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Care During Chemotherapy and Beyond

Paclitaxel Protein-Bound

(pac li TAKS el PROE teen bownd)

Trade name(s): Abraxane®

Other name(s): Paclitaxel albumin-bound

Paclitaxel (protein bound) is the generic name for the trade name drug Abraxane®. In some cases, health care professionals may use the trade name Abraxane® when referring to the generic drug name paclitaxel (protein bound).

Drug Type: Paclitaxel (protein bound) is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "plant alkaloid," a "taxane" and an "antimircotubule agent." (For more details, see "How Paclitaxel (protein bound) Works" section below)

What Paclitaxel (Protein Bound) Is Used For

  • Metastatic breast cancer
  • Non-small cell lung cancer
  • Pancreas cancer
  • Ovarian cancer
  • Cancer of the fallopian tubes
  • Primary peritoneal cancer

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Paclitaxel (Protein Bound) Is Given

  • Paclitaxel (protein bound) is administered into a vein by intravenous (IV) injection through a central line or a peripheral venous line. There is no pill form of paclitaxel.
  • Paclitaxel (protein bound) is generally given over 30 minutes.
  • Paclitaxel (protein bound) is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given. If the medication escapes from the vein it can cause tissue damage. The nurse or doctor who gives paclitaxel (protein bound) must be carefully trained. If you experience pain or notice redness or swelling at the IV site while you are receiving paclitaxel (protein bound), alert your health care professional immediately.

The amount of paclitaxel (protein bound) that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of paclitaxel (protein bound):

  • Most people will not experience all of the side effects listed.
  • Paclitaxel's (protein bound) side effects are often predictable in terms of their onset, duration, and severity.
  • Paclitaxel's (protein bound) side effects will improve after therapy is complete.
  • Paclitaxel's (protein bound) side effects may be quite manageable. There are many options to minimize or prevent the side effects of paclitaxel (protein bound).

The following side effects are common (occurring in greater than 30%) for patients taking paclitaxel (protein bound).

  • Low blood counts (your white and red blood cells may temporarily decrease which can put you at increased risk for infection and/or anemia)
  • Hair loss
  • Peripheral neuropathy (numbness and tingling of hands and feet)
  • Abnormal ECG (electrocardiogram) - we may monitor your heart by ECG, a harmless and painless test which detects the electrical activity of the heart. An abnormal ECG may show an abnormal heart rate, rhythm, or heart function)
  • Nausea and Vomiting
  • Weakness and fatigue
  • Diarrhea
  • Decreased appetite
  • Arthralgias and myalgias - pain in the joints and muscles (usually temporary occurring 2-3 days after paclitaxel (protein bound). Generally resolves within a few days.
  • Edema (swelling of feet, ankles, or hands)
  • Fever
  • Increases in blood tests measuring liver function (these return to normal once treatment is discontinued)

These are less common side effects (occurring in 10-29%) for patients receiving paclitaxel (protein bound):

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • If you notice any redness or pain at the site of injection.
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24-hour period).
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools.
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities).
  • Mouth sores (painful redness, swelling or ulcers).
  • Numbness and tingling of the hands and feet.

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting paclitaxel (protein bound) treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medicine. Paclitaxel (protein bound) blood concentrations may be increased when taking with grapefruit or grapefruit juice.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking paclitaxel (protein bound).
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (paclitaxel [protein bound] may be hazardous to the fetus). Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking paclitaxel (protein bound). Barrier methods of contraception, such as condoms, are recommended.
  • Do not breast feed while taking paclitaxel (protein bound).

Self-Care Tips

  • Paclitaxel (protein bound), or the medications that you take with paclitaxel (protein bound) may cause you to feel dizzy or drowsy. Do not operate any heavy machinery until you know how to respond to paclitaxel (protein bound).
  • If you notice any redness or pain at the injection site, place a warm compress, and notify your healthcare provider.
  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Acetaminophen or ibuprofen may help relieve discomfort from headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Paclitaxel (Protein Bound)

You will be checked regularly by your doctor while you are taking paclitaxel (protein bound), to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How Paclitaxel (Protein Bound) Works

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissu. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Paclitaxel (protein bound) belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. Paclitaxel belongs to a group of plant alkaloids known as taxanes, along with paclitaxel. Paclitaxel (protein bound) differs from paclitaxel by the addition of a large protein (human albumin) which changes the way it moves through cells. Taxanes are made from the bark of the Pacific Yew tree (taxus). The plant alkaloids are cell-cycle specific. This means they attack the cells during particular phases of division. They are also known as antimicrotubule agents due to the mechanism in which they work in cells.

Antimicrotubule agents (such as paclitaxel), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

References:

  • Abraxane® (paclitaxel protein bound) [package insert on the internet]. Summit, NJ: Celgene Corporation; [Updated July 2015]. Accessed October 2016. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021660s037lbl.pdf
  • Paclitaxel (protein bound). Lexicomp Online® [Updated September 1, 2016]. Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc.; Accessed October 2016.

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