Important Facts About Taxol

Taxol (paclitaxel) is one of the most commonly used and effective chemotherapy drugs for breast cancer. It's among several medications in a class called taxanes, and is used for several other forms of cancer as well.

If you or someone you know is prescribed Taxol (another brand name is Onxal), here are some important things to know about this powerful drug.

Taxol is an especially versatile drug. It is used for breast cancer in the early stages as well as for metastatic breast cancer; typically, it is given after combination anthracycline and Cytoxan therapy. It's also used prior to surgery in cases when it is necessary to shrink a tumor before it's removed.

Besides breast cancer, Taxol can be used to treat several other types of cancer, including ovarian cancer, lung cancer, and Kaposi’s sarcoma, a rare type of skin cancer that affects people with AIDS.

To understand how Taxol works, it helps to understand that tumor cells grow by a process called mitosis—the medical name for cell division. Taxol is a mitotic inhibitor: It targets rapidly growing cancer cells by getting inside them and attaching to the scaffold-like structure of the cells called microtubules. In this way, the drug prevents cancer cells from dividing.

Taxol is a clear, colorless fluid that's mixed with Cremophor EL (polyoxyethylated castor oil) and given by infusion—in other words, it's administered directly into a vein, meaning you'll have to go to a hospital or clinic to receive it. It's also thick and sticky, so a pump is necessary to properly infuse it. It can be given as high-dose chemo, once every two or three weeks, or in low doses once a week. In some cases, Taxol is given slowly over the course of 24 hours.

The amount of Taxol you're prescribed depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. A doctor or nurse must administer Taxol; if not administered properly, it can cause tissue damage.

You will be monitored regularly while you are taking Taxol to assess your response to therapy. Periodic blood work to monitor your complete blood count (CBC), as well as the function of other organs (such as your kidneys and liver), will also be ordered by your doctor.  

Most people tolerate Taxol well, especially in low doses. It does have side effects, however, which include:

• Peripheral neuropathy 
• Anemia 
• Neutropenia 
• Bone and muscle aches
• Hair loss
• Fatigue
• Nausea
• Vomiting
• Mild diarrhea
• Mucositis (irritation of mucous membrane inside the mouth)
• Amenhorrea
• Brittle or yellowed nails​

There are ways to prevent some of the problems these side effects can cause. Before you begin treatment with Taxol, your doctor will probably have you take supplements of an amino acid called L-Glutamine to prevent neuropathy; you also may have injections of either Neupogen (filgrastim) or Neulasta (pegfilgrastim) to boost white blood cell counts.

You'll be advised not to drink alcohol while you're being treated with Taxol, and to avoid medications that include aspirin.

Taxol is a pregnancy category D drug—meaning it can harm a developing fetus—so you'll have to use birth control if you're sexually active. Taxol can be passed through breast milk, so you will not be able to breastfeed if you already have a baby. It also is associated with future infertility; talk to your doctor before beginning therapy with Taxol if you plan to become pregnant.

Since chemotherapy drugs compromise the immune system, vaccines are not recommended while you are undergoing Taxol treatment.

Some people may have an allergic reaction to Taxol or to Cremophor EL.

A Word From Verywell

As with any form of chemotherapy, Taxol can take a toll on your energy. Try to eat healthily, exercise when you can, and get adequate rest during treatment.

You will also be susceptible to infections while on Taxol and they can often become very serious, even life-threatening. Call your doctor immediately if you develop a fever, chills, pain, or notice redness or swelling at the infusion site.