Introduction
Docexan is an anti-cancer medication used for the treatment of breast cancer, non-small cell lung cancer, prostate cancer and cancers of head and neck.
It is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
Infection and decrease blood cell count are some common side effects of this medicine. It may also cause serious side effects such as swelling of hands, lips, hair loss, and weight gain. To reduce these side effects your doctor may suggest some medication along with it. But, inform your doctor if you notice unexplained bruising or bleeding, sore throat, mouth ulcers, high temperature (fever). This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells and liver function. Your doctor may get regular blood tests done to monitor your blood cells and liver function during treatment with this medicine.
Before taking it, tell your doctor if you have heart disease, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Docexan
- Breast cancer
- Non-small cell lung cancer
- Prostate cancer
- Cancer of head and neck
Side effects of Docexan
Common
- Breathlessness
- Constipation
- Edema (swelling)
- Infection
- Loss of appetite
- Muscle pain
- Nail disorder
- Pain
- Weakness
How to use Docexan
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Docexan works
Docexan is an anticancer medication. It works by interfering with the microtubule structures which help the cancer cells to divide and multiply. This slows the growth of cancer cells and eventually kills them.
Indication
Breast cancer, Lung cancer, Prostate cancer, Stomach cancer, Head/neck cancer
Administration
IV Preparation
Dual vial formulation
Requires 2-step dilution
Reconstitute vial contents (20 mg/0.5 mL or 80 mg/2 mL) with supplied diluent (13% (w/w) ethanol/water) to obtain a 10 mg/mL solution
Further dilute with NS or D5W to a final concentration of 0.3-0.74 mg/mL and prepare in a glass bottle, polypropylene, or polyolefin plastic bag to prevent leaching of plasticizers
Use within 4 hr (including the 1 hr infusion)
Single vial formulation
Requires 1-step dilution
Available as 20 mg/mL solution; further dilute with NS or D5W to a final concentration of 0.3-0.74 mg/mL and prepare in a glass bottle, polypropylene, or polyolefin plastic bag to prevent leaching of plasticizers
Use within 4 hr (including the 1 hr infusion)
IV Administration
Anaphylactoid-like reactions have been reported: premedicate with dexamethasone (Breast CA, NSCLC: 8 mg PO q12hr for 3 days starting 1 day prior to administration of docetaxel; Prostate CA: 8 mg PO at 12 hr-, 3 hr- and 1 hr preinfusion)
Infuse over 1 hr
When administered as sequential infusions, taxane derivatives should be administered before platinum derivatives (cisplatin, carboplatin) to limit myelosuppression and to enhance efficacy
Adult Dose
Intravenous
Breast cancer
Adult: 60-100 mg/m2 by infusion over 1 hr once every 3 wk. In combination w/ doxorubicin or capecitabine or as adjuvant therapy w/ doxorubicin and cyclophosphamide: 75 mg/m2 once every 3 wk.
In combination w/ trastuzumab: 100 mg/m2 once every 3 wk.
Hepatic impairment: Mild to moderate: Reduce dose from 100 mg/m2 to 75 mg/m2. Severe: Avoid use.
Intravenous
Head and neck cancer; Prostate cancer ; Non-small cell lung cancer; Gastric adenocarcinoma
Adult: 75 mg/m2 by infusion over 1 hr once every 3 wk.
For gastric adenocarcinoma: Dose is given before cisplatin and fluorouracil.
For head and neck cancer: Given before cisplatin and fluorouracil for 3 cycles followed by chemoradiotherapy or 4 wk followed by radiotherapy alone.
For prostate cancer: May be given w/ oral prednisolone 5 mg bid continuously during treatment.
Renal Dose
Renal Impairment
Dose adjustment not necessary
Contraindication
Previous severe hypersensitivity reaction to docetaxel, the solvent or polysorbate 80. Severe neutropenia; pregnancy, severe liver impairment.
Mode of Action
Docetaxel disrupts the microtubular network in cells that is essential for vital mitotic and interphase cellular functions. It binds to the free tubulin and promotes the assembly of tubulin into stable microtubules while simultaneously inhibiting their disassembly, resulting in inhibition of mitosis.
Precaution
Lactation. Hepatic impairment. Monitor liver blood function and blood counts regularly. Premedication with oral dexamethsaone at 16 mg daily for 3 days, starting one day before docetaxel treatment is recommended.
Lactation: Not known if excreted in breast milk, do not nurse
Side Effect
>50%
Alopecia,Anemia,Leukopenia,Neutropenia,Asthenia
10-50%
Fever,Infections,Fluid retention,Hypersensitivity,Skin reactions,Diarrhea,Nausea,Vomiting,Sensory neuropathy,Myalgia,Nail changes
1-10%
Arthralgia,Thrombocytopenia
Potentially Fatal: Neutropenia; fluid retention syndrome; anaemia.
Pregnancy Category Note
Pregnancy
Based on findings in animal reproduction studies and its mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; limited available human data are not sufficient to inform drug-associated risk during pregnancy
Verify the pregnancy status of females of reproductive potential prior to initiating therapy
Contraception
Females of reproductive potential: Use effective contraception during treatment and for 6 months following last dose
Males with female partners of reproductive potential: Use effective contraception during treatment and for 3 months following last dose
Infertility
Based on findings in animal studies, therapy may impair fertility in males of reproductive potential
Lactation
There is no information regarding presence of docetaxel in human milk, or effects on milk production or the breast-fed child; no lactation studies in animals have been conducted; because of potential for serious adverse reactions in a breast-fed child from docetaxel exposure, including toxic death, hepatotoxicity, neutropenia, and acute myeloid leukemia, advise women not to breastfeed during treatment and for 2 weeks after last dose
Interaction
CYP3A4 inducers, inhibitors, or substrates may alter docetaxel metabolism.