Adult Dosing
Hormone-refractory metastatic prostate cancer
- 25 mg/m2 IV as 1-hr infusion q3 wks in combination with oral prednisone 10 mg/day
- Notes:
- Premedicate with antihistamine, corticosteroid and H2 antagonist 30 mins. prior to each dose
- Use G-CSF for secondary prophylaxis
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Neutropenic deaths have occurred [U.S. Black Box Warning]
- Monitor blood counts frequently for determining need for initiation of G-CSF and/or dosage modification
- Premedicate with corticosteroids and H2 antagonists due to risks of hypersensitivity reactions. Discontinue therapy immediately if severe reactions like generalized rash/erythema, hypotension and bronchospasm occur
- Gastrointestinal symptoms like nausea, vomiting, diarrhea may occur. Rehydrate and treat with anti-emetics and anti-diarrheals as mortality related to diarrhea has been reported. Modify dosage if experiencing Grade
3 diarrhea - Renal failure, including cases with fatal outcome, have occurred; identify cause and treat promptly
- Monitor closely elderly patients 65 years of age as they are more likely to experience fatal adverse events, including neutropenia and febrile neutropenia
- Administer G-CSF to reduce the risks of neutropenia associated with the drug. Consider primary prophylaxis in patients > 65 years, poor performance status, extensive prior radiation ports, previous episodes of febrile neutropenia, poor nutritional status, or other serious comorbidities
- Fatal harm can occur on administering to pregnant woman
- Avoid use in patients with hepatic impairment as it may increase the cabazitaxel concentrations
- Avoid concomitant use of strong CYP3A inducers such as phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, ST. Johns wort
- Monitor blood counts for neutropenia as neutropenic deaths have been reported. If neutrophil counts are
1,500 cells/mm3, administration is strictly contraindicated
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Pregnant woman
- Elderly patients 65 yrs of age
Pregnancy Category:D
Breastfeeding: Safety unknown; due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.
Note: Risk of severe hypersensitivity and neutropenia related deaths [U.S. Black Box Warning]
- HEMA: Neutropenia, febrile neutropenia, anemia, leukopenia, thrombocytopenia
- GI: Diarrhea, nausea, vomiting, constipation, abdominal pain, anorexia, dyspepsia
- CV: Peripheral edema, arrhythmia, hypotension
- CNS: Fatigue, asthenia, dysgeusia, dizziness, headache
- NEURO: Peripheral neuropathy
- GU: UTI, hematuria, dysuria
- METABOLIC: Weight decreased, dehydration
- MUSC: Arthralgia, muscle spasms, back pain
- RESP: Cough, dyspnea
- DERM: Alopecia
- RENAL: Possible renal failure
- MISC: Pyrexia, mucosal inflammation, pain, sepsis
