Beware of allergic reaction to Taxol

hendricks1

Beware of allergic reaction to Taxol

hendricks1

I don't know how common it is but I had a severe reaction to Taxol that landed me in the ICU for a night.  I truly thought I was going to die.  I had an anaphylactic reaction that caused my blood pressure to drop to the point that I required epi to get my heart going again.  I post this not to scare anyone, but just to make sure that your chemo RNs monitor you closely when you're first trying any new drugs.

kerri72

That must've been terrifying! I'm so glad you're all right. Just curious, was it your first Taxol treatment? Did you receive benadryl with your infusion? I've done several of my 12 weekly Taxol and would like as much info as you can give.

Thanks! 

hendricks1

Hi Kerri72-yes, it was my very first one and a few seconds in to the Taxol, I knew something was really wrong.  You shouldn't have anything to worry about-I think you either really Are allergic orreally Aren't.  I did get benadryl first and even that made me a little light headed but I'm now getting abraxane (another taxane) and I don't have to have benadryl with it.  My Dr said that abraxane is really well tolerated, requires less pre-meds, etc. and I asked why, if it's so great, didn't I get that first??  He said because it costs more so insurance makes you try Taxol first to whether you can tolerate it or not?  Nice huh?  The abraxane has been pretty easy so far.

Titan

Oh yes..I was watched very diligently the first taxol infusion..plus had my BP tested every 15 minutes..(treatment took 4 hours)...

Any good medical center will be diligent with you...they told me that is why they had the oxygen in the room with me...

It's scary..you survive the red devil..think that taxol will be easier but may not so much..

Oh yes..IF something is going to happen it will happen in the first 15 minutes

jenn3

I was watched very closely on the Taxol too.  What I've never seen in writing, is back spasams.  I had terrible, unbearable back pain during the infusion.  The first time it happened (on my 2nd infustion) I thought I had pulled my back and it was acting up.  I was in so much pain that they had to give me pain medicine and my poor Mom rubbed my back the entire time I was in the chair.  The next time it happened I thought, "what on earth is causing my back to act up".  Again, blamed myself - thinking I hurt my back or my nerves were on edge. The next time, I had pain medicine with me, took it before the infusion and was fine and had to do so before each infusion. The onc really didn't know why I was having this reaction and didn't think it was related.  Then one day heading to the restroom toting my IV pole with me one of the nurses asked me about the pain and what I was doing to help it, she was asking because she had another patient with the same complaints during Taxol infusions.  I know it was the Taxol, but I've never seen anything saying it can or has happened to someone else and my onc didn't seem to have heard of that reaction in other patients.

Thanks goodness for the nurses that keep an eye on us during infusions - they are wonderful.

Hendricks - I am so sorry you had such a terrible experience, but thank you for sharing so that other people will be aware of what can happen.  Belated (((hugs))) for such a terrible experience.

hendricks1

Thanks for your comments-sorry to hear about your back pain Jenn3-that is strange, you poor thing!

I guess my RNs thought I wouldn't have a problem.  They weren't overly cautious with that first treatment which is surprising.  Yeah, my FAC treatments were much more monitored and I too thought Taxol would be easy after that.  Oh well...I'm sure some of you can relate but now days, I just think "if it can happen, it'll probably happen to me!"

Tundra

Hi there,

 Yes, apparently some people get a reaction to Taxol. Sorry to hear yours was so dramatic!

 Apparently it's actually a reaction to the solvent that they need to administer along with the Taxol. So yes, they normally give you Benadryl and Stereiods as pre-meds to help prevent a reaction.

I was given a massive dose of Benadryl before my 1st Taxol tx... so much so that I was nearly blacking out. But yes, in the end I had allergic reactions to the solvent -- started feeling warm, chest got all red and rashy, and had some lower back pain.

During my second tx they stopped treatment for a bit to give me more Benadryl, but I kept having the reaction. So in the end I got switched to Abraxane.

Apparently Abraxane is just a reformulation of Taxol -- instead of needing to use the solvent, it's wrapped in fat molecules -- so you can take it as is and don't need any pre-meds.

