Cycle 4 docetaxel

Docetaxel

IMPORTANT SAFETY INFORMATION

WARNINGS:

• The incidence of treatment-related mortality associated with Taxotere® therapy is increased in patients with abnormal liver function, in patients receiving higher doses, and in patients with non-small cell lung carcinoma and a history of prior treatment with platinum-based chemotherapy who receive Taxotere® as a single agent at a dose of 100 mg/m²
• Taxotere® should not be given to patients with bilirubin >upper limit of normal (ULN), or to patients with AST and/or ALT>1.5 X ULN concomitant with alkaline phosphatase >2.5 X ULN
  • Patients with elevations of bilirubin or abnormalities of transaminase concurrent with alkaline phosphatase are at increased risk for the development of grade 4 neutropenia, febrile neutropenia, infections, severe thrombocytopenia, severe stomatitis, severe skin toxicity, and toxic death
  • Patients with isolated elevations of transaminase >1.5 X ULN also had a higher rate of febrile neutropenia grade 4 but did not have an increased incidence of toxic death
  • Bilirubin, AST or ALT, and alkaline phosphatase values should be obtained prior to each cycle of Taxotere® therapy
• Taxotere® therapy should not be given to patients with neutrophil counts of <1500 cells="" mm="" style="font-size: 0.7em; left: 1px; position: relative; top: -3px; vertical-align: middle;" sup="">3

• In order to monitor the occurrence of neutropenia, which may be severe and result in infection, frequent blood cell counts should be performed on all patients receiving Taxotere®

Severe hypersensitivity reactions characterized by generalized rash/erythema, hypotension and/or bronchospasm, or very rarely fatal anaphylaxis, have been reported in patients who received the recommended 3-day dexamethasone premedication

• Hypersensitivity reactions require immediate discontinuation of Taxotere® infusion and administration of appropriate therapy

Taxotere® must not be given to patients who have a history of severe hypersensitivity reactions to Taxotere® or to other drugs formulated with polysorbate 80

Severe fluid retention occurred in 6.5% (6/92) of patients despite use of a 3-day dexamethasone premedication regimen. It was characterized by one or more of the following events: poorly tolerated peripheral edema, generalized edema, pleural effusion requiring urgent drainage, dyspnea at rest, cardiac tamponade, or pronounced abdominal distention (due to ascites)

• Neutropenia (<2 mm="" neutrophils="" style="font-size: 0.7em; left: 1px; position: relative; top: -3px; vertical-align: middle;" sup="">3

) occurs in virtually all patients given 60-100 mg/m² of Taxotere® and grade 4 neutropenia (<500 cells="" mm="" style="font-size: 0.7em; left: 1px; position: relative; top: -3px; vertical-align: middle;" sup="">3) occurs in 85% of patients given 100 mg/m² and 75% of patients given
60 mg/m²

Patients should be premedicated with oral corticosteroids prior to each Taxotere® administration to reduce the incidence and severity of fluid retention. Patients with pre-existing effusions should be closely monitored from the first dose for possible exacerbation of the effusions

Treatment-related acute myeloid leukemia (AML) or myelodysplasia has occurred in patients given anthracyclines and/or cyclophosphamide, including use with Taxotere® in adjuvant therapy of breast cancer

Localized erythema of the extremities with edema followed by desquamation has been observed

• In case of severe skin toxicity, an adjustment in dosage is recommended

Severe neurosensory symptoms (paresthesia, dysesthesia, pain) were observed in 5.5% (53/965) ofmetastatic breast cancer patients, and resulted in treatment discontinuation in 6.1%

• When these symptoms occur, dosage must be adjusted; if symptoms persist, treatment should be discontinued

Severe asthenia was reported in 14.9% (144/965) of metastatic breast cancer patients, but led to treatment discontinuation in only 1.8%

• 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

Taxotere® can cause fetal harm when administered to pregnant women. Women of childbearing potential should be advised to avoid becoming pregnant during therapy with Taxotere®

The most common adverse reactions across all Taxotere® indications are infections, neutropenia, anemia, febrile neutropenia, hypersensitivity, thrombocytopenia, neuropathy, dysgeusia, dyspnea, constipation, anorexia, nail disorders, fluid retention, asthenia, pain, nausea, diarrhea, vomiting, mucositis, alopecia, skin reactions and myalgia

In patients treated with TCF for gastric cancer, the incidence of serious adverse events was higher in patients ≥65 years than in younger patients. Adverse events (all grades) occurring at rates ≥10% higher in elderly patients included lethargy, stomatitis, diarrhea, dizziness, edema, and febrile neutropenia/neutropenic infection.

