Prophylaxis for Paclitaxel Hypersensitivity Reactions

Abstract

OBJECTIVE:

To evaluate clinical literature supporting the prophylactic use of single-dose intravenous dexamethasone to prevent hypersensitivity reactions (HSRs) to paclitaxel infusion.

DATA SOURCES:

Clinical literature accessed through MEDLINE (from 1986 to 2000).

DATA SYNTHESIS:

Prophylaxis for paclitaxel-related HSRs generally includes repeated dexamethasone doses beginning 12 hours before paclitaxel, and administration of diphenhydramine plus a histamine₂-receptor antagonist 30 minutes before infusion of paclitaxel. Single-dose intravenous dexamethasone administered with ancillary medications 30 minutes before infusion of paclitaxel has been used to prevent regimen-related HSRs.

CONCLUSIONS:

Single-dose intravenous dexamethasone can be used in combination with appropriate ancillary medications to prevent paclitaxel-related HSRs.