Taxotere Side Effects

As of March 31, 2024, alopecia, emotional distress, psychological trauma and anxiety were the most frequently reported Taxotere side effects, according to the U.S. Food and Drug Administration (FDA).

Disclaimer: Reports sent to the FDA don’t necessarily mean the drug caused an adverse event. Consult a health care professional before stopping or changing medication.

The two most common side effects of taking the chemotherapy drug Taxotere are low white blood cell count (neutropenia) and anemia. According to the FDA, clinical trials found that of those who received 100 mg/m2 of Taxotere, 98% of breast cancer patients with normal liver function and 100% of those with elevated liver function, experienced neutropenia.

Even at a lower dosage of 60 mg/m2, taking the drug resulted in neutropenia in 95% of patients with normal liver function or NLF. Severe neutropenia was a side effect with a 100 mg/m2 dosage in 84% of patients with NLF. Anemia rates are nearly as high, occurring in 95% of patients with NLF and 94% of patients with elevated liver function, or ELF. However, the rate drops significantly to 65% in those with NLF who receive the lower dose.

Clinical trials demonstrate that Taxotere treatment for any tumor type commonly results in the following side effects and prevalence rates for those with NLF.

Taxotere combined with doxorubicin and cyclophosphamide leads to side effects not seen when used alone, including amenorrhea in 62% of patients, constipation in 34%, neuropathy in 26% and anorexia in 22%.

As with other chemotherapy drugs, low white blood cell count is the most common adverse effect for patients taking Taxotere. Almost all patients experience neutropenia, and 85% of those on a 100 mg/m2 dose see a severe decline in their white blood cell count. Severe neutropenia increases the risk of infections. This increased risk leads doctors to reduce dosing or pause treatment until counts return to an acceptable number.

White blood cell counts are usually at their lowest point between 10-14 days after treatment. Those with milder neutropenia often see their counts increase to safer levels before they receive their subsequent treatment. People with cancer are almost three times as likely to die from infection compared to those who don’t have cancer, and patients receiving chemotherapy have the highest risk.

Long-term side effects of docetaxel, the active ingredient in Taxotere, include alopecia, neuropathy, heart damage and cancer. Some long-term side effects may take months to resolve or, in some cases, continue indefinitely.

Peripheral Neuropathy

Peripheral neuropathy is a condition that involves damage to the peripheral nerves and has many potential symptoms. Women with invasive breast cancer receiving docetaxel were most likely to exhibit the neuropathy symptoms of muscle weakness in their legs and blurred vision, according to a 2022 report published in the Journal of the American Medical Association.

A studypublished in the European Journal of Cancer involving over 1,000 women with early-stage breast cancer found that 15% of those who survived breast cancer experienced significant symptoms from peripheral neuropathy. These symptoms lasted for one to three years after completing treatment and discontinuing their use of docetaxel.

Alopecia

While hair loss is common in chemotherapy patients, it is usually temporary. Alopecia, however, is a permanent hair loss condition. Research from the U.K. published in the European Journal of Cancer suggests that almost a quarter of women who use Taxotere could experience long-term hair loss. The researchers found that 23.3% of the women in the study experienced alopecia. They also found that postmenopausal women may be at higher risk.

Though the Taxotere drug sheet identifies alopecia as a potential side effect, plaintiffs have filed over 10,000 lawsuits against Taxotere’s maker, Sanofi. Plaintiffs allege that the manufacturer was aware of the risk of alopecia but failed to provide sufficient warning to consumers.

Febrile neutropenia and thrombocytopenia are less common in patients with NLF, but patients with ELF frequently experience these conditions. Additionally, patients receiving chemotherapy treatment that combines Taxotere with other agents, such as doxorubicin or cyclophosphamide, are at the highest risk of other possible adverse effects.

These side effects, though rare, are often distressing and painful. Patients may request treatment discontinuation, or physicians may pause treatment to address the side effects. However, these conditions are usually short-term and treatable.

Epiphora: Taxotere Eye Problem Risk

A 2021 study published in the Multidisciplinary Digital Publishing Institute found a significant link between docetaxel use and epiphora, which is a condition involving chronically watery eyes. However, the study did not find a statistically significant distinction concerning dosage frequency. The prevalence of epiphora between patients receiving treatment once a week and those receiving it every three weeks was 41.22% and 34.15%, respectively.

Canalicular stenosis, which is a condition that causes partial or total tear duct blockage, may be the underlying cause of epiphora. Because the condition interferes with daily activities such as reading, driving or watching TV, many patients reported a reduced quality of life. Nearly 200 patients who alleged that Taxotere caused them to develop canalicular stenosis have filed lawsuits against Sanofi.

Fluid Retention

Severe fluid retention, particularly in the extremities, can be an uncomfortable and potentially life-threatening condition. It primarily affects patients receiving treatment for breast cancer.

According to the FDA, moderate fluid retention occurred in 27.2% of patients pre-treated with corticosteroids. Another 6.5% experienced severe fluid retention. However, according to a 2023 study published in the Journal of Scientific Reports, treating patients with high doses of dexamethasone may significantly decrease symptoms or prevent fluid retention.

Infusion Reactions

Initial research into docetaxel indicated that patients frequently experienced infusion reactions, leading to steroid and antihistamine pretreatment. However, despite the precaution, research suggests that approximately 10% of patients still have an adverse reaction within minutes of injection, with 1% having a severe infusion reaction.

The most common symptoms include flushing, throat tightness, dyspnea and hypotension. Rarer symptoms include back and chest pain. Some patients experience rashes that occur within hours to weeks after receiving an infusion. Infusion reactions most often arise after the first or second treatment.

Though Taxotere is an effective cancer treatment, learning to cope with the side effects is necessary for many patients to continue receiving the medication.

Side effects vary in time of onset and severity. Those receiving treatment should remain vigilant for unusual symptoms between appointments and after the treatment finishes.

When experiencing mild symptoms, getting sufficient rest and nutrition and engaging in light exercise are essential to helping the body cope. However, patients should consider seeking immediate medical attention if they have signs of a severe reaction, such as breathing difficulties, fever, swelling at the injection site or in the extremities and mouth or throat pain.

Editor Lindsay Donaldson contributed to this article.