Docetaxel is a chemotherapy drug that is given as a treatment for some types of cancer. It is commonly known as Taxotere®. It is most commonly used to treat breast cancer, prostate cancer and non-small cell lung cancer, but may be used for many other types of cancer. This information describes Taxotere, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about your type of cancer, which give more information and advice.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

Taxotere is a yellow/brown liquid which, when diluted, forms a clear solution.

Taxotere is given as a drip (infusion) through a fine needle (cannula) inserted into the vein. It can also be given through a central line (a tube inserted into a vein in the chest) or a PICC line (a tube inserted into the crook of your arm). The infusion takes about 60 minutes.

The day before your chemotherapy you will be given steroids to take. These help to reduce some of the side effects and are taken for either one or three days (depending on the type of cancer you are being treated for).

Chemotherapy is usually given as a course of several sessions (or cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer for which you are being treated. Your nurse or doctor will discuss your treatment plan with you.

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given Taxotere, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common side effects and some of the less common ones, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you do notice any effects which you think may be due to the drug but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.

Lowered resistance to infection Taxotere can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin five days after treatment has been given and your resistance to infection usually reaches its lowest point seven days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels before your next course of chemotherapy is due.

Contact your doctor or the hospital straightaway if:

• your temperature goes above 38ºC (100.5ºF)
• you suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Taxotere can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.

Anaemia (low number of red blood cells) While having treatment with Taxotere you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these effects are a problem..

Feeling sick (nausea) and being sick (vomiting) If you do feel sick this may begin a few hours after the treatment is given. It is usually mild, and your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea and vomiting. If the sickness is not controlled, or continues, tell your doctor; they can prescribe other anti-sickness drugs which may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.

Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.

Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.

Diarrhoea This can usually be easily controlled with medicine, but let your doctor know if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Hair loss usually starts 2–3 weeks after the first dose of Taxotere, although it may occur earlier. Your hair may fall out completely or it may just thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. Hair loss is temporary and all your hair will regrow once the treatment ends. To help reduce hair loss, scalp cooling may be suitable for some people.

Skin changes Taxotere can cause a rash. Your doctor can prescribe medicine to help with this.

Soreness and redness of the palms of the hands and soles of the feet (Sometimes known as palmar plantar or hand-foot syndrome). This is temporary and will improve when treatment is finished.

Allergic reaction Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, redness of the face, a feeling of dizziness, a headache, breathlessness, anxiety and a need to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these symptoms.

Tiredness and feeling weak You may feel very tired. It is important to allow yourself plenty of time to rest.

Fluid retention You may notice that you gain weight and/or that your ankles and legs swell. This decreases slowly once your treatment has finished. To help reduce the chance of fluid retention you will be given steroid tablets (usually dexamethasone) to take for three days beginning the day before treatment. The dexamethasone may also help to reduce the chance of an allergic reaction.

Numbness or tingling in hands or feet This is due to the effect of Taxotere on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or other fiddly tasks. Tell your doctor if you notice any numbness or tingling in your hands or feet. This usually improves slowly a few months after the treatment ends.

Changes in nails The colour of your nails may change. This change grows out over several months once the treatment has finished. Pain in the nail bed (at the base of the nail) may occur, but this is rare.

Pain in the joints or muscles It is important to tell your doctor about this, so that appropriate painkillers can be prescribed.

Injection site If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site, it is very important that you tell the doctor or nurse immediately. If the area around the injection site becomes red or swollen at any time let your doctor or nurse know.

Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it is important to tell your doctor straightaway if you have any of these symptoms. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.

Other medicines Some other medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking Taxotere, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

This section is based on our Docetaxel factsheet which has been compiled using information from a number of reliable sources, including:

• Martindale: The Complete Drug Reference (35th edition). Eds. Sweetman et al. Pharmaceutical Press, 2007.
• British National Formulary (54th edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2007.
• The Medicines.org.uk website – www.medicines.org.uk (November 2007).
• The Chemotherapy Source Book (3rd edition). Ed. Perry. Lippincott, Williams and Wilkins, 2001.

For further references, please see general bibliography.