Precautions and Warnings With Paclitaxel

Prior to starting a new medication, it is important to review the drug's precautions and warnings. With paclitaxel, these include being aware of certain drug interactions and watching for potential side effects, such as irregular heart rhythm, nerve problems, and anemia. Precautions and warnings with paclitaxel also extend to those who are allergic to any components of the medicine or who have a low neutrophil count before starting treatment.

Paclitaxel: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking paclitaxel (Taxol®) if you have:
  • A history of low levels of white blood cells
  • Any infection
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all medicines you may be currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Paclitaxel

Warnings and precautions to be aware of prior to taking paclitaxel include the following:
  • The medication can decrease the bone marrow's ability to produce blood cells. This can result in anemia and other serious conditions. Because your immune system depends on certain blood cells, you may be more susceptible to infections while taking paclitaxel (see Chemotherapy and Infections). You may also be at a higher risk for bleeding (see Blood Clotting Problems and Chemotherapy). You will need regular blood tests to make sure that your blood counts are not too low.
  • Paclitaxel can cause life-threatening allergic reactions. Everyone taking the drug should be "premedicated" with certain medications before each paclitaxel dose in order to prevent allergic reactions.
  • The medication can cause an irregular heart rhythm (arrhythmia). If you develop a severe arrhythmia during a paclitaxel infusion, your heart rhythm should be monitored carefully (using a heart monitor) during any future doses.
  • Some people develop a slow heart rate (bradycardia), low blood pressure (hypotension), or high blood pressure (hypertension) during their paclitaxel infusions. Your heart rate and blood pressure should be monitored frequently during your infusion.
  • Paclitaxel can cause nerve problems, including nerve pain, weakness, or unusual sensations of burning or tingling (see Nerve and Muscle Problems During Chemotherapy).
  • If you have liver disease, you may need a lower paclitaxel dosage.
  • Paclitaxel can interact with other medications (see Drug Interactions With Paclitaxel).
  • Paclitaxel is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of taking the drug when pregnant (see Taxol and Pregnancy).
  • It is not known if paclitaxel passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Taxol and Breastfeeding).
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