition

The drug is produced in the form of a concentrate for the preparation of a solution for infusion: transparent, colorless or pale yellow viscous liquid (5; 16.7; 23.3; 25; 35; 41.7; 43.4; 46; 50 or 100 ml each) in glass vials, sealed with a rubber stopper with an aluminum / combined aluminum and plastic / aluminum cap with a plastic cap, in a cardboard box 1 bottle; 10 packs each with 1 bottle of 5 or 16.7 ml in a film; 1 pack with 1 bottle 23.3; 25; 35; 41.7; 43.4; 46; 50 or 100 ml in film; for hospitals, vials of 5 or 16.7 ml in a group box of 40 pcs. In dark glass vials, sealed with bromobutyl a rubber stopper and an aluminum cap with a sealing flip-off disk, 5 or 10 ml - 5 ml; 20 ml - 16.7 ml; 50 ml - 43.3 or 50 ml; 1 bottle in a cardboard box;for hospitals - in a cardboard box of 5, 10, 30, 50 or 100 bottles. Each pack also contains instructions for the use of Paclitaxel).

1 ml of concentrate contains:

• active substance: paclitaxel - 6 mg;
• additional components: depending on the manufacturer - citric acid anhydrous / citric acid monohydrate, ethanol (anhydrous ethanol), macrogol glyceryl ricinoleate (Cremophor EL) / polyoxyethylated castor oil (macrogol glycerol ricinoleate).

Pharmacological properties

Pharmacodynamics

Paclitaxel is a herbal antineoplastic agent. The active substance is obtained from the leaves of the short-leaved or Pacific yew (Taxus brevifolia) by biosynthesis. The mechanism of action of the drug is due to its ability to stimulate the assembly of microtubules from dimeric tubulin molecules, strengthen their structure and suppress dynamic reorganization in the interphase of mitosis. Due to the action of the active substance, abnormal bundles of microtubules arise during the full cell cycle and multiple star-shaped clumps (asters) during mitosis. Thus, paclitaxel leads to a violation of the mitotic function of the cell.

The drug provides a dose-dependent inhibition of bone marrow hematopoiesis.

Pharmacokinetics

After intravenous (IV) infusion of Paclitaxel for 3 hours at a dose of 135 mg / m2, the area under the concentration-time curve (AUC) is 7952 ng / ml / h, and the maximum concentration (C _max) is 2170 ng / ml; with the introduction of a similar dose over 24 hours - 6300 ng / ml / h and 195 ng / ml, respectively. Indicators AUC and C _max are dose-dependent: when intravenous infusion is carried out for 3 hours, an increase in the dose of the active substance to 175 mg / m2 provides an increase in these parameters by 89 and 68%, and within 24 hours - by 26 and 87%, respectively.

The average volume of distribution can vary from 198 to 688 l / m2, paclitaxel binds to plasma proteins by 88-98%. The half-life of the drug in the tissue from the blood is 30 minutes. The drug quickly enters the tissues and is easily absorbed by them, accumulates mainly in the liver, spleen, stomach, pancreas, intestines, muscles and heart.

Metabolic transformation of paclitaxel occurs in the liver through hydroxylation with the participation of cytochrome P ₄₅₀ isoenzymes CYP2D8, with the formation of a metabolite of 6-alpha-hydroxypaclitaxel, and CYP3A4, which leads to the formation of metabolites of 3-para-hydroxypaclitaxel and 6-alpha, 3-para-dihydroxypaclitaxel.

It is excreted mostly with bile - 90%, with repeated infusions, the accumulation of the active substance is not observed. The total clearance is 12.2-23.8 l / h / m², the half-life (T _1/2) is 13.1-52.7 hours, the variability of indicators is due to the dose of paclitaxel and the duration of the infusion.

After intravenous infusion (1–24 h), the total excretion by the kidneys can be 1.3–12.6% of the dose, which indicates the presence of intensive extrarenal clearance (the value of the total clearance is 11–24 l / h / m²).

