docetaxel (Rx)

Brand and Other Names:Taxotere
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 10mg/mL (2mL, 8mL, 16mL vials)
  • 20mg/mL (1mL, 4mL vials)

alcohol-free solution for injection

  • 20mg/mL
  • 80mg/4mL
  • 160mg/8mL

Breast Cancer

Locally advanced or metastatic

  • For locally advanced or metastatic breast cancer after failure of prior chemotherapy
  • Monotherapy: 60-100 mg/m² IV over 1 hr q3Weeks  

Operable node-positive

  • Adjuvant combination therapy: 75 mg/m² IV 1 hr after doxorubicin and cyclophosphamide q3Weeks x 6 cycles

Dosage modifications (advanced or metastatic)

  • Inital 100 mg/m²
  • Febrile neutropenia, ANC <500/mm³ for ≥1 week, or severe/cumulative cutaneous reactions
  • Reduce first to 75 mg/m²
  • If AEs persist: Reduce further to 55 mg/m² or discontinue

Dosage modifications (adjuvant treatment)

  • Initial: 75 mg/m²
  • Reduce to 60 mg/m² in patients with febrile neutropenia treated with G-CSF, or severe or cumulative cutaneous or neurosensory reactions

Other dosage modifications

  • Grade 3 peripheral neuropathy: Discontinue
  • Combo therapy (with doxorubicin and cyclophosphamide): Febrile neutropenia (give G-CSF in all, if continues, reduce to 60 mg/m², continue G-CSF)
  • Grade 3/4 Stomatitis: Decrease to 60 mg/m²
  • Severe/cumulative cutaneous reactions, moderate neurosensory S/S: Reduce to 60 mg/m²
  • Discontinue if adverse effects persists

Non-small Cell Lung Cancer

Indicated for treatment (as monotherapy) in patients with locally advanced or metastatic NSCLC after failure of prior platinum-based chemotherapy

Also indicated in combination with cisplatin for the treatment of unresectable, locally advanced or metastatic NSCLC in patients who have not previously received chemotherapy

75 mg/m2 IV over 1 hr q3Weeks  

Dose Modifications (Monotherapy)

  • Febrile neutropenia, ANC <500/mm3 for ≥1 week, other grade 3/4 nonhematological toxicities, severe/cumulative cutaneous reactions (withhold treatment until resolution; THEN, resume at 55 mg/m2)
  • Grade 3 peripheral neuropathy: Discontinue

Dose Modifications (Combination Therapy)

  • Febrile neutropenia,platelet nadir <25,000 cells/mm3 serious non-hematologic toxicities: Reduce first to 65 mg/m2; may reduce further to 50 mg/m²

Gastric Cancer

Indicated in combination with cisplatin and fluorouracil advanced gastric adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, in patients who have not received prior chemotherapy for advanced disease

Day 1: 75 mg/m2 IV infusion over 1 hour, followed by cisplatin 75 mg/m2 as a 1-3 hr infusion  

Post cisplatin: Fluorouracil 750 mg/m2 qDay given as a 24-hr continuous infusion for 5 days

Repeat cycle q3Weeks

Dose modifications (neutropenia)

  • Febrile neutropenia, prolonged neutropenia or neutropenic infection
  • First time: Use G-CSF
  • If continues despite G-CSF: Reduce to 60 mg/m2
  • If recurs thereafter: Reduce to 45 mg/m2

Grade 4 thrombocytopenia

  • Do not resume until ANC >1500/mm3 and platelets >100,000/mm3
  • Reduce to 60 mg/m2
  • If toxicities persist: Discontinue

Diarrhea

  • Grade 3 (first episode): Reduce fluorouracil dose by 20%
  • Grade 3 (second episode): Then reduce docetaxel dose by 20%
  • Grade 4 (first episode): Reduce docetaxel & fluorouracil doses by 20%
  • Grade 4 (second episode): Discontinue treatment

