Paclib Drug Interactions

Antineoplastic Agents: Administration of paclitaxel with other antineoplastic agents showed sequence-dependent interactions and may affect their toxicities.
It is recommended that paclitaxel be administered before cisplatin to decrease the risk of increased severity of myelosuppression.
When cyclophosphamide is administered after paclitaxel (by 24-hour IV infusion), the severity of neutropenia and thrombocytopenia has been reported to increase.
Plasma levels of doxorubicin and its active metabolite doxorubicinol may be increased when paclitaxel and doxorubicin are used concomitantly. Paclitaxel should be administered 24 hours after doxorubicin.
Fluorouracil pretreatment was reported to inhibit the action of paclitaxel.
Myelosuppressive Agents: The combination of paclitaxel with other myelosuppressive agents may increase the severity of myelosuppression depending on the dose.
Similar rates of neutropenia but less severe thrombocytopenia was reported when carboplatin is administered after paclitaxel compared with carboplatin administered alone.
Blood Dyscrasia: The combination of paclitaxel with these drugs can cause blood dyscrasia, usually in a minority of patients, and not dose-related: aminopyrine, angiotensin-converting enzyme (ACE) inhibitors, anticonvulsants, tricyclic antidepressants, oral antidiabetic agents, non-steroidal anti-inflammatory drugs (NSAIDs), carbamazepine, chloramphenicol, clozapine, dapsone, foscarnet, levamisole, penicillamine, phenothiazine, primaquine, primidone, procainamide, propafenone, rifampicin, sulfonamides, thioxanthenes, trimethoprim, valproate, and valproic acid.
Drugs Affecting Hepatic Enzymes: Concomitant use of drugs which induce or inhibit the action of cytochrome P450 isoenzymes may reduce or increase the plasma concentrations of paclitaxel, respectively.
Potential interactions between paclitaxel, a substrate of CYP3A4 and protease inhibitors (e.g., ritonavir, saquinavir, indinavir, and nelfinavir), which are substrates and/or inhibitors of CYP3A4, have not been evaluated.
Ketoconazole may inhibit the metabolism of paclitaxel when given together.
CNS Depressants: CNS depression due to the alcohol content of the formulation may be potentiated when paclitaxel and CNS depressants such as antihistamines or opiates are used together.
Vaccines: Paclitaxel may cause immunosuppression. The interval between the discontinuation of paclitaxel and the patient's capacity to respond to the vaccine depends on the type and intensity of immunosuppression. The estimated time is between 3 months and 1 year.
Immunization with oral poliovirus vaccine must be postponed in people who are in close contact with patients undergoing paclitaxel therapy, especially family members.