Indications for use

• ovarian carcinoma: a common form of the disease or residual tumor exceeding 1 cm, after the initial laparotomy - first-line therapy in combination with platinum drugs; metastatic ovarian cancer in the absence of a positive result after standard treatment - second-line therapy;
• breast carcinoma: the presence of metastases in the lymph nodes after the standard combined treatment - adjuvant therapy; late stage cancer or metastatic cancer after a relapse of the disease within 6 months from the start of adjuvant treatment with anthracycline drugs, in the absence of indications for their appointment - first-line therapy; late stage cancer or metastatic cancer - first-line therapy in combination with anthracyclines in the absence of contraindications for their use, or in combination with trastuzumab with immunohistochemically confirmed 2+ or 3+ level of HER-2 / neu expression; advanced stage of cancer or metastatic cancer against the background of disease progression after combined chemotherapy,including anthracyclines in the absence of contraindications for their appointment - second-line therapy;
• NSCLC (non-small cell lung cancer): first-line therapy in combination with cisplatin or as a monotherapy drug in the case when surgical treatment and / or radiation therapy is not planned;
• Kaposi's sarcoma associated with acquired immunodeficiency syndrome (AIDS): second-line therapy.

Contraindications

Absolute:

• the initial number of neutrophils less than 1500 / μl in patients with solid tumors;
• initial or recorded during therapy, the content of neutrophils less than 1000 / μl in patients with Kaposi's sarcoma caused by AIDS;
• uncontrolled serious infections developing against the background of Kaposi's sarcoma;
• age up to 18 years;
• pregnancy and lactation;
• hypersensitivity to any component of the drug, in particular to polyoxyethylated castor oil (macrogol glyceryl ricinoleate).

Relative (you must take paclitaxel with extreme caution):

• thrombocytopenia (platelet count less than 100,000 / μl), including after chemotherapy or radiation therapy;
• severe course of ischemic heart disease (IHD);
• arrhythmias;
• a history of myocardial infarction;
• liver failure;
• acute infectious lesions (including herpes, shingles, chickenpox).

Paclitaxel, instructions for use: method and dosage

In order to prevent severe hypersensitivity reactions, all patients require premedication with H ₁ and H ₂ -histamine receptor blockers, glucocorticosteroids (GCS), for example, dexamethasone (or its equivalent) orally at a dose of 20 mg for about 12 and 6 hours or dexamethasone in that the same IV dose, 30-60 minutes before the administration of Paclitaxel, diphenhydramine (or its equivalent) at a dose of 50 mg IV and 300 mg cimetidine or 50 mg Ranitidine IV 30-60 minutes before the start of the drug infusion …

In the presence of solid tumors, repeated courses of treatment with Paclitaxel are prescribed only after reaching the neutrophil count of 1500 / μl (1000 / μl in patients with AIDS-related Kaposi's sarcoma), and the platelet count is 100,000 / μl (75,000 / μl in patients with Kaposi's sarcoma) …

For persons who, after the administration of paclitaxel, had severe neutropenia (the number of neutrophils less than 500 / μL of blood for 7 days or longer) or severe peripheral neuropathy, during subsequent courses of treatment, it is recommended to reduce the dose of the antineoplastic agent by 20% (in patients with AIDS-related Kaposi's sarcoma - by 25%). Neurotoxicity and neutropenia are dose-dependent.

The solution prepared from the concentrate is injected intravenously (infusion).

Ovarian cancer (infusion is performed once every 3 weeks):

• 1st line therapy: infusion at a dose of 175 mg / m² for 3 hours or at a dose of 135 mg / m² for 24 hours, in both cases with further administration of platinum;
• 2nd line therapy: in monotherapy mode - at a dose of 175 mg / m² for 3 hours.

Mammary cancer:

• adjuvant therapy after standard combined treatment: at a dose of 175 mg / m² for 3 hours; in total, 4 courses are carried out with an interval of 3 weeks;
• 1st line therapy (infusion is carried out every 3 weeks): in monotherapy mode - at a dose of 175 mg / m² for 3 hours; combination therapy with trastuzumab: Paclitaxel is infused over 3 hours at a dose of 175 mg / m² the day after the first dose of trastuzumab; infusion of paclitaxel is prescribed if trastuzumab is well tolerated immediately after subsequent injections of this drug; combination therapy with doxorubicin (50 mg / m²): 24 hours after the administration of doxorubicin, paclitaxel is infused at a dose of 220 mg / m² for 3 hours;
• 2nd line therapy: every 3 weeks at a dose of 175 mg / m² for 3 hours.

