Docetaxel

Brand Names: Taxotere

Clinical Names: Docetaxel

Summary

generic name: Docetaxel

trade name: Taxotere®

type of drug: Chemotherapy.

used to treat: Late-stage cancer.

overview of interactions:
• nutrient affecting drug toxicity: Vitamin B6 (Pyridoxine)

• nutrient affecting drug toxicity: Flavonoids, such as Hesperidine




Interactions

nutrient affecting drug toxicity: Vitamin B6 (Pyridoxine)

• adverse drug effect: Some individuals receiving treatment with docetaxel have suffered from painful swelling and inflammation in their hands and feet.

• research: Vukelja et al reported two cases in which individuals experiencing these drug-induced side effects responded positively to supplementation with vitamin B6, 50 mg three times daily. The patients in this study reported initial relief from their symptoms within twelve to twenty-four hours with continued improvement over subsequent weeks.
(Vukelja SJ, et al. J Natl Cancer Inst 1993 Sep 1;85(17):1432-1433.)

• nutritional support: Vitamin B6 supplementation might counteract some of the adverse effects of treatment with docetaxel. While daily dosages of 200-500 mg can be used under supervision, vitamin B6 in dosages of over 100-200 mg per day for extended periods could potentially damage sensory nerves. As indicated by preliminary research, moderate dosages, well within the range considered generally safe, could be adequate for countering these adverse affects of docetaxel. Individuals being treated with docetaxel should consult their prescribing physician and/or a nutritionally trained healthcare professional before starting supplementation with vitamin B6.

nutrient affecting drug toxicity: Flavonoids, such as Hesperidine

• research: Fluid retention is a phenomenon associated with taxoids such as docetaxel. In a clinical trial Behar et al provided patients with what they described as "symptomatic flavonoid treatment," in the form of micronized diosmine hesperidine, typically after the last cycle of docetaxel. Specific investigations for fluid retention confirmed a relationship between cumulative docetaxel dose and development of fluid retention. After treating 18 of 24 patients in this manner they concluded that a vascular protector such as micronized diosmine hesperidine with recommended corticosteroid premedication and benzopyrones may be useful in preventing and treating docetaxel-induced fluid retention.
(Behar A, et al. Br J Clin Pharmacol 1997 Jun;43(6):653-658.)

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The information presented in Interactions is for informational and educational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, case reports, and/or traditional usage with sources as cited in each topic. The results reported may not necessarily occur in all individuals and different individuals with the same medical conditions with the same symptoms will often require differing treatments. For many of the conditions discussed, treatment with conventional medical therapies, including prescription drugs or over-the-counter medications, is also available. Consult your physician, an appropriately trained healthcare practitioner, and/or pharmacist for any health concern or medical problem before using any herbal products or nutritional supplements or before making any changes in prescribed medications and/or before attempting to independently treat a medical condition using supplements, herbs, remedies, or other forms of self-care.


References

Behar A, Pujade-Lauraine E, Maurel A, Brun MD, Chauvin FF, Feuilhade de Chauvin F, Oulid-Aissa D, Hille D. The pathophysiological mechanism of fluid retention in advanced cancer patients treated with docetaxel, but not receiving corticosteroid comedication. Br J Clin Pharmacol 1997 Jun;43(6):653-658.
Abstract: AIMS: Fluid retention is a phenomenon associated with taxoids. The principal objective of this study was to investigate the pathophysiological mechanism of docetaxel-induced fluid retention in advanced cancer patients. METHODS: Docetaxel was administered as a 1 h intravenous infusion every 3 weeks, for at least 4-6 consecutive cycles, to patients with advanced breast (n = 21) or ovarian (n = 3) carcinoma, who had received previous chemotherapy, 21 for advanced disease. Phase II clinical trials have shown that 5 day corticosteroid comedication, starting 1 day before docetaxel infusion, significantly reduces the incidence and severity of fluid retention. This prophylactic corticosteroid regimen is currently recommended for patients receiving docetaxel but was not permitted in this study because of its possible interference with the underlying pathophysiology of the fluid retention. RESULTS: Fluid retention occurred in 21 of the 24 patients but was mainly mild to moderate, with only five patients experiencing severe fluid retention. Eighteen patients received symptomatic flavonoid treatment, commonly prescribed after the last cycle. Specific investigations for fluid retention confirmed a relationship between cumulative docetaxel dose and development of fluid retention. Capillary filtration test analysis showed a two-step process for fluid retention generation, with progressive congestion of the interstitial space by proteins and water starting between the second and the fourth cycle, followed by insufficient lymphatic drainage. CONCLUSIONS: A vascular protector such as micronized diosmine hesperidine with recommended corticosteroid premedication and benzopyrones may be useful in preventing and treating docetaxel-induced fluid retention.

Vukelja SJ, Baker WJ, Burris HA 3d, Keeling JH, Von Hoff D. Pyridoxine therapy for palmar-plantar erythrodysesthesia associated with Taxotere. J Natl Cancer Inst 1993 Sep 1;85(17):1432-1433. (Letter)