Hepatotoxicity

  • AST/ALT 2.5-5 times ULN & alkaline phosphatase 2.5 times ULN, OR AST/ALT 1.5-5 times ULN & alkaline phosphatase 2.5-5 times ULN: Reduce by 20%
  • If AST/ALT >5 times upper limit of normal &/or alkaline phosphatase >5 times ULN: Discontinue

Head & Neck Cancer

Indicated in combination with cisplatin and fluorouracil for the induction treatment of patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN)

Induction chemotherapy followed by radiotherapy

  • For the induction treatment of locally advanced inoperable SCCHN
  • Day 1: 75 mg/m2 IV infusion over 1 hour, followed by cisplatin 75 mg/m2 as a 1 hr infusion  
  • Post cisplatin: Fluorouracil 750 mg/m2 qDay given as a 24-hr continuous IV infusion times 5 days
  • Repeat cycle q3Weeks 4 times

Induction chemotherapy followed by chemoradiotherapy

  • For the induction treatment of patients with locally advanced (unresectable, low surgical cure, or organ preservation) SCCHN
  • Day 1: 75 mg/m2 IV infusion over 1 hr, followed by cisplatin 100 mg/m2 as a 0.5-3 hr IV infusion
  • Post cisplatin: Fluorouracil 1000 mg/m2 qDay given as a 24-hr continuous IV infusion from day 1 to day 4
  • Repeat cycle q3Weeks times 3 cycles

Dosage Modifications

  • As with gastric cancer

Prostate Cancer

Indicated for hormone-refractory metastatic prostate cancer in combination with prednisone

75 mg/m2 IV over 1 hr q3Weeks with daily prednisone 5 mg PO q12hr  

Dose Modifications

  • Febrile neutropenia, ANC <500/mm3 for >1 week, or severe/cumulative cutaneous reactions, moderate neurosensory S/S
  • Reduce to 60 mg/m2
  • If AEs persist: Discontinue

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Do not administer if AST/ALT >5x ULN or alkaline phosphatase (AP) >5x ULN

Avoid in patients with bilirubin >ULN and patients with AST and/or ALT >1.5 × ULN concomitant with alkaline phosphatase >2.5 × ULN

Reduce dose by 20% if AST/ALT >2.5-5x ULN and AP ≤2.5x ULN

Reduce dose by 20% if AST/ALT >1.5-5x ULN and AP >2.5-5x ULN

Consider alcohol content of docetaxel when given to patients with hepatic impairment

Safety and efficacy not established

Investigational use for a variety of solid tumors in children is ongoing

Docetaxel has been studied in a total of 289 pediatric patients: 239 in 2 trials with monotherapy and 50 in combination treatment with cisplatin and 5-fluorouracil (see Prescribing Information)

Next:

Interactions

Interaction Checker

and docetaxel

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (21)

              • adenovirus types 4 and 7 live, oral

                docetaxel decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.

              • apalutamide

                apalutamide will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

              • chloramphenicol

                chloramphenicol will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • deferiprone

                deferiprone, docetaxel. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

              • enzalutamide

                enzalutamide will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • erdafitinib

                erdafitinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.

              • fexinidazole

                fexinidazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

              • idelalisib

                idelalisib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

              • influenza virus vaccine quadrivalent, adjuvanted

                docetaxel decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • influenza virus vaccine trivalent, adjuvanted

                docetaxel decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • itraconazole

                itraconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration is unavoidable, consider a 50% docetaxel dose reduction and monitor for increased docetaxel toxicities.

              • lasmiditan

                lasmiditan increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • lonafarnib

                docetaxel will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              • nefazodone

                nefazodone will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • palifermin

                palifermin increases toxicity of docetaxel by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

              • quinidine

                quinidine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

              • selinexor

                selinexor, docetaxel. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • sotorasib

                sotorasib will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.

              • tepotinib

                tepotinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.

              • tucatinib

                tucatinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

              • voxelotor

                voxelotor will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

              Monitor Closely (100)

              • acalabrutinib

                acalabrutinib, docetaxel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

              • amiodarone

                amiodarone will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • atorvastatin

                atorvastatin will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • avapritinib

                docetaxel will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                docetaxel increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • belatacept

                belatacept and docetaxel both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

              • belzutifan

                belzutifan will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

              • berotralstat

                berotralstat will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.

