1st-line & subsequent therapy for advanced carcinoma of the ovary. As 1st-line therapy in combination w/ cisplatin. Treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse w/in 6 mth of adjuvant therapy. Prior therapy should have included an anthracycline unless clinically contraindicated.
Dosage/Direction for Use
175 mg/m2 IV over 3-hr every 3 wk. Patients must be premedicated w/ either of the following: Dexamethasone 20 mg orally approx 12 & 6 hr prior initiation, or diphenhydramine 50 mg IV 30-60 min prior initiation, or cimetidine 300 mg or ranitidine 50 mg IV 30-60 min before administration.
Contraindications
Hypersensitivity to paclitaxel or other drugs formulated in polyoxyl 35 castor oil; patients w/ baseline neutrophil count <1,500 cells/mm3 or AIDS related to Kaposi's sarcoma w/ baseline neutrophil count <1,000 cells/mm3.
Special Precautions
Myelotoxicity; bone marrow suppression; monitor peripheral blood cell counts; hypersensitivity reactions eg, flushing, skin reactions, dyspnea, hypotension, tachycardia; discontinue in case of dyspnea requiring bronchodilators, hypotension requiring treatment, angioedema, generalized urticaria; bradycardia; monitor vital signs frequently. Conduction abnormalities; peripheral neuropathy; moderate to severe hepatic impairment; toxicity is enhanced in patients w/ elevated liver enzymes. Pregnancy.
Adverse Reactions
Bone marrow suppression; hypersensitivity reactions, hypotension, bradycardia; peripheral neuropathy, alopecia, GI effects, significant elevations (5 x normal values) in AST, alkaline phosphatase & bilirubin.
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