Paclitaxel

Paclitaxel is a type of chemotherapy. You pronounce it as pac-lih-tax-ul.

It is a treatment for a number of different cancer types.

How does paclitaxel work?

Paclitaxel works by stopping cancer cells from separating into two new cells. This blocks the growth of the cancer.

Find out more about how chemotherapy works

How do you have paclitaxel?

You have paclitaxel as a drip into your bloodstream (intravenously).

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line

• PICC line

• portacath

Find out more about central lines, PICCs and portacaths

If you don't have a central line

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.

Risk of tissue damage

When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.

Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.

How often do you have paclitaxel?

You have paclitaxel as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover.

You might have paclitaxel weekly or every 2 or 3 weeks. You might have it on its own or with other chemotherapy drugs.

You usually have it as a course of several cycles of treatment. Each cycle varies depending on what type of cancer you have. Your doctor or nurse will tell you more about this.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of paclitaxel?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.

Allergic reaction

You might have a mild allergic reaction during or shortly after treatment. This can cause symptoms such as itching, a rash or a red face. Your nurse gives you medicine just before having the chemotherapy to reduce the risk of an allergic reaction. But still tell them if you get any of these symptoms. 

Less often you may develop a severe allergic reaction. Symptoms include breathlessness, swelling of your face and lips, and dizziness. Let your nurse know straight away if you have any of these symptoms or feel unwell. Your nurse will keep a close eye on you and give you treatment for this straight away if it happens.

Numbness and tingling in hands and feet

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

This can continue for a long time after treatment finishes, and may be permanent. 

Low blood pressure (hypotension)

Tell your doctor or nurse if you feel lightheaded or dizzy. You have your blood pressure checked regularly.

Diarrhoea

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a ​stoma​ , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Sore mouth

Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before. 

Some people may have permanent hair loss although this is very rare.

Muscle and joint pain

You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Less commonly you may get cramps in your legs.

Urinary tract infections (UTIs)

Tell your doctor or nurse if you think you might have a urinary tract infection. You might find it difficult to pass urine, want to go with some urgency or are going more often. There may be pain or burning when you go. You may see blood in your urine, or your urine might smell bad or look cloudy.

Tummy (abdominal pain)

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Feeling very sleepy

You might feel very tired or find you are falling asleep during the day. Do not drive or operate machinery. Let your doctor know straight away. 

Tiredness and weakness (fatigue)

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Fluid build up (oedema)

You may have swelling of your hands and legs due to a build up of fluid (oedema).

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• depression

• problems sleeping (insomnia)

• an unusual way of walking and slower, reduced movement

• taste changes

• slower or faster heart rate

• changes to the way you think

• fainting

• indigestion

• bleeding in your stomach which can cause black, tarry poo

• nail and skin changes - these are usually mild and return to normal after treatment is finished

• inflammation around the drip site - tell your nurse straight away if you notice any redness, swelling or leaking at your drip site

• changes to the way the liver works – you will have regular blood tests to check your liver

• flu like symptoms - can include fever, chills, headache, muscle or body aches, cough, sore throat, runny nose and feeling tired

• chest pain

Rare side effects

These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:

• sepsis - a serious reaction to an infection. Signs can include feeling very unwell, not passing urine, a very high or very low temperature, shivering, slurred speech or confusion, breathlessness, mottled or discoloured skin, extreme shivering or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these

• weight gain or weight loss

• dry eyes or vision problems

• changes to the heart including heart attack and fast beating heart rate

• inflammation of the blood vessels

• high blood pressure

• blood clots that can be life threatening; signs are pain, swelling and redness where the clot is - feeling breathless can be a sign of a blood clot on the lung

• changes to the lung tissue that can cause cough and breathlessness - rarely this can be life threatening

• inflammation of your bowel (colitis) or a blocked bowel

• inflammation of the pancreas (pancreatitis)

Contact your advice line or doctor straight away if you have any symptoms of these side effects.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

Read more about how to cope with side effects

What else do you need to know?

Other medicines, food and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Pregnancy and contraception

This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for at least 6 months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment. 

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.

Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.

You can usually have:

• other vaccines, but they might not give you as much protection as usual

• the flu vaccine (as an injection)

• the coronavirus (COVID-19) vaccine

Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your ​immune system​ is weakened.

Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.

Read more about immunisations and cancer treatment

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

eMC website

You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.

Report a side effect to the MHRA