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Taxotere and Cytoxan

Taxotere (docetaxel) and Cytoxan (cyclophosphamide) are commonly used together to treat breast cancer in what’s known as a TC regimen. The two drugs work differently to stop cancer cells from multiplying. Although they effectively treat cancer, they may cause rare but serious side effects.

Last Modified: November 16, 2023
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What Is Taxotere and Cytoxan Therapy?

Docetaxel, a chemotherapy drug with the brand name Taxotere, is an anti-microtubule inhibitor. Derived from yew trees, it stops fast-growing cancer cells from dividing and multiplying. 

Cytoxan is the brand name for cyclophosphamide, a chemotherapy drug classed as an alkylating agent. It also helps stop fast-growing cancer cells from dividing and making new cells. Patients often take the two drugs together for breast cancer treatment. Because they work differently, using both makes the overall treatment more effective.

Key facts:
  • The combined use of docetaxel and cyclophosphamide is often called TC or DC.
  • As an adjuvant breast cancer treatment, TC had better results than doxorubicin and cyclophosphamide (AC), according to the American Oncology Research Trial 9735.
  • Doctors administer Taxotere with an injection.
  • Cytoxan is available as a tablet, and there are generic alternatives for cyclophosphamide injections and oral tablets and capsules.
  • Taxotere and Cytoxan are cytotoxic agents that kill cells and may stop cancer cells from dividing and growing. They can also cause tumors to shrink in size.

Cytoxan is a strong chemotherapy drug that treats several types of cancer. Breast cancer patients may also use Cytoxan with Taxotere and Adriamycin (doxorubicin hydrochloride) as an adjuvant therapy for cancer with a relatively high level of recurrence. Patients with Hodgkin or non-Hodgkin lymphoma may use this drug alone or in combination with other medications.

Who Is Eligible for a TC Chemotherapy Regimen?

The eligibility criteria for the TC chemotherapy regimen depend on the type of cancer. Your oncologist will review your medical history and relevant test results to determine your eligibility. Discuss any concerns or questions you may have with your health care team.

Other TC eligibility criteria are:
  • Invasive breast cancer
  • Node positive disease
  • No significant comorbidities that outweigh the potential toxicities
  • Patient agrees to adjuvant chemotherapy

Doctors particularly recommend TC for patients who cannot have standard anthracycline-based adjuvant chemotherapy because of a history of cardiac disease. Patients with early-stage breast cancer may be eligible for clinical trials. 

Taxotere and Cytoxan Contraindications and Interactions

People with certain conditions should not use Taxotere and Cytoxan. Allergies to alkylating agents, for example, is a contraindication for Cytoxan use. Allergies or hypersensitivity reactions to taxanes are also contraindications for Taxotere use.

Possible TC drug-drug interactions may occur with the following:
  • Allopurinol
  • Antifungals
  • Clarithromycin
  • Cortisone acetate
  • Doxorubicin
  • Herbal supplements
  • HIV protease inhibitors
  • Hydrocortisone
  • Indinavir
  • Medications containing alcohol
  • Nelfinavir
  • Ketoconazole
  • Nefazodone
  • Pain medications
  • Phenobarbital
  • Ritonavir
  • Saquinavir
  • Sleeping pills
  • Telithromycin
  • Voriconazole

Taxotere may not be appropriate for people who have or have ever had liver disease or who have had treatment with cisplatin or carboplatin for lung cancer. Always inform your doctor about any prescription or over-the-counter medications, supplements or vitamins you take.

What Can I Expect With Taxotere and Cytoxan Treatment?

Before beginning treatment with Taxotere and Cytoxan, you may need to take premedication in the form of an oral corticosteroid. Doctors recommend that you stay hydrated before and after the treatment and to eat light meals to keep your strength up.

  1. Before treatment begins, you’ll have a blood test to check your blood cell counts.
  2. You may be given premedications on the day of treatment to help prevent side effects.
  3. You’ll receive Taxotere and Cytoxan through an IV infusion for 2-4 hours.
  4. After the infusion, your doctor will monitor you for any immediate side effects.
  5. Your doctor will give you instructions on managing side effects at home.

Consult with your oncologist about any other specific instructions they may have to prepare for treatment. Follow your doctor’s instructions for self-care following each infusion.

Taxotere and Cytoxan Treatment Cycles

A study of a select population of node-negative breast cancer associated four cycles of TC with encouraging long-term survival. Without a randomized comparison between four and six cycles of TC, the study is real-world evidence that four cycles of TC is a reasonable option for treatment.

Another study retrospectively reviewed patients who received diagnoses of early breast cancer between 2007 and 2017 and had either four or six cycles of TC. The study found that four cycles is “non-inferior” to six cycles in terms of death and recurrence.

Lawsuit Information
Women with breast cancer who were given Taxotere and later suffered permanent and irreversible eye damage are filing lawsuits.
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Side Effects of Taxotere and Cytoxan

The most common side effects of TC include hair loss, fatigue and low blood counts. Because TC combines two medications, patients may experience side effects from both Taxotere and Cytoxan at any time during and following treatment.

Side effects include:
  • Bladder damage
  • Constipation
  • Diarrhea
  • Fatigue
  • Fever
  • Hair loss
  • Heartburn or reflux
  • Infection
  • Joint and muscle aches
  • Leukemia
  • Low blood counts
  • Lung inflammation
  • Mild infusion reaction
  • Mouth sores
  • Nail changes
  • Nausea
  • Numbness and tingling of hands and feet
  • Swelling of extremities
  • Vomiting

Most side effects are generally manageable with a combination of prescription and over-the-counter medications. Report side effects to your oncologist who may offer approaches to managing side effects.

Side Effects of Taxotere

TC therapy involves two different drugs, each with its own side effects. Taxotere has both mild and more severe side effects.

Long-term Taxotere side effects include:
  • Acute Myeloid Leukemia
  • Alopecia
  • Blocked Tear Ducts
  • Excessive Tears
  • Neuropathy

Some people who took this drug to treat breast cancer have filed Taxotere lawsuits. They allege that the drug caused eye damage. 

Cytoxan Side Effects

Common side effects of Cytoxan include nausea, fatigue, hair loss and anemia. According to some studies, Cytoxan may irritate the bladder and increase the risk of bladder cancer.

Rare but serious possible long-term effects include:
  • Bladder cancer
  • Bone marrow failure
  • Infertility
  • Leukemia
  • Lymphoma

Cytoxan does not cause Shingles. However, because the drug can suppress the immune system, taking Cytoxan may make it easier for the shingles virus to reactivate.

Please seek the advice of a medical professional before making health care decisions.