              • bosutinib

                bosutinib increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • carbamazepine

                carbamazepine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cenobamate

                cenobamate will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

              • cholera vaccine

                docetaxel decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.

              • cimetidine

                cimetidine will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • clarithromycin

                clarithromycin will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                clarithromycin will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • clotrimazole

                clotrimazole will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • cobicistat

                cobicistat will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. May consider reducing docetaxel dosing 50% if concomitant administration cannot be avoided

              • crizotinib

                crizotinib increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

                crizotinib increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • cyclosporine

                cyclosporine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • dabrafenib

                dabrafenib will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • dengue vaccine

                docetaxel, dengue vaccine. immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.

              • denosumab

                docetaxel, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

              • diltiazem

                diltiazem will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • dronedarone

                dronedarone will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • duvelisib

                duvelisib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

              • efavirenz

                efavirenz will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • elagolix

                elagolix will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

              • eliglustat

                eliglustat increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

              • encorafenib

                encorafenib, docetaxel. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

              • erythromycin base

                erythromycin base will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                erythromycin base will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                erythromycin ethylsuccinate will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                erythromycin lactobionate will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                erythromycin stearate will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ethotoin

                docetaxel decreases levels of ethotoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                docetaxel decreases levels of ethotoin by increasing metabolism. Use Caution/Monitor.

              • fedratinib

                fedratinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              • felodipine

                felodipine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • finerenone

                docetaxel will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • fingolimod

                docetaxel increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .

              • flibanserin

                docetaxel will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                docetaxel decreases levels of fosphenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                docetaxel decreases levels of fosphenytoin by increasing metabolism. Use Caution/Monitor.

              • fostamatinib

                fostamatinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.

              • glecaprevir/pibrentasvir

                glecaprevir/pibrentasvir will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • hydroxyurea

                docetaxel, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.

              • iloperidone

                iloperidone increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

              • isavuconazonium sulfate

                docetaxel will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • isoniazid

                isoniazid will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • istradefylline

                istradefylline will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

                istradefylline will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.

              • ivacaftor

                ivacaftor increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

              • ivosidenib

                ivosidenib will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ketoconazole

                ketoconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                ketoconazole will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lapatinib

                lapatinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lemborexant

                docetaxel will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • letermovir

                letermovir increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lomitapide

                docetaxel increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

                lomitapide increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.

              • lonafarnib

                lonafarnib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.

              • lopinavir

                lopinavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • loratadine

                loratadine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • lorlatinib

                lorlatinib will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lovastatin

                lovastatin will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • meningococcal group B vaccine

                docetaxel decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.

              • midazolam intranasal

                docetaxel will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

              • mifepristone

                mifepristone will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Closely monitor for docetaxel-related adverse reactions and consider 50% dose reduction of docetaxel if concomitant use of docetaxel with chronic mifepristone necessary; clinical significance of this interaction with short-term use of mifepristone for termination of pregnancy unknown

              • mitotane

                mitotane decreases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

              • nefazodone

                nefazodone will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nicardipine

                nicardipine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nifedipine

                nifedipine will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • nilotinib

                nilotinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ofatumumab SC

                ofatumumab SC, docetaxel. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

              • olaparib

                docetaxel and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.

              • oxaliplatin

                oxaliplatin, docetaxel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression. Administer taxanes derivative before oxaliplatin when given as sequential infusions to limit toxicity. .

              • phenobarbital

                phenobarbital will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • phenytoin

                phenytoin will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

                docetaxel decreases levels of phenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                docetaxel decreases levels of phenytoin by increasing metabolism. Use Caution/Monitor.

              • ponatinib

                ponatinib increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • quercetin

                quercetin will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ranolazine

                ranolazine will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ribociclib

                ribociclib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rifabutin

                rifabutin will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                rifampin will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • ritonavir

                ritonavir will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • rucaparib

                rucaparib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

              • saquinavir

                saquinavir increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .

              • sarecycline

                sarecycline will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.

