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Cabazitaxel

Trade/Other Name(s): Jevtana®

Why would this drug be used?

Cabazitaxel is used to treat advanced prostate cancer that is no longer responding to hormone therapy. It is also being studied for use against other kinds of cancer.

How does this drug work?

Cabazitaxel is a type of chemotherapy drug known as a taxane. It interferes with microtubules, which are part of the internal structure that cells need when they are dividing. This leads to cell death. Because cancer cells divide faster than normal cells, they are more likely than normal cells to be affected by this drug.

Before taking this medicine

Tell your doctor…

  • If you are allergic to any medicines, dyes, additives, or foods.
  • If you have any type of liver disease (including hepatitis). This drug is cleared from the body mainly by the liver. Reduced liver function might result in more drug than expected staying in the body, which could lead to serious side effects. Your doctor may need to adjust your dose accordingly.
  • If you have any type of kidney disease. This drug may affect the kidneys, which could make any kidney problems you already have worse.
  • If you have any other medical conditions such as heart disease, diabetes, gout, high blood pressure, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause problems with the fetus if taken at the time of conception or during pregnancy.
  • Check with your doctor about what kinds of birth control can be used with this medicine. In pregnant women, treatment with this drug should be used only if the potential benefit to the mother outweighs the risk to the fetus.
  • If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Breast-feeding is not recommended during treatment with this drug.
  • If you think you might want to have children in the future. This drug may affect fertility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Cabazitaxel may interact with a number of drugs and supplements, which may either raise or lower the level of cabazitaxel in your blood. This can worsen side effects or make the drug less effective. Tell your doctor if you are taking any of the following:

  • antidepressant drugs such as nefazodone (Serzone), trazodone (Desyrel), fluvoxamine (Luvox), or buspirone (Buspar)
  • antibiotics such as erythromycin or clarithromycin
  • anti-fungal antibiotics such as ketoconazole and itraconazole
  • the anti-nausea drug aprepitant
  • blood pressure medicines such as diltiazem and verapamil
  • HIV drugs such as indinavir, ritonavir, amprenavir, fosamprenavir, and nelfinavir
  • anti-seizure drugs such as carbamazepine, phenobarbital, and phenytoin
  • TB drugs such as rifampin and rifabutin
  • tranquilizers such as alprazolam (Xanax), diazepam (Valium), triazolam (Halcion), and midazolam (Versed)
  • St. John's wort (an herbal supplement)
  • methadone
  • sildenafil (Viagra)

If you are on any of these medicines when you start taking cabazitaxel, talk to your doctor before you stop taking them. Many other medicines may also affect cabazitaxel, and changing any of your medicines may change the actual amount of the drug that stays in your body.

Research on interactions with other drugs is incomplete at this time. Check with your doctor, nurse, or pharmacist about your other medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

Grapefruit or grapefruit juice may change the level of cabazitaxel in your blood. Check with your doctor, nurse, or pharmacist about whether these or other foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Cabazitaxel is given by an infusion into a vein over 1 hour, usually every 3 weeks. At least 30 minutes before the drug is given, you will probably be given medicine to lessen the chance you will have an allergic reaction or get swelling in your body. These medicines include a steroid (such as dexamethasone), an antihistamine (such as diphenhydramine), and an H2-blocking drug (such as ranitidine). You will also get an anti-nausea medicine before the cabazitaxel.

The dose of cabazitaxel that you will get at first will depend on your body size. Future doses may be lowered or treatment delayed if you had severe side effects or your blood counts are too low or other lab test results are not normal.

Precautions

This drug can cause allergic reactions in some people when the drug is given, especially with the first few treatments. Although you will be given medicine ahead of time to lower this risk, reactions are still possible. Mild reactions may consist of fever, chills, skin itching, or feeling flushed. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), chest tightness, shortness of breath, back pain, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

Your doctor will likely test your blood frequently throughout your treatment, looking for possible effects of the drug on blood counts or on blood chemistry levels. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether. Be sure to keep all appointments for lab work and doctor visits.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting serious, or even life-threatening, infections. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your red blood cell count. If this occurs, it is usually a few months after starting treatment. A low red blood cell count (known as anemia) can cause shortness of breath, or make you to feel weak or tired all the time. If it becomes a problem, your doctor may give you medicines to help treat this condition, or you may need to get blood transfusions.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

This drug can cause kidney problems and even lead to kidney failure. Your doctor will check your blood while you are on treatment to look for signs of kidney problems and treat any problems including dehydration and chemical imbalances. Tell your doctor right away if you notice any possible signs of kidney problems, such as urinating less or swelling in your face or other parts of your body.

This drug can cause diarrhea, which in some cases may be severe. If left unchecked, this could lead to dehydration and chemical imbalances in the body. Your doctor may prescribe medicine to help prevent or control this side effect. It is very important that you take this medicine as prescribed. Make sure you get the medicine right away, so that you will have it at home when you need it.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and how to cope with them.

Common

  • Low white blood cell count with increased risk of serious infection*
  • Nausea*
  • Diarrhea*
  • Constipation
  • Feeling weak
  • Feeling tired
  • Low red blood cell count (anemia)*
  • Low blood platelet count*

Less common

  • Nerve damage (neuropathy) leading to numbness and tingling in the hands and feet
  • Hair loss, including face and body hair
  • Abdominal (belly) pain
  • Back and joint pain
  • Shortness of breath
  • Cough
  • Fever
  • Dehydration
  • Irregular heartbeat
  • Dizziness
  • Headache
  • Low blood pressure
  • Loss of appetite
  • Weight loss
  • Change in the way things taste
  • Blood in the urine
  • Pain with urination

Rare

  • Severe infection*
  • Kidney failure*
  • Death

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes, approved in 2010.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 06/22/2010
Last Revised: 06/22/2010