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Paclitaxel is an agent that inhibits mitochondrial reticulum disintegration, preventing untwisting, causing abnormal formation of clusters or bundles of microreticular networks during the cell cycle. . Paclitaxel is the active ingredient in Pataxel. What does Pataxel do?
1. What is Pataxel?
Pataxel is prepared in the form of a concentrated solution for intravenous infusion, the drug has many different packaging specifications: vials of 30mg/5ml, 100mg/16.7ml or 300mg/50ml. The main ingredient of Pataxel is Paclitaxel, concentration 6mg/ml. The drug is manufactured at Vianex S.A. - EGYPT and circulated in Vietnam with registration number: VN-17868-14.
2. What does Pataxel do?
Indications for Pataxel include:
Pataxel is used to treat metastatic ovarian cancer, usually starting with Pataxel when conventional therapies with anthracyclines and platinum have failed or been resisted. point; Paclitaxel is used in combination with the active ingredient doxorubicin in adjuvant therapy as first-line therapy in the treatment of metastatic breast cancer. Pataxel is indicated for the treatment of metastatic breast cancer when conventional therapy with anthracyclines has failed or the breast cancer has recurred within 6 months of adjuvant therapy; Pataxel is used to treat AIDS-related non-small cell lung cancer and Kaposi's cancer.
3. Dosage - How to use Pataxel
Dosage of Pataxel: Depending on the response to therapy, the use of Pataxel also depends on tumor nature, tumor volume, and the increase in tolerance to chemotherapy containing chemotherapy. previous platinum of cancer patients. Treatment with Pataxel must be carried out by a physician experienced in anticancer chemotherapy.
3.1. Treatment before using Pataxel Before the infusion of Pataxel, it is necessary to use Dexamethasone at a dose of 20 mg orally (before 12 and 6 hours) or intravenously (before 14 and 7 hours). In the case of patients with HIV disease, the oral dose of Dexamethasone can be reduced to 10 mg. It is recommended to use Diphenhydramine (50 mg intravenously, 30-60 minutes before taking Pataxel) and Cimetidine, Famotidine, Ranitidine. 3.2. Treatment of ovarian cancer First-line regimen of first choice for the treatment of advanced epithelial ovarian cancer: When combined with cisplatin for the initial treatment of advanced ovarian cancer, there are 2 active regimens. Paclitaxel is recommended, the choice of regimen should consider the toxicity that the drug causes is appropriate for the patient:
Use Paclitaxel 175 mg/m2 (body area) intravenously over 3 hours, then Then intravenous infusion of Cisplatin 75mg/m2, every 3 weeks. Use paclitaxel 135mg/m2 intravenous infusion over 24 hours, then intravenous infusion of Cisplatin 75mg/m2, every 3 weeks. Second-line or next-line therapy for advanced ovarian cancer: For monotherapy in patients unresponsive to first-line or next-line chemotherapy, the recommended regimen is paclitaxel 135 or 175 mg/m2 IV over 3 hours, repeated every 3 weeks if tolerated.
3.3. Treatment of breast cancer Adjuvant treatment in lymph node breast cancer: Using active ingredient Paclitaxel 175 mg/m2, intravenous infusion over 3 hours, every 3 weeks, using the drug in 4 cycles, after completion All drugs used doxorubicin in the combination regimen. Tried on many patients using 4 courses of Doxorubicin and Cyclophosphamide followed by adjuvant treatment with Paclitaxel. Second line therapy for advanced breast cancer: For metastatic breast cancer that has been refractory to chemotherapy or for breast cancer that has recurred within 6 months of adjuvant therapy, use the usual active ingredient Paclitaxel 175 mg/m2, intravenous infusion over 3 hours, every 3 weeks. 3.4. Treatment of non-small cell lung cancer Pataxel and cisplatin are used in combination for the initial treatment of non-small cell lung cancer in patients with no indication for surgery or radiation therapy.
