Taxol Drug Interactions

Combination Therapy with Cisplatin: In combination therapy with cisplatin, Taxol should always be administered before cisplatin. In this case, the safety event profile of Taxol is similar to that reported in Taxol monotherapy.
Administration of Taxol after cisplatin treatment leads to about 20% decrease in paclitaxel clearance and greater myelosuppression.
Combination Therapy with Doxorubicin/Cyclophosphamide: In the sequential administration of four cycles of doxorubicin/cyclophosphamide followed by four cycles of Taxol for the adjuvant treatment of breast cancer, Taxol should always be administered after doxorubicin/cyclophosphamide. More pronounced neutropenia and stomatitis (due to doxorubicin) have been observed when Taxol was administered before doxorubicin/cyclophosphamide and beyond the recommended treatment duration.
Co-Medication with Substances that Influence CYP2C8 and 3A4: The metabolism of paclitaxel is catalyzed to a certain extent by the cytochrome P450 isoenzymes CYP2C8 and 3A4 (see also Pharmacology: Pharmacokinetics under Actions).
Therefore, caution is required when paclitaxel is used together with other drugs that inhibit either CYP2C8 or CYP3A4 (e.g. ketoconazole and other imidazole antimycotics, erythromycin, fluoxetine, gemfibrozil, clopidogrel, cimetidine, ritonavir, saquinavir, indinavir and nelfinavir) or induce them (e.g. rifampicin, carbamazepine, phenytoin, efavirenz, nevirapine).