Taxotere® should be administered in a facility equipped to manage possible complications (e.g. anaphylaxis)

Please click here for Taxotere full prescribing information, including boxedWARNING.
Taxotere® (docetaxel) Injection Concentrate Indications
Breast Cancer
TAXOTERE® is indicated for the treatment of patients with locally advanced or metastatic breast cancer after failure of prior chemotherapy
TAXOTERE® in combination with doxorubicin and cyclophosphamide is indicated for the adjuvant treatment of patients with operable node-positive breast cancer
Advanced Non-Small Cell Lung Cancer
TAXOTERE®, as a single agent, is indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) after failure of prior platinum-based chemotherapy
TAXOTERE® in combination with cisplatin is indicated for the treatment of patients with unresectable, locally advanced or metastatic NSCLC who have not previously received chemotherapy for this condition.
Metastatic Androgen-Independent Prostate Cancer
TAXOTERE® in combination with prednisone is indicated for the treatment of patients with androgen-independent (hormone-refractory) metastatic prostate cancer.
Advanced Gastric/GE Junction Cancer
TAXOTERE® in combination with cisplatin and fluorouracil is indicated for the treatment of patients with advanced gastric adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, who have not received prior chemotherapy for advanced disease.
Locally Advanced Head and Neck Cancer
TAXOTERE® in combination with cisplatin and fluorouracil is indicated for the induction treatment of patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).

ha..mesti tak larat baca kan.aku rasa doktor je rajin baca benda-benda ni. so 2/4 begin my first round of docetaxel. ubat ni katanya lebih kuat dari fec,tp since kawan-kawan aku di private hosp pun gunakan ubat yang sama so aku xdela nak argue dgn doktor.argue pun kena ada basis kan. oncologist dari selayang, dr fazlina.consultan selayang dr richard n consultant dari uitm/hkl dr natasha bersepakat 3 round of fec and another 3 round of docetaxel.
since ubat ni cepat expired..so kami ( aku dan theva) dah siap-siap amik darah semalam dan datang je pagi, farmasi dah boleh bancuh ubat.yang bestnya ubat kali just masuk thru drip shj dan 1 beg shj! so the procedure is quite fast, punch chemo port, flushing dengan saline and heparin- unuk mengelakkan blood clot, masuk air, masuk premed( 4 jenis ubat), then masuk docetaxel, habiskan air, flushing lagi sekali, cabut chemo port dan dah boleh gi amik ubat di farmasi dan balik. walaupun sekejap sempat juga dera HO dr syed arif dengan soalan macam-macam.au byk tanya pasal cost dia study medic di ireland,berangan nak htr my daughters amik medic di sana, tp dengar kos 1.2million sorang, adehhh..anak-anak, belajar local jelah ye!  by two aku dah siap sampai rumah. masa tu memang xrasa apa-apa. theva macam biasa, ratu muntah, belum masuk ubat dah muntah 3x, xtahulah dari selayang ke pd tu dia muntah x.aku alhamdulillah ok.
Tp start kul 6, dah mula rasa sakit perut. niat nak dengar ceramah ustaz ismail kamus tak dapat juga.,masjid bbs ni hebat, suka jemput penceramah best-best contoh ustaz azhar idrus, ustazah norhafizah musa dan latest datuk ismail kamus. sygnya tiap x buat tu mesti aku xde rezeki nak p. skt perut ni mcm biasala, memulas-mulas mcm nak bersalin.malam dah xlalu nak mkn,nasib siang tu aku dah bantai puas-puas. masa kimo ni,time lalu,kena mkn.kalau x, mcm ms cycle 3 tu aku skt tekak dkt 2 minggu,seksa nak mkn,tu pun aku paksa jugak mkn.tp best part,time amik berat pg td, berat aku maintain!yahuu..kalau x,tiap kali timbang mesti naik.
dalam keadaan sakit perut tu, adik pulak demam sepanas-panasnya.aku berlawan dengan sakit perut utk mengelap badannya sekejap-kejap untuk menurunkan suhu badan.bagi dia mkn ubat setiap 6jam,kena kejut,dengar dia menganga(dia senang mkn ubat,tp dia ckp benci ubat demam).kesian dia semangat nak p rombongan kilang coklat di shah alam esok tp nampak gayanya harapan tinggal harapan

day 2
perut masih skt,tp ingat adik,gagah juga pergi klinik.aku menyuarakan susah hati aku kepada dr khadijah,kenapa adik selalu sgt sakit, dr cakap dia ada asma,kalau xpantang,memang dia sakit.hehe, part langgar pantang selalu umilah punya kerja,umikan asik sakit tekak,bila sakit tekak belasah anything yg sejuk,such aiskrim n yogurt,pdhal adik kena pantang benda sejuk.budak2 manalah tahan tgk aiskrim esp aifa munirah.adik dia kuat juga iman tgk aiskrim,tp dah nama pun budak..so ni SEMUA SALAH UMI!
oh ya, arini kena makan dexa lagi, dr richard ckp kesan ubat ni lebih lth dan skt badan berbanding fec jd aku amik jugak mc smpi nxt week,tgk macam mana,kalau ok,nxt cycle aku kurangkan mc. tkt dok telan anak org ja kalau p sekolah.sbb apa aku lg tkt dengan kesan ubat ni,hospital bekalkan panadol dekat 240 biji!masha allah,,diorang ni overker nak menakutkan aku.ada 2 ubat xade, farmasi suh g amik arini,  memandangkan aku xberapa nak rajin,aku amik je presciption tu dan beli ubat di farmasi dekat dgn umah. huh,mahalnya harga ubat. jgnla malaysia buat mcm us atau kebanyakan negara lain,ubat kena beli sendiri. bygkan nant aku kena mkn tamoxifen tu selama 5tahun, kalau di gov hosp  free, kalau di private hosp sebiji kdg charge smpi rm8 (depends on ur hosp and insurance), kalau kena beli di farmasi around rm6 sebiji. kalau sebiji rm6 X 365 hari X 5 tahun.dah berapa?meh nakira jap ...total rm10,950.peh,leh buat down payment innova tuh!hehe.