Recommended regimen: paclitaxel 135mg/m2 intravenous infusion for 24 hours, then intravenous infusion of cisplatin 75mg/m2, 1 course every 3 weeks. Another regimen: use Paclitaxel 175 mg/m2 intravenously over 3 hours, then cisplatin 80 mg/m2, every 3 weeks. 3.4. AIDS-associated Kaposi's sarcoma For patients with advanced HIV disease, patients should only be started on Paclitaxel if the patient has a neutrophil count of at least 1,000/mm3; For patients with AIDS-related Kaposi's sarcoma who are not responding to first-line or next-line chemotherapy, two regimens with Paclitaxel are now recommended: Paclitaxel 135mg/ m2 intravenous infusion every 3 hours, every 3 weeks. Or use paclitaxel 100mg/m2 intravenously over 3 hours, every 2 weeks. These regimens have dose levels of 45 - 50 mg/m2 per week. In phase II studies, the high-dose regimen was associated with greater toxicity and worse patient outcomes with the paclitaxel 100 mg/m2 regimen every 2 weeks. The dose of Pataxel may be reduced in patients with hepatic impairment.
In patients with a severely reduced granulocyte count (, 0.5 x 109/liter) (500/mm3) during treatment with Pataxel, the dose of Pataxel should be reduced by 20%.
Repeat therapy with Pataxel is only conducted when the granulocyte count ≥ 1,500 cells/mm3 and the platelet count ≥ 100,000 cells/mm3. For HIV-infected patients, the cycle of Pataxel should be repeated only when the granulocyte count is at least 1,000/mm3.
3.6. How to use Pataxel When preparing the drug Pataxel should wear gloves and proceed with caution to avoid contact with the skin and mucous membranes, if in contact, wash the skin thoroughly with soap and water. If mucous membranes come into contact with Pataxel, rinse thoroughly with water. The preparation of the drug Pataxel must ensure sterility. The diluent for Pataxel may be: 0.9% sodium chloride solution, 5% glucose solution, a mixture of 0.9% sodium chloride solution and 5% glucose, or a 5% glucose solution and ringer mixture. . The drug is mixed into one of the above solutions so that the infusion solution has an active concentration of paclitaxel 0.3 - 1.2 mg/ml. Use only glass, polypropylene, or polyolefin infusion bottles. The transmission line must be made of polyethylene. Administer the infusion immediately or within 3 hours after reconstitution, do not refrigerate the reconstituted infusion. During the preparation process, Pataxel infusion solution may become slightly cloudy due to the solvent of the preparation, even if filtered, it is not clear.
4. Contraindications to the use of Pataxel
Contraindicated to use Pataxel in the following cases:
Do not use Pataxel in patients with hypersensitivity to Paclitaxel or to any of its components, especially hypersensitivity to Cremophor EL oil; Do not use Pataxel in patients with neutrophil counts < 1500/mm3 or with obvious motor neuron disease. Pregnancy/breastfeeding. Children under 18.
5. Side effects of the drug Pataxel
Side effects of the drug Pataxel may occur during use as follows:
Myelosuppression; Lower blood pressure; Increase liver enzymes ; Musculoskeletal pain; Digestive disorders; Hair loss; Peripheral neuropathy.
6. Be careful when using Pataxel
Be careful when using Pataxel in the following cases:
It is necessary to reduce the dose of Pataxel in patients with disorders or impaired liver function. Paclitaxel is not recommended in cases of 10-fold increase in transaminase or bilirubin > 7.5 mg/100 ml, or 5-fold increase in upper limit of normal. Use caution in patients with heart disease; In the drug preparation Pataxel, there is cremophor EL as the excipient, which is more likely to cause an adverse reaction; Pataxel should be used with caution in patients with a history of peripheral neuropathy; When multidrug infusion, taxane derivatives (paclitaxel, docetaxel) should be given before platinum derivatives to reduce the risk of myelosuppression. The elderly are at increased risk of toxicity when taking Pataxel (neuropathy, agranulocytosis). Pataxel is prepared as a concentrated solution for intravenous infusion and is indicated for the treatment of a number of cancer diseases. To ensure effective treatment and avoid unwanted side effects, patients need to strictly follow the instructions of the doctor and medical staff.
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