A 15-min premedication for 1-h paclitaxel infusion: optimizing patients' care.
BACKGROUND
Paclitaxel is a plant product highly active in numerous cancers, but anaphylactic-like hypersensitivity reactions with it have been reported in about 28% of patients receiving the drug. Thirty to sixty minutes are needed to give a standard premedication with steroids and diphenhydramine, leading to patients and nurses' discomfort and stealing time from other infusional treatments.


METHODS
Eighty-nine patients with advanced NSCLC never pre-treated with taxanes, received paclitaxel followed by gemcitabine on days 1, 8, 15 q4wks. Premedication consisted of prednisone 25 mg/os on day 0 and hydrocortisone plus clorfenamina maleato given intravenous on day 1 by a 15 min infusion immediately before paclitaxel administration.


RESULTS
Hypersensitivity reactions occurred in 3/341 (0.8%) cycles. In all three cases we observed severe dyspnoea and bronchospasm, that required treatment discontinuation but one was probably due to gemcitabine and another had a protracting time after premedication.


CONCLUSIONS
A 15-min premedication infusion administered immediately before paclitaxel appeared to be highly effective in patients treated with 1h-infusion paclitaxel.
Milani
Alessandra
A
De Pas
Tommaso
T
Noberasco
Cristina
C
McDonnell
Colette
C
Libutti
Livio
L
Limardi
Ivan
I
Zencovich
Claudia
C
Boselli
Sabrina
S
Bianchi
Monica
M
de Braud
Filippo
F
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage* / Q000627:therapeutic use*; D005791:Patient Care; D011292:Premedication; D013997:Time Factors
D017239:Paclitaxel