NSCLC (infusions every 3 weeks):

• in monotherapy mode: at a dose of 175-225 mg / m² for 3 hours;
• combination therapy: at a dose of 175 mg / m² for 3 hours or at a dose of 135 mg / m² for 24 hours by infusion, followed by the introduction of platinum.

AIDS-related Kaposi's sarcoma:

• 2nd line therapy: every 3 weeks infusion at a dose of 135 mg / m² for 3 hours or every 2 weeks at a dose of 100 mg / m² intravenously over 3 hours (45-50 mg / m² per week);
• therapy against the background of an advanced form of AIDS (recommendations are given taking into account the level of immunosuppression): dexamethasone as part of premedication, administered orally, should be reduced to 10 mg; the use of Paclitaxel is allowed only when the level of neutrophils is not lower than 1000 cells / μl of blood, and platelets - 75,000 / μl; with severe peripheral neuropathy or severe neutropenia (at least 500 cells / μl of blood for 1 week or more) - during subsequent courses of therapy, the dose should be reduced by 25%, if necessary, supportive treatment is carried out using granulocyte colony-stimulating factor (G-CSF) …

The solution for intravenous infusion must be prepared immediately before the infusion. It is recommended to dilute the concentrate, strictly adhering to the rules of asepsis, with one of the following solutions: sodium chloride solution 0.9%; dextrose solution 5%; dextrose solution 5% in sodium chloride solution 0.9% or (depending on the manufacturer) dextrose solution 5% in Ringer's solution, to a final concentration of 0.3-1.2 mg / ml. The resulting solutions can become opalescent due to the composition of the carrier base, which is not removed by filtration and does not affect the effect of Paclitaxel. The ready-to-use solution should be visually examined for the presence of mechanical impurities, precipitation or color change.

The prepared drug should be injected through a membrane filter with a pore diameter of less than 0.22 μm built into the infusion system. The resulting solutions, if stored at a temperature of 25 ± 2 ° C, are stable for 27 hours.

There are sporadic reports of sedimentation at the end of a 24-hour paclitaxel infusion. To reduce the risk of insoluble sediment occurrence, it is necessary to use the drug immediately after dilution, avoiding strong shaking or mixing of the resulting solution. During the infusion period, the appearance of the solution should be constantly monitored and, if a precipitate is detected, stop the administration of the agent.

Equipment that does not contain polyvinyl chloride (PVC) parts should be used to prepare, store and administer the infusion solution to minimize patient exposure to the carcinogenic plasticizer diethylhexyl phthalate (DEGP) that can be released from such parts. The use of filters, which are equipped with built-in short plasticized PVC inlet and / or outlet tubes, did not cause significant DEGP leaching.

Side effects

Side effects associated with the use of paclitaxel, in most cases, are similar in frequency and severity in the treatment of breast cancer, ovarian cancer, NSCLC or Kaposi's sarcoma. At the same time, in patients with Kaposi's sarcoma caused by AIDS, febrile neutropenia, suppression of hematopoietic function, and infections (including opportunistic ones) are more often than usual recorded and more severe.

Side effects of paclitaxel observed with monotherapy:

• immune system: very often - mild hypersensitivity reactions, usually in the form of hyperemia and skin rash; infrequently - severe hypersensitivity reactions such as edema, chills, back pain, decreased blood pressure (BP), angioedema, generalized urticaria, impaired respiratory function; rarely * - anaphylactic reactions, including with a fatal outcome; extremely rare * - anaphylactic shock;
• hematopoietic organs: very often - fever, anemia, bleeding, leukopenia, myelosuppression, thrombocytopenia, neutropenia; rarely * - febrile neutropenia; extremely rare * - myelodysplastic syndrome, acute myeloid leukemia;
• cardiovascular system: very often - changes in the electrocardiogram (ECG), arterial hypotension; often - bradycardia; infrequently - thrombosis, thrombophlebitis, increased blood pressure, asymptomatic ventricular tachycardia, cardiomyopathy, atrioventricular block and syncope, tachycardia with bigeminy, myocardial infarction; extremely rarely - supraventricular tachycardia, atrial fibrillation, shock;
• organ of hearing: very rarely * - tinnitus, hearing loss, vertigo, ototoxicity;
• organ of vision: very rarely * - reversible visual impairment and / or damage to the optic nerve (ocular migraine or ciliated scotoma), destruction of the vitreous body of the eye, photopsia; with an unknown frequency * - macular edema;
• central and peripheral nervous system: very often - neurotoxicity, mainly peripheral neuropathy (usually moderately severe; the frequency of development increased with the accumulation of funds in the body); rarely * - motor neuropathy, with further slight atrophy of the distal muscles; extremely rare * - autonomic neuropathy, expressed by orthostatic hypotension and paralytic intestinal obstruction; ataxia, headache, dizziness, confusion, convulsions, encephalopathy, epileptic tonic-clonic seizures of the grand mal type;
• liver and biliary tract: extremely rare * - hepatic encephalopathy (including fatal), hepatonecrosis (including fatal);
• gastrointestinal tract: very often - vomiting, diarrhea, nausea, mucositis (most often with a 24-hour infusion); rarely * - ischemic colitis, intestinal perforation, intestinal obstruction, pancreatitis; extremely rare * - constipation, anorexia, ascites, esophagitis, pseudomembranous colitis, mesenteric artery thrombosis;
• respiratory system: rarely * - respiratory failure, shortness of breath, pulmonary fibrosis, pleural effusion, interstitial pneumonia, pulmonary embolism; extremely rare * - cough;
• musculoskeletal system: very often - myalgia, arthralgia; with an unknown frequency * - systemic lupus erythematosus;
• skin, subcutaneous tissue and skin appendages: very often - alopecia; often - minor transient changes in the skin and nails; rarely * - rash, itching, phlebitis, erythema, exfoliation of the skin, inflammation of the subcutaneous fat, skin lesions similar to the effects of radiation therapy; fibrosis and skin necrosis; extremely rare * - urticaria, onycholysis, exfoliative dermatitis, exudative erythema multiforme, epidermal necrolysis, Stevens-Johnson syndrome; with an unknown frequency - cutaneous lupus erythematosus *, scleroderma;
• laboratory parameters: often - increased activity of aspartate aminotransferase (ACT) or alkaline phosphatase; infrequently - an increase in the level of bilirubin; rarely * - an increase in serum creatinine;
• local reactions: often - pain, erythema, local edema, induration;
• others: very often - the addition of secondary infections; infrequently - septic shock; rarely * - increased body temperature, general malaise, peripheral edema, dehydration, asthenia, pneumonia, sepsis; frequency unknown * - tumor lysis syndrome.

* - post-marketing data on the side effects of paclitaxel.

Adverse events reported with the combined use of Paclitaxel with the following drugs as part of a combination treatment:

• cisplatin in 1st-line treatment of ovarian cancer: the severity and incidence of arthralgia / myalgia, neurotoxicity and hypersensitivity were higher when compared with treatment with cisplatin and cyclophosphamide, however, the manifestations of myelosuppression were less common and were less pronounced; when used in combination with cisplatin at a dose of 75 mg / m2, manifestations of severe neurotoxicity were recorded less frequently with the administration of Paclitaxel at a dose of 135 mg / m2 over a 24-hour infusion than with its use for 3 hours at a dose of 175 mg / m2;
• trastuzumab in the treatment of metastatic breast cancer of the 1st line: the following adverse reactions were observed more often than with paclitaxel monotherapy: reactions at the injection site, rash, acne, herpes sores, chills, fever, insomnia, rhinitis, sinusitis, nosebleeds, cough, diarrhea, arthralgia, accidental injury, infection, increased blood pressure, tachycardia, heart failure; during treatment of the 2nd line of breast cancer (after anthracycline drugs), the frequency and severity of cardiac abnormalities increased (in some cases with a fatal outcome) when compared with Paclitaxel in monotherapy; in the overwhelming majority, adverse reactions were reversible after appropriate treatment;
• doxorubicin in the treatment of breast cancer: in patients who had not previously received chemotherapy, there were cases of congestive heart failure, and in those previously treated (mainly with the use of anthracyclines), cardiac activity, failure of ventricular function and a decrease in left ventricular ejection fraction were often observed, in some cases - myocardial infarction.