              • simvastatin

                simvastatin will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • siponimod

                siponimod and docetaxel both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • sipuleucel-T

                docetaxel decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

              • sirolimus

                sirolimus will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • St John's Wort

                St John's Wort will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                St John's Wort will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • stiripentol

                stiripentol, docetaxel. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

                stiripentol will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

              • tacrolimus

                tacrolimus will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • tazemetostat

                tazemetostat will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                docetaxel will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tecovirimat

                tecovirimat will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

              • tinidazole

                docetaxel will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tipranavir

                tipranavir increases levels of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .

              • tolvaptan

                tolvaptan will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • trastuzumab

                trastuzumab, docetaxel. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • trastuzumab deruxtecan

                trastuzumab deruxtecan, docetaxel. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • trazodone

                trazodone will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • tucatinib

                tucatinib will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.

              • vemurafenib

                vemurafenib increases levels of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              • verapamil

                verapamil will increase the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              Minor (55)

              • amobarbital

                amobarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • aprepitant

                aprepitant will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • armodafinil

                armodafinil will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • artemether/lumefantrine

                artemether/lumefantrine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • atazanavir

                atazanavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • bosentan

                bosentan will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butabarbital

                butabarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butalbital

                butalbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • conivaptan

                conivaptan will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • cyclosporine

                cyclosporine will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darifenacin

                darifenacin will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darunavir

                darunavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dasatinib

                dasatinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • deferasirox

                deferasirox will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • DHEA, herbal

                DHEA, herbal will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dronedarone

                dronedarone will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • eslicarbazepine acetate

                eslicarbazepine acetate will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • etravirine

                etravirine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fluconazole

                fluconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosamprenavir

                fosamprenavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • grapefruit

                grapefruit will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • griseofulvin

                griseofulvin will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • indinavir

                indinavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • lapatinib

                lapatinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • lumefantrine

                lumefantrine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • maitake

                maitake increases effects of docetaxel by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).

              • marijuana

                marijuana will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • metronidazole

                metronidazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • modafinil

                modafinil will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nelfinavir

                nelfinavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nevirapine

                nevirapine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nilotinib

                nilotinib will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • oxcarbazepine

                oxcarbazepine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • pentobarbital

                pentobarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • phenytoin

                phenytoin will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • posaconazole

                posaconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • prednisone

                prednisone will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • primidone

                primidone will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • quinupristin/dalfopristin

                quinupristin/dalfopristin will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rifapentine

                rifapentine will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ritonavir

                ritonavir will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rufinamide

                rufinamide will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ruxolitinib

                docetaxel will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • secobarbital

                secobarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • taurine

                docetaxel decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.

              • verapamil

                verapamil will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • vitamin A

                vitamin A, docetaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vitamin E

                vitamin E, docetaxel. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • voriconazole

                voriconazole will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • zafirlukast

                zafirlukast will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              Previous
              Next:

              Adverse Effects

              Varies according to indication and treatment regimen

              >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

              Postmarketing Reports

              Body as a whole: Diffuse pain, chest pain, radiation recall phenomenon, injection site recall reaction (recurrence of skin reaction at a site of previous extravasation following administration of docetaxel at a different site) at the site of previous extravasation, myositis

              Cardiovascular: Atrial fibrillation, DVT, ECG abnormalities, thrombophlebitis, pulmonary embolism, syncope, tachycardia, myocardial infarction; ventricular arrhythmia including ventricular tachycardia reported when treated with docetaxel in combination regimens including doxorubicin, 5-FU and/or cyclophosphamide, and may be associated with fatal outcome

              Cutaneous: Cutaneous lupus erythematosus (very rare) and rare cases of bullous eruptions (eg, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and scleroderma-like changes usually preceded by peripheral lymphedema); in some cases multiple factors may have contributed to the development of these effects; severe hand and foot syndrome; permanent alopecia

              Gastrointestinal: Enterocolitis, including colitis, ischemic colitis, and neutropenic enterocolitis, reported with a potential fatal outcome; abdominal pain, anorexia, constipation, duodenal ulcer, esophagitis, gastrointestinal hemorrhage, GI perforation, intestinal obstruction, ileus, and dehydration as a consequence to GI events