I believe Abraxene is more expensive and requires a bit more time to prepare, hence them trying people out on Taxol first. 

I've now had 5 weekly Abraxene treatments and everything's been a-ok. It's nice too to not have to get both knocked out by the Benadryl and pumped up by the steriods.

Good luck to you!

Patrithia

Hello,

I started Taxol/Herceptin in September (with premeds) and developed a rash on my back.  It was manageable but got progressively worse each week so my doctor switched to Abraxene for the last 5 treatments.  The rash got progressively worse so I took steriods (6 pack/12 pack/6 pack/12 pack).  The steriods helped with the rash but I hated the side effects.  After completing chemo on Nov. 17 the rash got really bad. Two months later (no chemo) and the rash starts at my neck and ends on my toes (it's awful).  The itching is unbearable and it's hard to get a good night's sleep.  I've had a skin biopsy.  I'm taking antihistimines, using a topical seriod cream and I took more steroids.  Over two months since my last chemo and the rash is getting worse. Has anyone out there had the same problem?  The biopsy confirmed that the rash was "chemically induced" but can't tell me what chemical. The "half-life" of taxol is 17 days....so it may take up to 100 days to leave my system.  It's very uncomfortable and it's a full time job trying to keep the rash under control.  I would love some advice as the doctors just don't know what to do.  Thank you.  Patricia

doxie

Patrithia - following up from another thread since you posted here.  No luck with finding help from an oncology pharmacist?  So sorry you are still in misery.  I still have my hives, so it wasn't only the Neulasta, though they aren't as bad this round.  Thinking that my MO was right that Taxotere could also be causing them.  Three weeks after my last round and the eighth week with the hives.  But I'm experiencing nothing as bad as you are.  

Are you still holding off on more Herceptin? 

Patrithia

Hello Doxie,

I'll have to call Mayo and ask about the oncology pharmacist.  I am seeing a dermatologist at Mayo and had a biopsy of the rash done there.  Not sure whtat to ask the pharmacist?  Yes still suffering with the rash.....just keeps on going and going..no end in sight.

Thanks for writing!

Patricia 

doxie

Patrithia - I'd just tell the pharmacist your story.  Ask if he/she has any ideas of why you are still reacting to the T and/or H.  At the least you are informing them that there are such problems with chemo for some people, regardless of how rare.  

You may be having an autoimmune reaction also, so might need to see an immunologist.  My hives are slowly getting better, otherwise I would ask to see one.  

 Hang in there.   

gamergirl

Both Taxotere and Taxol caused me to go in to anaphylactic shock.  I too am on Abraxane now.  I wonder when the price of Abraxane will become reasonable enough that they can use it more often.  I am still using pre-meds with the Abraxane, because they aren't sure I'm just allergic to taxane drugs, not just the solvents in them.

Jenn - I had the horrific back pain with both reactions.  My nurse said it was the adrenal glands located in your lower back... they start spasming to pump out as much adrenaline as possible.  I was given dilaudid through my IV... and that barely made it tolerable.  I feel for you, the pain was so bad it went down to my knees.  

In general, only 1-3% of us have the hypersensitivity to Taxol.   It's just no fun to be unusual during chemo!

Sassa

When we were first discussing my chemo, the use of ACT + herceptin was mentioned.

Because I already  knew that I developed a rash whenever I prune yews and juniper bushes, I told my oncologist about my skin reactions. She promptly told me that she would not use the taxol on me, "would save it in case we need it later."

It's been 5 years and I have not needed the back up plan.

Kimberly53

Hello, my sister was just diagnosed with IBC . Started 1st. treatment of Taxol, bad reaction, so will try something new next week. How are you doing?

