Taxol Dosage/Direction for Use

Taxol shall only be handled by medical personnel experienced in the use of cytostatic chemotherapy. Furthermore, appropriate equipment must be available to treat possibly occurring complications.
Usual Dosage: Premedication: Prior to Taxol treatment, premedication with a corticosteroid, a H₁ and a H₂ antagonist is required (e.g. according to the following dosage regimen): See Table 1.

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Primary treatment of advanced ovarian carcinomas: The recommended dose of Taxol is 175 mg/m² body surface, administered as intravenous infusion over 3 hours, followed by cisplatin 75 mg/m². If a 24-hour infusion is selected, the dose of Taxol is 135 mg/m², followed by 75 mg/m² of cisplatin. A 3-week interval should be respected between treatment courses.
Taxol should always be administered prior to cisplatin. Also refer to Interactions. For cisplatin, refer to its product information.
Secondary treatment of metastatic ovarian carcinoma resistant to standard therapy: The recommended dose of Taxol is 175 mg/m² body surface, administered as intravenous infusion over 3 hours, with a 3-week interval between treatment courses.
Treatment of non-small cell lung carcinoma: The recommended dose of Taxol is 175 mg/m² body surface area, administered as intravenous infusion over 3 hours. The Taxol infusion is followed by a treatment with cisplatin (in the EORTC study 08925, 80 mg/m² cisplatin in combination with Taxol). A 3-week interval should be respected between treatment courses. Therapy should be limited to 6 courses.
Taxol should always be administered prior to cisplatin. Also refer to Interactions. For cisplatin, refer to its product information.
First-line therapy of metastatic breast carcinoma in combination with trastuzumab: The recommended dose of Taxol is 175 mg/m² body surface, administered as intravenous infusion over 3 hours. A 3-week interval should be respected between treatment courses. Taxol infusion is initiated the day following the first trastuzumab dose or immediately following the 2^nd trastuzumab dose if the initial trastuzumab dose was well tolerated. For trastuzumab, refer to its product information.
Secondary treatment of metastatic breast carcinoma resistant to standard therapy: The recommended dose of Taxol is 175 mg/m² body surface, administered as intravenous infusion over 3 hours, with a 3-week interval between treatment courses.
Adjuvant treatment in patients with breast carcinoma: Following administration of 4 courses of doxorubicin 60 mg/m² in combination with cyclophosphamide 600 mg/m², additional 4 courses of Taxol 175 mg/m² by 3-hr infusion are administered. An interval of 3 weeks should be respected between treatment courses.
The 4 Taxol courses must always be applied after the 4 doxorubicin/cyclophosphamide courses. Also refer to Interactions. For doxorubicin and cyclophosphamide, refer to their product information.
Dosage for the Treatment of Undesirable Effects: A treatment course with Taxol should not be considered before the neutrophil count is at least 1,500/mm³ and the platelet count at least 100,000/mm³.
In patients who, on Taxol treatment, develop severe neutropenia (neutrophil granulocytes <500/mm³) or severe peripheral neuropathy, dose reduction by 20% should be effected for the treatment courses.
Special Populations: Impaired liver function: Risk of toxicity is increased in case of mildly impaired liver function (in particular myelosuppression grade III-IV). Dose adjustment as shown in the following table is recommended in case of impaired liver function and patients should be carefully monitored for the development of profound myelosuppression. (See Table 2.)

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Pediatric use: The safety and effectiveness of Taxol in pediatric patients has not been established.