docetaxel

CLINICAL USE

Antineoplastic agent:Treatment of breast cancer, prostate cancer and non-small cell lung cancer unresponsive to alternative therapies

DOSE IN NORMAL RENAL FUNCTION

Breast cancer: 100 mg/m 2 every 3 weeksIn combination for breast cancer, non- small cell lung cancer, prostate cancer: 75 mg/m2 every 3 weeks

PHARMACOKINETICS

Molecular weight :807.9

%Protein binding :>95

%Excreted unchanged in urine : 6

Volume of distribution (L/kg) :113 litres

half-life – normal/ESRD (hrs) :4 min(α)/36 min(β)/11.1 hr(γ)

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

HDF/high flux :Unlikely to be dialysed. Dose as in normal renal function

CAV/VVHD :Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntipsychotics: avoid concomitant use with clozapine – increased risk of agranulocytosisCiclosporin: possibly inhibits metabolism of ciclosporin

ADMINISTRATION

Reconstition

With diluent provided

Route

Rate of Administration

Over 1 hour

Comments

Allow vials to come to room temperature for 5 minutesDoses of up to 200 mg can be added to 250 mL infusion bags of glucose 5% or sodium chloride 0.9%Doses greater than 200 mg should be diluted to a concentration of 0.74 mg/mLAdminister within 4 hours of dilution

OTHER INFORMATION

Give premedication with oral dexamethasone 16 mg daily for 3 days, starting 1 day before commencing chemotherapyCytochrome P–450 mediated metabolism. In animal studies, drug distributed to all tissues and organs except the brain. 6% and 75% of the dose is excreted via the renal and faecal route respectively within 7 days

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