ScottC

I am so sad. My 75 year old mother was diagnosed
with Stage 4 breast cancer that metastasized to the liver and bone. She was
diagnosed on a Friday, released from the hospital on the following Monday after
12 days there. We met with the Oncologist, Dr. Segal on Friday who informed us
that the liver had tumors "too numerous to count" and recommended
chemotherapy ASAP. Taxol, Herceptin and Aredia (for the bone). Monday we went
to Zangmeister Cancer Center in Columbus Ohio for the first treatment. We were
briefed on the possible side effects of the medications and told that allergic
reactions to the Taxol is 1-2%. Benadryl and a steroid were given prior to the
Taxol. My mom was falling asleep through the entire briefing as she had no
energy and was sleeping quite a bit in most of the recent days. Well they
started the treatment and we left. Soon after a nurse came to find us and tell
us she had an allergic reaction to the medicine. When I got there she had a
non-rebreather mask on, was terrified and disoriented trying to stand and could
not. The medics were trying to get a blood pressure and I overheard him say
"I can't hear one". I was told her oxygen saturation was in the 70's.
Are you kidding me! Is anyone watching her during the treatment?? She must have
been in respiratory distress for some time before they saw her. Anyway they
took her to the emergency room where she was intubated and placed on a
respirator. The doctors told us that when she was going through this anaphylactic
reaction that her blood pressure dropped and caused her kidneys to distress
nearly placing her in kidney failure. She was taken off the respirator Tuesday
night and lived long enough to come home the next afternoon where she died at
home (as she wished, "never let me die in the hospital please!") five
days later. Please be careful with the Taxol, my mom was weak and never
probably should have opted for any chemotherapy as she was showing most of the
end stage signs of the breast cancer in her liver. I wish I would have stayed back with her during the treatment so I could have kept an eye on her.  Don't let the facility tell you that you cannot stay with your loved one during the chemotherapy.  It happened so quickly.  I am still so sad.

Denise-G

ScottC - I am so terribly sorry to hear of your mom's passing and because of the anaphylactic reaction to Taxol.  That is so very tragic.  I cannot begin to express my sorrow to you. 

When I had my first Taxol treatment, I was watched like a  hawk at the Univ of Michigan and was told anaphylactic shock could happen so if it did, do not be alarmed if they called Code Blue on me.  They put me in the chemo chair that was closest to the nurses desk so someone was watching me at all times.  They said if it happens, which is rare, it would happen within the first 10 minutes.

It will be difficult not to blame yourself for leaving, but you thought she was being taken care of.  My thoughts and prayers are with you and your family.  Denise

hendricks1

Wow-I too am so sorry to hear that.  I now know that I will have someone with me for any first time of a new drug but how do you know that unless you've been through the experience.  It's crazy and I'm so sorry for your loss.

chanah

My nurses (once it hspoened) told me back pain is a classic symptom of an allergic reaction to Taxol starting. Though heavily pre-medicated (oral steroids the night before and morning of plus IV benedryl and stetoids the day of), I too had INTENSE shooting back pain which went on to also include heart pain, racing heart rate and - before the reaction was reversed - began to have some breathing difficulty, too. This was early in treatment #2. They gave me more meds, then even more and "re-challenged" getting once the reaction ended, continuing the rest of the Taxol. But on treatment #3, with even more premeds, the reaction came sooner, faster and, though I didn't think possible, even more severe. They did not finish any more of the Taxol, gave me a week off and onlybthen told me I could switch to Abraxane. It has the exact same active ingredient - just a safer solvent. Abraxane is not given regularly in place of Taxol only because it is still under patent (read expensive here). How sad patients are put through risk of reaction for such a non-medical reason. I certainly would have stopped during treatment 2 and switched right then if I had known. Why did it take a second potentially life threatening experience to be told there is that option?

NickyJ

Thought I'd let everyone know how it works here in Bordeaux. Every time you start a new treatment, the first time you're brought in first thing in the morning -8am. The day starts with the nurse explaining all about the treatment And the possible se's. this nurse is assigned to just you for the full day. Blood pressure is monitored every half hour and the infusion is run twice as slowly as usual to allow every opportunity to monitor any reactions. I'm very lucky to be part of this system; there's a strong sense of security to be monitored so closely. It makes me sad to read some of the stories here where ladies were not so lucky. Maybe there's something to learn from the French?
Forgot to mention that regardless how long the infusion takes, the first day you stay in the chemo treatment room until 6pm for monitoring.

