Paclitaxel

CLINICAL USE

Ovarian and breast cancer Non-small cell lung carcinoma AIDS-related Kaposi’s sarcoma

DOSE IN NORMAL RENAL FUNCTION

100–220 mg/m2 every 3 weeks depending on local regime and duration of infusion

PHARMACOKINETICS

Molecular weight :853.9

%Protein binding :89–98

%Excreted unchanged in urine : 1.3–12.6

Volume of distribution (L/kg) :198–688 litres/m2

half-life – normal/ESRD (hrs) :3–52.7

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntidiabetics: metabolism of rosiglitazone possibly inhibited

Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)

ADMINISTRATION

Reconstition

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Route

Rate of Administration

3 hours depending on regime

Comments

Dilute to a concentration of 0.3–1.2 mg/ mL with sodium chloride 0.9% or glucose 5%Stable for 27 hours at room temperature

OTHER INFORMATION

Administer through a 0.22µm in line filter Use non-PVC infusion bags Hepatic metabolism and biliary clearance are the principal mechanisms for disposal. Mean values for cumulative urinary recovery of unchanged drug ranged from 1.3 to 12.6% of the dose, indicating extensive non-renal clearance.

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