Abraxane (Nab-Paclitaxel) IV: Use, Side Effects, Dosage
What Is Abraxane?
Abraxane (nab-paclitaxel) is a chemotherapy medication that treats certain types of breast cancer, non-small cell lung cancer (NSCLC), and pancreatic cancer.
It belongs to a class called microtubule inhibitors, which work to keep cancer cells from continuing to make copies of themselves and grow. The chemotherapy medication paclitaxel is attached to a protein called albumin. This helps reduce the risk of developing an allergic reaction to paclitaxel, which can be common.
Abraxane is taken through an intravenous (IV) infusion in a healthcare setting.
Drug Facts
Generic Name: Nab-paclitaxel
Brand Name(s): Abraxane
Drug Availability: Prescription
Administration Route: Intravenous
Therapeutic Classification: Microtubule inhibitor, taxane
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Paclitaxel protein-bound
Dosage Form(s): Powder for reconstitution
What Does Abraxane Treat?
The U.S. Food and Drug Administration (FDA) approved Abraxane for use in treating three different types of cancer:
- Metastatic breast cancer that has previously been treated with a different combination of chemotherapy for metastatic disease. Metastatic means the disease has spread to other parts of the body. It can also be used if breast cancer becomes metastatic within six months of chemotherapy after surgery.
- Metastatic NSCLC, or locally advanced NSCLC in those who will not benefit from surgery or radiation to cure their disease. In this setting, it is used in combination with carboplatin.
- Metastatic pancreatic cancer, used in first-line treatment in combination with gemcitabine.
How to Take Abraxane
Trained healthcare providers administer Abraxane at an infusion center. You will receive it through an IV or a central line. The infusion is recommended to be given over 30 minutes.
How Long Does Abraxane Take to Work?
After the Abraxane has been administered, it may start to work quickly. However, it can take a few weeks to months of regular treatment to see a noticeable decrease in the size of the tumor cells on imaging.
What Are the Side Effects of Abraxane?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
As chemotherapy, Abraxane has the potential to cause side effects. Side effects may vary based on what type of cancer it is treating.
Some common side effects of Abraxane can include:
Severe Side Effects
Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Severe neutropenia, which can increase the risk of infection
- Severe thrombocytopenia, with bleeding and bruising
- Sepsis (a life-threatening infection), which can initially cause fever, hypothermia (low body temperature), sweating, rapid heart rate, and rapid breathing
- Severe neuropathy, with numbness and tingling in the extremities
- Pneumonitis, with shortness of breath, fever, and chest pain
- Severe hypersensitivity reactions, with fever, chills, rash, or shortness of breath during infusion
Long-Term Side Effects
Sometimes, a severe side effect can be persistent. This can happen in instances of neuropathy and pneumonitis.
Report Side Effects
Abraxane may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Abraxane Should I Take?
The exact dose of Abraxane prescribed to someone depends upon the type of cancer they have, as well as their height and weight. The dose is calculated using body surface area, using the abbreviation m2. The recommended dosages are as follows:
- Metastatic breast cancer: 260 milligrams/m2, given once every three weeks
- NSCLC: 100 milligrams/m2 given on days one, eight, and 15 every 21 days
- Metastatic pancreatic cancer: 125 milligrams/m2 given on days one, eight, and 15 every 28 days
Modifications
Your healthcare provider may lower your dose of Abraxane if you develop side effects, especially low blood cell counts, to prevent them from worsening.
Missed Dose
Missing a dose of Abraxane may be necessary if you experience severe side effects or if your blood counts aren’t high enough on the day of your treatment. Your oncologist will monitor this and resume Abraxane when it’s safe to do so.
Overdose: What Happens if I Take Too Much Abraxane?
An overdose is unlikely because pharmacists and nurses mix Abraxane to its prescribed dose and then check this with multiple healthcare providers to ensure accuracy.
However, if too much Abraxane is taken, side effects can include:
- Severely decreased blood counts
- Severe mucositis (sores in the mouth and on the tongue)
- Severe neuropathy
What Happens if I Overdose on Abraxane?
If you think you or someone else may have overdosed on Abraxane, call a healthcare provider Poison Control (800-222-1222).
If someone collapses or isn’t breathing after taking Abraxane, call 911 immediately.
Precautions
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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
Men who are receiving this medicine should not father a child. This medicine can harm the unborn baby of your partner.
This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are receiving this medicine.
Paclitaxel can temporarily lower the number of white blood cells in your blood, which will increase the chance of getting an infection. It can also lower the number of platelets in your blood, which are necessary for proper blood clotting. If this occurs, these are the precautions you can take to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection, or if you get a fever or chills, cough or hoarseness, lower back or side pain, or have painful or difficult urination.
- Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in your urine or stools, or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects, such as a safety razor, fingernail clippers, or toenail clippers.
- Avoid contact sports or other situations where bruising or injury could occur.
This medicine is made from donated human blood. Although the risk is low, some people have received viruses from human blood products. Human donors and donated blood are both tested for viruses before the medicine is prepared. Talk with your doctor if this concerns you.
Check with your doctor right away if you have burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. These could be symptoms of a condition called sensory neuropathy.
Lung or breathing problems may occur if you are receiving this medicine together with gemcitabine. Tell your doctor right away if you have shortness of breath, trouble breathing, or a persistent dry cough.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are the Reasons I Shouldn’t Take Abraxane?
You should not take Abraxane if you:
- Have severely low white blood cells (your oncologist will monitor this to ensure blood counts are high enough to receive treatment safely)
- Have ever had a severe allergic reaction to Abraxane
What Other Medications Interact With Abraxane?
Certain classes of medications may have the potential to interact with Abraxane. These can include:
- CYP2C8 inhibitors, which include Lopid (gemfibrozil), Singulair (montelukast), and Nardil (phenelzine)
- CYP2C8 inducers, such as rifampin
- CYP3A4 inhibitors, which include Sporanox (itraconazole), Norvir (ritonavir), and grapefruit juice
- CYP3A4 inducers, which include rifampin, Tegretol (carbamazepine), and Dilantin (phenytoin)
CYP2C8 and CYP3A4 are liver proteins that break down and clear out certain drugs from the body. Drugs that inhibit CYP2C8 or CYP3A4 can prevent these enzymes from working as well, which can lead to higher levels of Abraxane in the body. Drugs that induce CYP2C8 or CYP3A4 encourage the enzymes to break Abraxane more quickly, which can reduce how well it works.
Before starting treatment, tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.
Which Medications Are Similar?
Abraxane belongs to the class of microtubule inhibitors called taxanes. Other examples of taxanes include:
- Paclitaxel: Paclitaxel is the same active ingredient in Abraxane. However, on its own, paclitaxel is not attached to albumin like Abraxane (nab-paclitaxel). This means it must be infused with other medications to prevent a severe reaction during the infusion.
- Docetaxel: Docetaxel is taken alone or with other therapies to treat certain cancers, including breast cancer, NSCLC, and prostate cancer.
How Can I Stay Healthy While Taking Abraxane?
Like other chemotherapies, Abraxane has the potential to cause side effects. Though the potential list of side effects may seem daunting, this does not mean you will definitely experience them. However, it is especially important to communicate any side effects you do notice with your oncologist. Your oncology care team can help you effectively manage them.
Never hesitate to reach out to your healthcare providers about any questions or concerns regarding your treatment.
Medical Disclaimer
Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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