With the simultaneous appointment of paclitaxel and radiation therapy, cases of radiation pneumonitis have been recorded.

Overdose

Symptoms of a paclitaxel overdose may include mucositis, peripheral neuropathy, and bone marrow aplasia.

Treatment is symptomatic, the specific antidote is unknown. The patient, if an overdose is suspected, should be under close medical supervision.

special instructions

The use of paclitaxel should be supervised by a specialist experienced in anticancer chemotherapy drugs.

The drug should be administered as a diluted solution.

Despite the premedication, less than 1% of patients with drug therapy experienced serious hypersensitivity reactions. The frequency and severity of such complications did not depend on the dose and schedule of administration of the agent. In the case of the development of severe reactions, most often there were flushes of blood to the skin, chest pain, choking, tachycardia, as well as pain in the limbs, abdominal pain, increased sweating, increased blood pressure. At the first signs of severe hypersensitivity reactions, it is necessary to urgently stop the administration of Paclitaxel and conduct symptomatic treatment; repeated courses in such cases are not prescribed.

At the site of intravenous administration of the solution, as a rule, mild reactions were recorded in the form of edema, erythema, sensitivity / pain, induration, hemorrhage, which could provoke the development of cellulite. These effects occurred more frequently with 24-hour infusion than with 3-hour infusion. In some cases, the onset of such phenomena was noted both directly during the infusion procedure, and after 7-10 days.

Suppression of bone marrow function (neutropenia in most cases) is the main toxic reaction that leads to the need for dose limitation. The probability of manifestation of this reaction depends on the scheme of use and the amount of the drug administered. With cisplatin at a dose of 75 mg / m² and Paclitaxel at a dose of 175 mg / m² in the form of a 3-hour infusion, severe neurotoxicity was recorded more often than with the introduction of the latter at a dose of 135 mg / m² in the form of a 24-hour infusion. An increase in the duration of the infusion exacerbates the threat of myelosuppression to a greater extent than an increase in the dose.

In patients with ovarian cancer, the risk of renal failure was higher with the combination of paclitaxel and cisplatin, compared with cisplatin monotherapy.

During treatment, infections were often detected, sometimes with a fatal outcome, including pneumonia, sepsis, peritonitis. Complicated infections of the urinary system and upper respiratory tract were most often observed in patients. Individuals with immunosuppression, human immunodeficiency virus (HIV), AIDS-related Kaposi's sarcoma have had at least one opportunistic infection.

During drug therapy, it is necessary to regularly monitor the blood picture. During the treatment period, there were cases of bleeding, most of which were local. The frequency of their development did not show a direct dependence on the dose of paclitaxel administered and the administration schedule.

Bradycardia and a decrease / increase in blood pressure, noted during the administration of the solution, in most cases are asymptomatic and do not require treatment. A decrease in blood pressure and bradycardia were usually recorded during the first 3 hours of infusion. During therapy, it is necessary to regularly monitor blood pressure, heart rate (HR) and other parameters of vital functions (especially during the first hour of infusion). Cardiac function monitoring is recommended when paclitaxel is used in combination with doxorubicin or trastuzumab.

If signs of impaired cardiac conduction are detected, it is necessary to carry out continuous cardiac monitoring with repeated injections and prescribe appropriate treatment. In severe cases, the use of Paclitaxel should be suspended or discontinued.

Symptoms of neuropathy decreased or disappeared completely for several months after the end of therapy.

The occurrence of neuropathy against the background of previous therapy is not a contraindication for paclitaxel treatment.

The likelihood of exposure to ethanol contained in the preparation must be taken into account.

Given the potential risk of the mutagenic effect of paclitaxel, patients of both sexes are advised to use effective contraception during therapy and within six months after its completion. For male patients, in addition, due to the threat of reduced fertility and for the possibility of successful conception of a child in the future, it is recommended to consider the issue of cryopreservation of sperm.

Influence on the ability to drive vehicles and complex mechanisms

During the period of therapy, one should refrain from engaging in potentially hazardous activities (including driving a car), which require an increased concentration of attention and quick reactions. It should be borne in mind that premedication before the administration of Paclitaxel can also have a negative impact on the ability to concentrate and reaction speed.

