Paclib Dosage/Direction for Use

Premedication Regimen: Premedicate all patients with oral dexamethasone (20 mg) approximately 12 and 6 hours before paclitaxel administration, IV diphenhydramine or its equivalent (50 mg) 30 to 60 minutes before paclitaxel, and either IV cimetidine (300 mg) or IV ranitidine (50 mg) 30 to 60 minutes before paclitaxel in order to reduce the incidence of hypersensitivity reactions.
Patients with HIV infection may follow the same premedication regimen with the exception of a reduced dose of oral dexamethasone (10 mg).
Paclitaxel Injection must be diluted prior to intravenous infusion. (See Table 1.)

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General Dosing Information: Monitor vital signs regularly, particularly during the first hour of administration. Cardiac monitoring is not required except in patients with preexisting cardiac abnormalities.
Closely monitor the infusion site for possible infiltration during drug administration particularly during longer periods of infusion (e.g., 24 hours). Local reactions may appear 7 to 10 days after completion of paclitaxel infusion.
Dose Adjustments: For patients with solid tumors (ovary, breast, NSCLC): Paclitaxel courses should not be repeated until the patient's neutrophil count is at least 1500 cells/mm³ and platelet count is at least 100,000 cells/mm³.
Reduce dose by 20% for subsequent courses of paclitaxel in patients who experience severe neutropenia (neutrophil <500 cells/mm³ for a week or longer) or severe peripheral neuropathy during paclitaxel therapy.
For AIDS-related Kaposi's Sarcoma: Initiate or repeat treatment only if the neutrophil count is at least 1000 cells/mm³.
Reduce dose by 20% for subsequent courses of paclitaxel in patients who experience severe neutropenia (neutrophil <500 cells/mm³ for a week or longer).
Initiate concomitant hematopoietic growth factor (G-CSF) as clinically needed.
Dosing in Patients with Hepatic Impairment: See Table 2.

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