Nicky

Skagitphoenix

Well, it seems that the cost of Abraxane must still be far more expensive than the Taxol, because it is still not the first drug of choice. I had my first round 3 weeks ago & reacted to the Taxol within 10 minutes or so (I was premedicated with large doses of benadryl and steroids). I got really hot & turned bright red. They turned the Taxol down to a very slow drip & gave me more benadry & steroids. I was there a total of 9 hours! It was awful, but not as bad as yesterday. Yesterday within just a few minutes of starting the Taxol I couldn't breath or move. There was no way I was able to push that button that was next to my hand. Thankfully a nurse was standing right there & heard me croaking/gasping. She called a code & everyone reacted super fast. It was the weirdest thing I've ever been through. I wasn't scared, just very confused. I could hear everyone, but I couldn't respond. I wonder if its like being in a coma? They injected a bunch of stuff in my IV, stopped the Taxol & shoved a breathing tube in my nose to force oxygen into my lungs. It was still quite a while before I was able to hold my head up & talk, but all in all I was impressed with how fast they reacted & knew just what to do.

ScottC please note that my "episode" happened extremely fast & I don't think it takes long for a person's oxygen level to drop when they are getting zero or very little air. I'd like to believe the staff was doing everything they could & did not leave your mother alone. I don't think I've ever been left alone for any of my treatments. The nurses are either in the room with me and the other patients or they are sitting at their computers within site of us. I also usually have a friend/relative stay with me during the treatments and no one has ever questioned it.

Please know that you did everything you could for your mother. It sounds like you were/are a wonderful son - someone I wish I had to help me through this cancer rollercoaster.

RHGSR

just found this blog. Had DD Taxol #2 today. Did fine with a slowly infused #1 but within seconds of bring infused with #2 I got hot, red all over, couldn't hear (Ringing in ears), then I could feel my throat closing up. I also got the severe low back pain. 

They pushed a bunch if steroids and re-challenged at a slow rate and I was able to finish it. 

I was told that for #3 we would increase the premed Benadryl and steroids. But after reading these posts... I'm really nervous 

chanah

RHGSR, I strongly suggest you have someone with you.  Have you asked to get Abraxane?  It is the same drug but in a different solution becuase it is the solvent that most are allergic to.

rumoret

I reacted to Taxotere within the first couple of drips or bump. It felt like a belt was squeezing me right below my breasts across my rib cage. My heart took off beating and blood pressure set the ALARMS off. The nurse gave me a shot to bring everything back to normal. The oncologist was called....and she told my nurse to give me more premeds and then to try it once again. The nurse started the drip again trying to get through the first bump.....no such luck......ALARMS took off.....and the squeezing of my rib cage began. The oncologist came back and stated for me to return the next day and they would "Challenge Me". The next day they shot me up with more premeds and decided to drip Taxotere into my veins over 3 hours rather than 1 hour.

I managed to get through 3 complete sessions with no further incidents. Then on my 4th chemo treatment someone decided to push Taxotere into my body over 1 hour and not the 3 hours. I left feeling really strange and later that week I had projectile throwing up, caused by an obstructed small bowel. I ended up in the acute care of KAISER and had tubes pushed down my nose to remove fluids.....I was there for a week. I also had fluid around my heart. I was released after one week.....and three days later my daughter was watching me breathe and suspected something was up. I was taken to emergency and was discovered to have pneumonia......but what kind? After another week in the hospital it was determined that the hospital gave me hospital induced pneumonia!

When I was released from hospital and met with my oncologist....my husband and I tried to get to the bottom of WHY I was givenTaxotere over 1 hour rather than 3 hours. My oncologist just flipped back and forth through my medical file and never once gave us an answer. We just wanted the truth....we did not get it. I immediately made a decision to change Medical Insurance when selection came up in the next 2 months.

Later on when I had recovered I went searching for the INSERT LABEL on Taxotere. I discovered that by the 5th or 6th Taxotere session some people have experienced SMALL BOWEL OBSTRUCTION and FLUID AROUND HEART. This can be fatal.

