Paclitaxel (Taxol) | OncoLink Cancer Resources

Side effects of paclitaxel

Some of the possible side effects and suggestions for dealing with them include:

Allergic Reactions

Allergic reactions are very common with paclitaxel, although it is not clear what causes them. The use of certain medications prior to the infusion decreases the risk of a reaction greatly. Signs of a reaction can include: shortness of breath or difficulty breathing, chest pain, rash, flushing or itching or a decrease in blood pressure. If you notice any changes in how you feel during the infusion, let your nurse know immediately. The infusion will be stopped if this occurs. Depending on the severity of your reaction, you may still be able to receive paclitaxel with additional pre-medication.

Low White Blood Cell Count (leukopenia or neutropenia)

White blood cells are important for fighting infection. While receiving treatment, you are at a higher risk of getting infections. You should wash your hands frequently and avoid large crowds or people who are sick (i.e.: those who have a cold, fever or cough) or large crowds. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4 ° ), sore throat or cold, shortness of breath, cough, or a sore that doesn't heal. Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.

Low Platelet Count (thrombocytopenia)

Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. You should avoid using a razor (you can use an electric razor with caution); playing contact sports, or taking aspirin or ibuprofen products (these can also increase the risk of bleeding). Let your doctor or nurse know if you have any bleeding, including nose bleeds or bleeding gums. If the count becomes too low, you may receive a transfusion of platelets.

Low Red Blood Cell Count (Anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing or pain in your chest. If the count gets too low, you may receive a blood transfusion.

Loss or thinning of scalp and body hair ( alopecia )

Your hair may become thin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun.

Mouth ulcers (sores)

Notify your doctor or nurse if your mouth, tongue, or inside of your cheek becomes white, ulcerated, or painful. Brush with a soft-bristle toothbrush or cotton swab twice a day. Avoid mouthwashes that contain alcohol. A baking soda and/or salt warm water mouth rinse (2 level teaspoons of baking soda or 1 level teaspoon salt in an eight ounce glass of warm water) is recommended 4 times daily. If your mouth becomes dry, eat moist foods, drink plenty of fluids (at least 6-8 glasses), and suck on sugarless hard candy. Avoid drinking alcoholic beverages and citrus juices, smoking, and chewing tobacco. If mouth sores become painful, your doctor or nurse can recommend a pain reliever.

Peripheral Neuropathy

Peripheral neuropathy is a toxicity that affects the nerves. It causes a numbness or tingling feeling in the hands and feet, often in the pattern of a stocking or glove. This can get progressively worse with additional doses of the drug. In some people, the symptoms slowly resolve after the drug is stopped, but for some it never goes away completely. You should let your healthcare provider know if you experience numbness or tingling in the hands and feet, as they may need to change the doses of your medication. See OncoLink's section on peripheral neuropathy for tips on dealing with this side effect.

Diarrhea

Your doctor or nurse can recommend medication to relieve diarrhea. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Avoid raw fruits, vegetables, whole grain breads and cereals, and seeds. Soluble fiber is a type of fiber found in some foods. Soluble fiber absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber include: applesauce, bananas (ripe), canned fruit, orange and grapefruit sections, boiled potatoes, white rice and products made with white flour, oatmeal, cream of rice, cream of wheat and farina. Drink 8-10 glasses of non-alcoholic fluid a day to prevent dehydration.

Nausea and/or Vomiting

Nausea and vomiting is not too common with paclitaxel. If you do experience nausea or vomiting, there are many effective drugs that will prevent, eliminate, or lessen the severity of it if you need them, so just ask your doctor which is best for you. In addition, dietary adjustments may help. Avoid things that worsen the symptoms, such as heavy or greasy foods. Try antacids, like milk of magnesia and calcium tablets (like Tums), saltines, or ginger ale to lessen symptoms.

Fatigue

See OncoLink's section on fatigue for helpful tips on dealing with this side effect.

Sexual and reproductive changes

The menstrual cycle or sperm production may become irregular or stop permanently. Women may experience menopausal effects including hot flashes and vaginal dryness. The desire for sex may decrease during treatment. You should not have sexual intercourse when your white blood cell or platelet count is low.

Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. You may want to consider sperm banking or egg harvesting if you may wish to have a child in the future. See OncoLink's section on sexuality & fertility for helpful tips for dealing with these side effects.

Other side effects

Some patients will develop muscle and joint aches after a paclitaxel infusion, which can last for a few days. Ask your doctor or nurse what you can take to relieve this discomfort.

Paclitaxel can damage your nails, resulting in markings on the nails, thinning or brittleness of the nails or loss of a nail. Keep your nails clean and trimmed. You should not wear fake fingernails as these can increase the risk of infection.

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