paclitaxel albumin at a glance
Medicine class
Albumin-bound taxane chemotherapy, also called nab-paclitaxel.
How it is given
A specialist cancer team gives it through a vein after preparing the powder as a milky dispersion.
Important distinction
It is not interchangeable with conventional paclitaxel because the formulations differ in licensing, pharmacokinetics, preparation and administration.
Routine checks
Blood counts and treatment-related symptoms are assessed regularly because bone-marrow suppression and peripheral neuropathy are important toxicities.
What is paclitaxel albumin used for?
The selected UK product is licensed for adults in the following settings:
Metastatic breast cancer after first-line treatment has failed, when standard anthracycline-containing treatment is not indicated.
First-line treatment of metastatic adenocarcinoma of the pancreas, combined with gemcitabine.
First-line treatment of non-small cell lung cancer, combined with carboplatin, when potentially curative surgery or radiotherapy is unsuitable.
How does paclitaxel albumin work?
Paclitaxel stabilises microtubules, structures that cells must repeatedly assemble and dismantle to divide normally. This disrupts cell division and can lead to cancer-cell death. Albumin keeps paclitaxel dispersed in the bloodstream and may assist its movement across blood-vessel walls.
paclitaxel albumin preparations and strengths
Dispersion for infusion
Route: Intravenous
Strengths: 5 mg/mL
How to take paclitaxel albumin
Paclitaxel albumin is not taken by mouth. Trained staff prepare it and administer it through a vein in a specialist cancer unit. The product name and formulation must be verified because albumin-bound and conventional paclitaxel must not be substituted for one another.
Tell the team about new symptoms and every prescription, non-prescription or herbal product before treatment.
Blood tests and clinical assessment are normally performed before treatment proceeds.
Report pain, burning, redness or swelling around the infusion site immediately.
paclitaxel albumin side effects
Common or expected effects
- Reduced white cells, red cells or platelets, increasing the risks of infection, tiredness, bruising or bleeding
- Numbness, tingling, pain or altered sensation in the hands or feet
- Nausea, vomiting, diarrhoea, constipation or a sore mouth
- Hair loss
- Tiredness, weakness or fever
- Muscle or joint pain
- Reduced appetite, rash or nail changes
Get urgent medical advice
- Fever, chills or other signs of infection, which may indicate neutropenic infection or sepsis
- Sudden wheezing, swelling, rash, dizziness or breathing difficulty suggesting severe hypersensitivity
- New or worsening cough or breathlessness, which may indicate pneumonitis or another serious lung problem
- Unexpected bleeding, extensive bruising or marked weakness associated with low blood counts
- New significant visual impairment
- Severe blistering, peeling or widespread painful rash
paclitaxel albumin in pregnancy
Paclitaxel albumin is generally avoided during pregnancy unless specialist assessment finds treatment clinically necessary. A pregnancy test is advised before treatment. Effective contraception is required during treatment and for at least six months afterwards for patients who could become pregnant; male patients with partners who could become pregnant should use effective contraception during treatment and for at least three months afterwards. Any pregnancy or planned pregnancy requires prompt discussion with the oncology team.
paclitaxel albumin while breastfeeding
Breastfeeding is contraindicated during paclitaxel albumin treatment because serious effects in a breastfed child are possible. Discuss future breastfeeding with the cancer and maternity teams before restarting it after treatment.
paclitaxel albumin interactions
The cancer team should review all medicines, including non-prescription and herbal products. Important examples include:
CYP2C8 or CYP3A4 inhibitors, including azole antifungals, erythromycin, some HIV medicines, gemfibrozil and clopidogrel
These may increase paclitaxel exposure and toxicity, so additional caution and review are needed.
CYP2C8 or CYP3A4 inducers, including rifampicin, carbamazepine, phenytoin, efavirenz and nevirapine
These may lower paclitaxel exposure and compromise effectiveness; concurrent use is not recommended by the product information.
Erlotinib
It should not be co-administered with paclitaxel albumin plus gemcitabine.
Common questions about paclitaxel albumin
Answers are fully visible for fast scanning and source review.
Is paclitaxel albumin the same as ordinary paclitaxel?
No. Both deliver paclitaxel, but the albumin-bound and conventional formulations differ in licensing, pharmacokinetics, preparation and administration and must not be substituted for each other.
Why is paclitaxel attached to albumin?
Albumin helps keep paclitaxel dispersed in blood and may assist transport across blood-vessel walls. The formulation avoids the solvent system used in conventional paclitaxel.
How is paclitaxel albumin administered?
It is prepared as a dispersion and given through a vein by trained staff in a specialist cancer unit.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.