[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/) › Docetaxel

[Pharmacology](https://durgical.com/en/pharmacology/) · [Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/)

# 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](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/)
- Target: β-tubulin (taxane site, inside the microtubule)
- ATC code: L01CD02
- WHO Model List of Essential Medicines

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

◆**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](https://www.rcsb.org/structure/1TUB) · Drag to rotate · pinch to zoom

## 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 →](https://durgical.com/en/conditions/breast-cancer/)
- Non-small cell lung cancer, alone after platinum or with cisplatin. [Lung cancer →](https://durgical.com/en/conditions/lung-cancer/)
- Metastatic castration-resistant prostate cancer, with prednisone. [Prostate cancer →](https://durgical.com/en/conditions/prostate-cancer/)
- Advanced gastric adenocarcinoma, with cisplatin and fluorouracil. [Gastric cancer →](https://durgical.com/en/conditions/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) →](https://durgical.com/en/conditions/head-and-neck-squamous-cell-carcinoma/)

## 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

### Serious (rare, important)

- Treatment-related deaths, more likely with abnormal liver function or higher doses
- Severe hypersensitivity, including fatal anaphylaxis despite premedication
- Severe fluid retention (pleural effusion, tamponade, ascites)
- Neutropenic enterocolitis; severe skin reactions; cystoid macular oedema
- Second cancers (acute myeloid leukaemia, myelodysplasia)

## 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.

## Memory aid

DOCEtaxel «DOCks water»: fluid retention, so steroids go first. And a «DOC» needs a healthy liver: check bilirubin before every cycle.

## 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.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/docetaxel/)

## Related drugs

- [Paclitaxel](https://durgical.com/en/pharmacology/paclitaxel/)
- [Cisplatin](https://durgical.com/en/pharmacology/cisplatin/)

## Related conditions

- [Breast cancer](https://durgical.com/en/conditions/breast-cancer/)
- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)
- [Prostate cancer](https://durgical.com/en/conditions/prostate-cancer/)
- [Gastric cancer](https://durgical.com/en/conditions/gastric-cancer/)
- [Head and neck squamous cell carcinoma (oral cavity and oropharynx, HPV)](https://durgical.com/en/conditions/head-and-neck-squamous-cell-carcinoma/)

[← Back to the class: Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/)

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](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a6417655-9448-4886-ba03-f57f36bcbd14) (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](https://atcddd.fhi.no/atc_ddd_index/?code=L01CD02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/docetaxel/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/docetaxel/