              Hearing: Ototoxicity (rare); hearing disorders and/or hearing loss, including cases associated with other ototoxic drugs;

              Hematologic: Bleeding episodes; DIC, often in association with sepsis or multiorgan failure, tumor lysis syndrome, sometimes fatal

              Hepatic: Hepatitis (rare), including fatalities primarily in patients with preexisting liver disorders

              Hypersensitivity: Anaphylactic shock (rare), including fatal outcomes despite premedication (very rare); hypersensitivity reactions with potential fatal outcome reported with docetaxel in patients who previously experienced hypersensitivity reactions to paclitaxel

              Metabolism and nutrition disorders: Electrolyte imbalance, including hyponatremia, hypokalemia, hypomagnesemia, and hypocalcemia

              Neurologic: Confusion; seizures or transient loss of consciousness (rare) observed, sometimes appearing during administration

              Ophthalmologic: Conjunctivitis, lacrimation or lacrimation with or without conjunctivitis; excessive tearing which may be attributable to lacrimal duct obstruction; rare cases of transient visual disturbances (flashes, flashing lights, scotomata) typically occurring during drug infusion and in association with hypersensitivity reactions reported; these were reversible upon discontinuation; cystoid macular edema (CME)

              Respiratory: Dyspnea, acute pulmonary edema, acute respiratory distress syndrome/pneumonitis, interstitial lung disease, interstitial pneumonia, respiratory failure, and pulmonary fibrosis have rarely been reported and may be associated with fatal outcome; radiation pneumonitis (rare) reported in patients receiving concomitant radiotherapy

              Renal: Renal insufficiency and renal failure, majority associated with concomitant nephrotoxic drugs

              Second primary malignancies: Second primary malignancies reported, including AML, MDS, NHL, and renal cancer

              Previous
              Next:

              Warnings

              Black Box Warnings

              The drug should be administered under the supervision of an experienced cancer chemotherapy physician

              Increased mortality reported in patients with liver impairment receiving higher doses, patients with non-small lung cancer, and a history of platinum-based chemotherapy receiving docetaxel as a single agent at a dose of 100 mg/m²

              Patients with elevations in bilirubin or abnormalities of transaminase concurrent with alkaline phosphatase are at increased risk of developing grade 4 neutropenia, febrile neutropenia, infections, severe neutropenia, severe stomatitis, and toxic death

              Avoid use in patients with bilirubin > upper limit of normal (ULN), or patients with AST and/or ALT > 1.5 × ULN concomitant with alkaline phosphatase > 2.5 × ULN; patients with elevations of bilirubin or abnormalities of transaminase concurrent with alkaline phosphatase are at increased risk for development of severe neutropenia, febrile neutropenia, infections, severe thrombocytopenia, severe stomatitis, severe skin toxicity, and toxic death; patients with isolated elevations of transaminase > 1.5 × ULN also had a higher rate of febrile neutropenia; measure bilirubin, AST or ALT, and alkaline phosphatase prior to each therapeutic cycle

              Perform blood cell counts on all patients receiving docetaxel; if neutrophil count <1500 cells/mm3, do not administer; monitor blood counts frequently as neutropenia may be severe and result in infection

              Severe hypersensitivity reactions, characterized by generalized rash/erythema, hypotension, and/or bronchospasm, or very rarely fatal anaphylaxis, reported in patients receiving the recommended 3-day dexamethasone premedication; discontinue infusion and administer appropriate therapy if hypersensitivity reaction occurs

              Do not give docetaxel to patients with documented hypersensitivity to the drug or drugs formulated with polysorbate 80

              Severe fluid retention may occur despite use of a 3-day dexamethasone premedication regimen; it may be characterized by poorly tolerated peripheral edema, generalized edema, pleural effusion requiring urgent drainage, dyspnea at rest, cardiac tamponade, or pronounced abdominal distention (due to ascites)