Application during pregnancy and lactation

During pregnancy and lactation, the use of Paclitaxel is contraindicated.

In the course of preclinical studies, paclitaxel exhibited embryotoxic and fetotoxic effects. When using the drug for the treatment of pregnant women, as with therapy with other cytotoxic drugs, fetal damage is possible.

It has not been established whether paclitaxel passes into breast milk. During the period of therapy, it is necessary to stop breastfeeding.

Pediatric use

For pediatric patients under the age of 18, paclitaxel therapy is contraindicated due to the lack of sufficient data to support its safety and effectiveness in children and adolescents.

For violations of liver function

In the presence of liver failure, aggravating the risk of toxicity (in particular, myelosuppression of III – IV degree), a change in the dose of Paclitaxel is recommended. During therapy, patients in this group require careful medical supervision.

Recommended doses for patients with functional disorders of the liver, depending on the level of hepatic transaminases and the level of serum bilirubin in the blood, with a 24-hour infusion (VGN - the upper limit of the norm):

• the level of transaminases is less than 2 VGN; bilirubin not lower than 26 μmol / l - 135 mg / m²;
• the level of transaminases 2-10 VGN; bilirubin not lower than 26 μmol / l - 100 mg / m²;
• the level of transaminases is less than 10 VGN; bilirubin 28–129 μmol / l - 50 mg / m²;
• the level of transaminases is not less than 10 VGN or bilirubin is higher than 129 μmol / l - paclitaxel should not be administered.

Recommended doses for patients with impaired liver function with a 3-hour infusion:

• the level of transaminases is less than 10 VGN; bilirubin 22, 22–35 or 35–86 VGN - doses of the drug 175, 135 and 90 mg / m², respectively;
• the level of transaminases is not less than 10 VGN or bilirubin is above 86 VGN - it is not recommended to inject paclitaxel.

The above doses are recommended for the first course of therapy; during subsequent courses, dose adjustment should be based on the individual tolerance of the antineoplastic agent.

Drug interactions

• doxorubicin: an increase in the serum concentration of this substance and its active metabolite in the blood is possible; adverse reactions in the form of neutropenia and stomatitis are more pronounced when using paclitaxel before doxorubicin is administered, as well as when infusion is longer than recommended;
• cisplatin: when the drug is administered after cisplatin, a more pronounced myelosuppression is observed and a decrease in paclitaxel clearance by 20% in comparison with the drug infusion before cisplatin; if this combination is necessary, paclitaxel should be administered first, followed by cisplatin;
• substrates (eletriptan, midazolam, felodipine, repaglinide, lovastatin, buspirone, sildenafil, triazolam, rosiglitazone, simvastatin), inducers (nevirapine, carbamazepine, efavirenz, rifampicin, phenytoin (indavi-ritin), and inhibitor ketoconazole) of CYP2C8 and CYP3A4 isoenzymes: caution is required when prescribing paclitaxel, since the latter is metabolized by these isoenzymes;
• live vaccines: the threat of a fatal systemic vaccine disease is aggravated, as a result of which the use of live vaccines is not recommended in patients with immunosuppression.

Analogs

The analogues of Paclitaxel are Abraxan, Abitaxel, Intaxel, Paclikal, Kanataxen, Mitotax, Paklitera, Sindaxel, Paclitaxel-LENS, Celiksel, etc.

Terms and conditions of storage

Store out of the reach of children and protected from light penetration at a temperature not exceeding 25 ° C.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews of Paclitaxel

On specialized sites, patients currently leave insufficient reviews about Paclitaxel, which makes it difficult to objectively assess the effectiveness and safety of an anticancer agent. Experts, however, consider the drug to be one of the most effective drugs used in the treatment of breast cancer, which has demonstrated its effectiveness in various clinical situations, both in monotherapy and in combination with other cytostatics.

Price for Paclitaxel in pharmacies

There is no reliable data on the price of Paclitaxel, since the drug is currently not available in the pharmacy network.

The cost of an analogue of the drug, Paclitaxel-LENS, concentrate for solution for infusion (6 mg / ml) can be 11 550–11 700 rubles. for a bottle of 23.3 ml.

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!