Docetaxel !

A semisynthetic taxane used in breast, lung, prostate, gastric and head and neck cancer. Neutropenia and fluid retention are its hallmarks.

Updated 2026-11-01

Class: Microtubule inhibitors
Target: β-tubulin (taxane site, inside the microtubule)
ATC code: L01CD02
WHO Model List of Essential Medicines

β-tubulin (taxane site, inside the microtubule)Docetaxel

Electron-crystallography model of pig α/β-tubulin from zinc-induced sheets, with docetaxel in the taxane site.

Target in 3D: β-tubulin (taxane site, inside the microtubule). PDB structure 1TUB (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

Docetaxel binds free tubulin and promotes its assembly into stable microtubules while blocking their disassembly. The frozen microtubule network cannot support mitosis or normal interphase functions, so the cell dies.

Docetaxel binds tubulin in the taxane site
Stable microtubules form and cannot disassemble
Mitosis fails: the cell dies

Pharmacokinetics

Absorption: Intravenous infusion only.
Metabolism: Liver, by CYP3A4; toxicity rises sharply with liver impairment.

Indications

Breast cancer: metastatic after prior chemotherapy, and adjuvant with doxorubicin and cyclophosphamide in node-positive disease. Breast cancer →
Non-small cell lung cancer, alone after platinum or with cisplatin. Lung cancer →
Metastatic castration-resistant prostate cancer, with prednisone. Prostate cancer →
Advanced gastric adenocarcinoma, with cisplatin and fluorouracil. Gastric cancer →
Induction treatment of locally advanced head and neck squamous cell carcinoma, with cisplatin and fluorouracil. Head and neck squamous cell carcinoma (oral cavity and oropharynx, HPV) →

Adverse effects

Common

Neutropenia in virtually all patients
Fluid retention: leg oedema, effusions, weight gain
Hair loss (sometimes permanent) and nail changes
Sensory neuropathy, weakness and mouth sores
Skin redness and peeling of hands and feet

Contraindications

Low neutrophil count
Severe hypersensitivity to docetaxel or to drugs formulated with polysorbate 80
Avoided when bilirubin is above normal or transaminases and alkaline phosphatase are both raised

Key interactions

Strong CYP3A4 inhibitors (e.g. ketoconazole, ritonavir): Raise docetaxel exposure and toxicity; avoided.
Alcohol-sensitive situations: The infusion contains ethanol, which may affect driving or people who must avoid alcohol.

What is monitored

Bilirubin, transaminases and alkaline phosphatase before each cycle
Frequent blood counts
Weight and oedema (fluid retention)
Vision changes, skin and neurological symptoms

Administration and safety

Oral corticosteroid premedication starting the day before each cycle reduces fluid retention and hypersensitivity.
Close observation during the first and second infusions; emergency drugs ready.
Contains alcohol: considered in people who should avoid alcohol and before driving.
Hazardous drug: prepared and given following hazardous-drug handling procedures (impervious gloves, no skin contact) and disposed of as cytotoxic waste.

Nursing care

Independent double check of drug, patient, route and cycle before giving it (high-alert medicine).
Confirm the corticosteroid premedication was taken; ask about any past reaction to paclitaxel.
Weigh at each visit and check for leg swelling, breathlessness or abdominal distension.
Blood count before each cycle; fever with neutropenia is treated as an emergency.
Teaching: report blurred vision, skin blisters, abdominal pain with fever, or numbness.

Pregnancy and breastfeeding

Can cause fetal harm; pregnancy is avoided during treatment.

Test yourself

Think of the answer, then tap the question to see it.

Why are corticosteroids given before docetaxel?

To reduce fluid retention and the severity of hypersensitivity reactions.

Which laboratory tests decide whether docetaxel can be given safely?

Neutrophil count and liver tests (bilirubin, transaminases, alkaline phosphatase), because liver impairment greatly increases toxicity.

With which drug is docetaxel combined in metastatic castration-resistant prostate cancer?

Prednisone.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - DOCETAXEL injection, solution, concentrate (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 70 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); eEML - Electronic Essential Medicines List (World Health Organization, 2025).

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Representative model, for educational purposes only.