              Contraindications

              Hypersensitivity to docetaxel or polysorbate 80

              Solid tumor with baseline ANC<1500/mm3

              Cautions

              Treatment-related mortality higher in patients with hepatic impairment, those receiving higher doses, and in patients with NSCLC and history of prior platinum-based chemotherapy who receive docetaxel as monotherapy at 100 mg/m²

              Sepsis reported in breast cancer patients receiving therapy; half of them reported during first cycle of therapy

              Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated docetaxel

              Perform frequent blood cell counts on all patients; do not retreat until neutrophils recover to >1500 cells/mm3 and platelets to >100,000 cell/mm3 (see Dosage Modifications)

              Enterocolitis and neutropenic colitis (typhlitis) reported; caution for patients with neutropenia, who are particularly at risk for developing GI complications; enterocolitis and neutropenic enterocolitis may develop at any time, and could lead to death as early as the first day of symptom onset

              A 25% reduction in dose of recommended during subsequent cycles following severe neutropenia (<500 cells/mm3) lasting 7 days or more, febrile neutropenia, or a grade 4 infection in a treatment cycle

              Observed closely for hypersensitivity reactions, especially during the first and second infusions; severe hypersensitivity reactions characterized by generalized rash/erythema, hypotension and/or bronchospasm, or very rarely fatal anaphylaxis, have been reported in patients premedicated with 3 days of corticosteroids; severe hypersensitivity reactions require immediate discontinuation of the infusion and aggressive therapy; patients with history of severe hypersensitivity reactions should not be rechallenged; patients with history of paclitaxel hypersensitivity may develop a reaction to docetaxel

              Severe fluid retention reported; premedicate with oral corticosteroids prior to each administration to reduce incidence and severity

              Second primary malignancies reported, notably acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), non-Hodgkin lymphoma (NHL), and renal cancer; may occur several months or years after docetaxel therapy

              Localized erythema of the extremities with edema followed by desquamation has been observed; adjust dose for severe skin toxicity

              Severe neurosensory symptoms (eg, paresthesia, dysesthesia, pain) were observed; adjust dose or discontinue if symptoms persist

              Cystoid macular edema (CME) reported; if impaired vision occurs, promptly schedule a comprehensive ophthalmologic examination; if CME diagnosed, discontinue docetaxel

              Severe asthenia reported; symptoms of fatigue and weakness may last a few days up to several weeks and may be associated with deterioration of performance status in patients with progressive disease

              Based on findings from animal reproduction studies and its mechanism of action, can cause fetal harm when administered to pregnant women

              Monitor patients closely from onset of any symptoms of gastrointestinal toxicity. Inform patients to contact their healthcare provider with new, or worsening symptoms of gastrointestinal toxicity

              In gastric cancer patients treated with docetaxel in combination with cisplatin and fluorouracil (TCF), febrile neutropenia and/or neutropenic infection reported; monitor patients receiving TCF during first and subsequent cycles for febrile neutropenia and neutropenic infection

              Severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP) reported in association with docetaxel treatment; patients should be informed about signs and symptoms of serious skin manifestations and monitored closely; permanent treatment discontinuation should be considered in patients who experience SCARs

              If minor reactions such as flushing or localized skin reactions occur, interruption of therapy not required; all patients should be premedicated with an oral corticosteroid prior to initiation of infusion of drug

              Tumor lysis syndrome reported; patients at risk of tumor lysis syndrome (e.g., with renal impairment, hyperuricemia, bulky tumor) should be closely monitored prior to initiating therapy and periodically during treatment; correction of dehydration and treatment of high uric acid levels are recommended prior to initiation of treatment

              Cases of alcohol intoxication reported with some formulations of docetaxel owing to the alcohol content (100 mg/m2 dose delivers 2 g/m2 of ethanol)

              Drug interaction overview

              • Docetaxel is a CYP3A4 substrate
              • Metabolism of docetaxel may be modified if coadministered with CYP3A4 inducers or inhibitors
              • Avoid use with strong CYP3A4 inhibitors; if unable to avoid, consider reducing docetaxel dose by 50%
              Previous
              Next:

              Pregnancy & Lactation

              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

              Animal studies

              • Administration to pregnant rats and rabbits during period of organogenesis caused an increased incidence of embryo-fetal toxicities, including intra-uterine mortality, at doses as low as 0.02 and 0.003 times the recommended human dose based on body surface area, respectively
              • Advise pregnant women and females of reproductive potential of potential risk to fetus

              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

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

              Previous
              Next:

              Pharmacology

              Mechanism of Action

              Semisynthetic taxane, prevents depolymerization of cellular microtubules, which results in DNA, RNA, and protein synthesis inhibition

              Pharmacokinetics

              Half-life elimination: 11 hr (terminal)

              Protein bound: 94-97%

              Vd: 80-90 L/m²

              Metabolism: Liver (CYP3A4)

              Clearance: 21 L/hr/m²

              rExcretion: Feces 75%; urine 6%

              Previous
              Next:

              Administration

              IV Incompatibilities

              Y-site: amphotericin B, doxorubicin liposomal, methylprednisolone sodium succinate, nalbuphine

              IV Compatibilities

              Solution: D5W, NS

              Y-site (partial list): acyclovir, ampicillin, ampicillin/sulbactam, most cephalosporins, clindamycin, diphenhydramine, dopamine, fluconazole, gemcitabine, heparin, hydromorphone, hydroxyzine, imipenem-cilastatin, lorazepam, meperidine, morphine SO4, ondansetron, KCl, prochlorperazine, NaHCO3, TMP-SMX, vancomycin, zidovudine

              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)
              • Non-PVC tubing must be used

              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)
              • Non-PVC tubing must be used

              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

              Storage

              Unused vials: Store at 2-25°C (36-77°F)

              Opened multi-use vials: Store at 2-8°C (36-46°F) and stable for up to 28 days

              Diluted solutions: Store at 2-25°C (36-77°F); use within 4 hr including 1 hr of IV infusion

              Protect from light

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              docetaxel intravenous
              -
              160 mg/16 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/8 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/2 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              20 mg/mL vial
              docetaxel intravenous
              -
              160 mg/8 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              160 mg/8 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              160 mg/8 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              160 mg/8 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/4 mL (20 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              160 mg/16 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/8 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/2 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/mL (1 mL) vial
              docetaxel intravenous
              -
              160 mg/16 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              80 mg/8 mL (10 mg/mL) vial
              docetaxel intravenous
              -
              20 mg/2 mL (10 mg/mL) vial
              Docefrez intravenous
              -
              20 mg vial
              Docefrez intravenous
              -
              80 mg vial

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Patient Education
              docetaxel intravenous

              DOCETAXEL - INJECTION

              (doh-seh-TAX-ell)

              COMMON BRAND NAME(S): Taxotere

              WARNING: Docetaxel has caused severe (rarely fatal) allergic reactions and swelling (fluid retention/edema) even with the use of preventive medications. This drug must not be used in patients who have previously had an allergic reaction to it or to other medications containing polysorbate 80.There is an increased risk of serious (possibly fatal) reactions in patients using docetaxel who have liver problems, patients receiving higher doses, and patients with non-small cell lung cancer who have received certain other chemotherapy drugs known as "platinums."If you have a low white blood cell count or liver problems, notify your doctor before using docetaxel.Get medical help right away if you experience swelling, dizziness or fainting, difficulty breathing, irregular heartbeat, severe swelling of the abdomen, skin rash, easy bleeding or bruising, sores in the mouth or throat, or symptoms of infection (such as fever and sore throat).Your doctor will closely monitor you and your blood counts and liver tests while you are receiving docetaxel.

              USES: This medication is used to treat cancer (such as breast, lung, prostate, stomach, and head/neck cancer). Docetaxel is a member of a family of drugs called taxanes. This drug works by slowing cell growth.