I decided to not take the next two Taxotere treatments and my oncologist thought 4 Taxotere treatments would be enough!  YEAH.....no kidding!!  (Four Taxotere sessions was the former protocol before they decided to try Six Taxotere as the next best thing.)

I posted this years ago......but saw this post and thought I would post again.

Hugs,

Terry

ChrissyLB

OMG! I am begining this medicine on 4/`14/14 and after reading all of this i am freaking out! I do not want this med at all! Geez-a-loo! I am calling my MO first thing, I cannot believe this drug is used with so many SE... Hoping I can change this, I do have some food allergies I just wonder which ones would effect the use of this med on me?  Wish me luck@

PamelaC47

I'm surprised hearing that any hospitals are trying to infuse Taxol over one hour.  I was told that because of the potential for allergic reaction it was mandatory to administer it over a three hour period.  There are a lot of drugs out there that can cause a reaction by being administered too quickly...I had that happen with an antibiotic in the hospital after my BMX.  It was supposed to run over several hours, the nurse made an error, I reacted at once.....I have a child with food allergies and know the symptoms of an allergic reaction so I knew within seconds I was having one and they stopped it immediately.  The hospital where I got my treatment, the standard for taxol is huge dose of steroids and Benadryl,  run over three hours with a BP cuff on at all times, and they watched me very closely.  I made sure I had my husband sitting with me the entire time watching me too. 

RHGSR

I just finished my fourth DD Taxol. They increased my premeds and ran #3 & 4 over 3-4 hours. No allergic reactions. I would suggest having this med run slowly even if you tolerate the first one well. And have someone with you. 

Leah_S

ChrissyLB, I'm the Allergy Queen but I didn't have problems with DD Taxol. I got Phenergan premed (maybe steroids, too, I don't remember since this was 5 years ago). It was administered slowly, 3-4 hours I think. I don't know exactly how long since the Phenergan (antihistimine that's VERY strong) put me to sleep. DH got to watch Sleeping Beauty for a few hours.

Best of luck with your treatment.

Leah

mike3121

I am the husband of a Stage 4 BC, initial DX (ER+ PR+ HER2-). I come to this forum mainly to check on new advances and treatments; it gives me hope. My wife doesn't want to post here or any forum about cancer - her choice. Anyway January 2013 she got a full dose of Taxol and was to get one each week. About 1/3rd of the way into her second dose she had a full blown reaction, shaking, passing out, etc. Full crash cart and dozens of nurses surrounding her. As a side note, later they gave her a shot of Neulasta to improve her white cell count and she had the same reaction, ER, crash cart, etc. They continued her chemo but with A-C. Wow, A-C mush have walloped the nasty old cancer because she's NED after only 3 sessions. Her OC calls her remarkable, phenomenal and such.

Radical2Squared

I start Taxol in 5 days. On my last visit, my onc explained that I should plan to spend the day in the infusion center. She said pre-meds would take about an hour, then Taxol would be pushed very slowly over about 4-5 hours due to the risk of allergic reaction.

I was told the reaction usually happens on the first or second visit and that even after a reaction, infusion can resume. The body builds some kind of tollerance as long as the drug is introduced very slowly. She also said I would be monitored constantly.

Astarte

I had my first Taxol treatment last week and experienced horrific back pain as the week wore on. Had my second infusion today and as I got in the car the pain started. I already have osteoarthritis so this is making it three times worse. Worse than I daresay, Neulasta. Lots of muscle pain, feeling of excess lactic acid build up. I sure hope this isn't a sign of an allergic reaction.

Edited to say: Six days later and I'm still in severe, debilitating pain. It definitely is the Taxol, my docs know about it, and have lowered this weeks dose. My fingernails are also breaking in painful places (way up high) and look (and feel) like they are going to fall off. The neuropathy has moved to my middle finger of my left hand. So only my two fingers most to the left I can feel fully. My appetite has been good though. I worry about getting fat again.