Paclitaxel is a chemotherapy drug. Chemotherapy drugs (also called cytotoxic drugs) aim to destroy cancer cells by interfering with how they develop and grow. Different drugs do this in different ways.
Paclitaxel is the generic (non-branded) name of the drug, but you may hear it called by one of its brand names such as Taxol. Paclitaxel can be combined with a protein which may reduce some of its side effects. When combined with a protein the drug is called nab-paclitaxel or Abraxane.
How does paclitaxel work?
Paclitaxel works by stopping the cancer cells from dividing and multiplying which blocks the growth of the cancer.
When might paclitaxel be offered?
Paclitaxel may be used alone or in combination with other drugs to treat breast cancer that has spread to areas around the breast, such as the lymph nodes above or below the collarbone (known as regional or locally advanced recurrence), or to other parts of the body (secondary breast cancer).
Paclitaxel is sometimes used in combination with other drugs to treat primary breast cancer (cancer that started in the breast and has not spread to other parts of the body) or it might be given as part of a clinical trial for primary breast cancer.
Clinical trials are studies that aim to find the best treatment for a particular condition.
How is paclitaxel given?
Paclitaxel is given through a drip into a vein (intravenously) in the hand or arm. If it’s difficult to find suitable veins it may be given via a skin tunnelled catheter (a tube that allows fluids to be given) that can stay in place for weeks or months. See our Chemotherapy for breast cancer booklet for more information about these.
Paclitaxel can be given over a three-hour period once every three weeks, or two weekly (accelerated), or it may be given weekly in lower doses over one hour. The interval between each course of treatment gives your body time to recover, and may vary depending on whether the number of blood cells has returned to normal between each cycle.
Before each dose of paclitaxel you will be given other medication through the drip including a steroid. This is given to reduce the chances of any possible reactions and to prevent nausea and vomiting.
What are the side effects of paclitaxel?
Like any drug, paclitaxel can cause side effects and we list the main ones below. Everyone reacts differently to drugs and some people have more side effects than others. The side effects of paclitaxel can usually be controlled and those described here will not affect everyone.
If you are concerned about any side effects, regardless of whether they are listed here, talk to your chemotherapy nurse or cancer specialist (oncologist).
If you are being given other chemotherapy or anti-cancer drugs with paclitaxel, you may have additional side effects from these drugs.
Side effects common to all chemotherapy drugs
- effects on the blood (such as risk of infection, anaemia, bruising and bleeding)
- hair loss (alopecia)
- nausea and vomiting
- sore mouth
- tiredness (fatigue)
- effects on fertility.
Find out more about the side effects common to all chemotherapy regimes.
Other common side effects of paclitaxel
Numbness and tingling in hands or feet
Some people having paclitaxel experience numbness or tingling in their hands and feet. This is due to the effect of paclitaxel on the nerves and is known as peripheral neuropathy. In most cases it’s mild and goes away soon after treatment stops. If it’s severe, it may be necessary to reduce the dose of paclitaxel or to stop it completely. It normally improves a few months after the treatment has finished, but it may not disappear completely.
If you experience numbness or tingling, mention this to your specialist team when you see them next so that the symptoms can be monitored.
Painful muscles and joints
Your muscles or joints may ache or become painful two to three days after you have your treatment. This usually wears off after a few days. However, it can be severe and you may need to take mild pain relief or anti-inflammatory drugs. It’s a good idea to have some of these available before starting your treatment just in case you need them.
You may develop a rash anywhere on your body or your skin may discolour. This may be red and itchy. Or you may feel flushed. Your doctor may prescribe medicine to help. If you have skin reactions, mention this to your specialist team when you see them next so they can monitor the symptoms.
You may have diarrhoea but your specialist or GP can prescribe medicine to help control it. If you have persistent diarrhoea, you should contact your specialist team.
Low blood pressure
Your blood pressure will be checked regularly while you are on paclitaxel. Let your doctor or nurse know if you feel dizzy or light headed.
Less common side effects
After a few doses of paclitaxel, the colour of your nails may change but this will normally grow out over several months. The nails may also become brittle, crack or change in texture, for example ridges may form. A few people lose nails on their fingers or toes during or shortly after treatment, but they will grow back.
Reaction in the injection site
Pain, redness, discolouration or swelling can occur where the needle has been inserted or anywhere along the vein. If you experience any of these, tell your chemotherapy nurse. After a few weeks you may notice tenderness, darkening and hardening around where the needle was inserted. This should fade in time.
Effects on the liver
Paclitaxel may affect how well your liver works. This is temporary and your liver function will usually return to normal when the treatment has stopped and you are unlikely to notice any symptoms. You will have regular blood tests to monitor this throughout your treatment.
Rare side effects
Changes in heart rate
Paclitaxel can alter your heart rate, so you will be carefully monitored for this during your treatment. If changes to your heart rate occur this can usually be treated easily and you will not have to stop your treatment. This is not the same as having an allergic reaction to paclitaxel (see below).
If you have an allergic reaction to paclitaxel, it will probably happen within the first few minutes of your treatment. It is more likely to happen the first or second time you have the drug. Reactions can vary from mild to severe, although severe reactions are uncommon. Before your treatment starts, you will be given drugs to reduce the risk of an allergic reaction.
You will be monitored closely during your treatment so that any reaction can be dealt with immediately. Symptoms include flushing, skin rash, itching, back pain, shortness of breath, faintness, fever or chills. If you have a severe reaction, treatment will be stopped immediately. You may not be given paclitaxel again or it may be given with extra drugs to prevent another reaction, and/or the paclitaxel may be given more slowly.
Fertility and contraception
Paclitaxel can cause temporary or permanent infertility (being unable to get pregnant). Find out more about fertility issues and breast cancer treatment.
Some women can still become pregnant even if their periods are irregular or have stopped. Having paclitaxel when pregnant may be harmful to a developing baby so effective barrier method contraception, such as condoms should be used. Read more information about chemotherapy and sexual health (including the effect of chemotherapy on fertility).
For useful information on how you may feel while having chemotherapy, or practical issues like going on holiday or having vaccinations, see our section Chemotherapy: other issues.