              HOW TO USE: Read the Patient Information Leaflet available from your pharmacist. Consult your doctor, nurse or pharmacist if you have any questions.This medication is given by injection into a vein by a health care professional, generally over 1 hour every 3 weeks or as directed by your doctor. The dosage and frequency is based on your medical condition, body size, and response to treatment.Your doctor may prescribe pre-medications (e.g., corticosteroids such as dexamethasone) to prevent side effects like swelling (fluid retention/edema) and allergic reactions. These are generally started 1 day before treatment and continued for a total of 3 days. Carefully follow your doctor's orders to prepare for your treatment. If you forget to take your pre-medication, or do not take it on schedule, tell your doctor or nurse before you receive your docetaxel treatment.

              SIDE EFFECTS: See also Warning section.Pain or swelling at the injection site, nausea, vomiting, diarrhea, excessive tearing, fatigue, dizziness, drowsiness, feeling drunk, constipation, and loss of appetite may occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Temporary hair loss and nail changes may occur. Normal hair growth and nail appearance should return after treatment has ended. However, hair loss may be permanent for some people.People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.This medication can decrease your body's ability to fight an infection. Tell your doctor right away if you develop any signs of an infection (such as a sore throat that doesn't go away, fever, or chills).Although docetaxel is used to treat cancer, it may rarely increase your risk of getting other cancers (such as acute myeloid leukemia-AML, Non-Hodgkin's Lymphoma, kidney cancer). This may occur months to years after treatment. Your doctor should monitor you closely while you receive this medication and after treatment with this medication.Docetaxel sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). To lower your risk, your doctor may add a medication and tell you to drink plenty of fluids. Tell your doctor right away if you have symptoms such as: low back/side pain (flank pain), signs of kidney problems (such as painful urination, pink/bloody urine, change in the amount of urine), muscle spasms/weakness.Tell your doctor right away if you have any serious side effects, including: swelling of the hands/feet/legs, unexplained weight gain, numbness or tingling of the hands or feet, muscle or joint pain, persistent weakness or fatigue, eye pain, irregular heartbeat, stomach/abdominal pain, severe diarrhea, diarrhea with blood or mucus, severe headache.Get medical help right away if you have any very serious side effects, including: chest pain, vision changes (such as blurred vision, decreased vision, seeing flashes of light).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: See also Warning section.Before using docetaxel, tell your doctor or pharmacist if you are allergic to it; or to similar drugs (taxane-type drugs such as paclitaxel, cabazitaxel); or if you have any other allergies. This product may contain inactive ingredients (such as polysorbate 80), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before receiving docetaxel, tell your doctor or pharmacist your medical history, especially of: liver problems, lung problems (e.g., pulmonary effusions), heart problems (e.g., congestive heart failure), weak immune system (e.g., neutropenia), blood problems (e.g., anemia, thrombocytopenia), blood pressure problems.This medication may make you dizzy or drowsy. It also contains alcohol, which can increase these symptoms and also make you feel drunk. Caution is advised if you have liver disease or any other condition that requires you to limit/avoid alcohol. Marijuana (cannabis) can also make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness for 1 to 2 hours after you receive this medication and until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine.Use caution with sharp objects like razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised or injured.Wash your hands well to prevent the spread of infections.Older adults may be more sensitive to the side effects of this drug, especially anemia, dizziness, diarrhea, infection, swelling, mouth sores, and weight loss.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using docetaxel. Docetaxel may harm an unborn baby. Your doctor should order a pregnancy test before you start this medication. Women using this medication should use reliable forms of birth control during treatment and for 6 months after stopping treatment. Men using this medication should use reliable forms of birth control during treatment and for 3 months after stopping treatment. If you or your partner become pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding is not recommended while using this drug and for 1 week after stopping treatment. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: medications that may have a bad reaction with alcohol (such as disulfiram, metronidazole, tinidazole).Other medications can affect the removal of docetaxel from your body, which may affect how docetaxel works. Examples include azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), HIV drugs (such as ritonavir), St. John's wort, among others.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as other alcohol-containing medications or alcoholic beverages, marijuana (cannabis), opioid pain or cough relievers (such as codeine, hydrocodone), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Laboratory and/or medical tests (e.g., blood cell counts and liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. Keep all scheduled medical appointments.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

              STORAGE: Not applicable. This medication is given in a clinic and will not be stored at home.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.