Also known as Anzatax, Asotax, Bristaxol, Praxel, Taxol, Taxol A, Taxol Konzentrat

A compound extracted from the Pacific yew tree Taxus brevifolia with antineoplastic activity. Paclitaxel binds to tubulin and inhibits the disassembly of microtubules, thereby resulting in the inhibition of cell division. This agent also induces apoptosis by binding to and blocking the function of the apoptosis inhibitor protein Bcl-2 (B-cell Leukemia 2). (NCI04)

Originator: NCI Thesaurus | Source: The website of the National Cancer Institute (http://www.cancer.gov)

Can I take Paclitaxel while breastfeeding?

Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.[1] Based on limited data, paclitaxel appears to be excreted into milk in relatively large amounts. It might be possible to breastfeed safely during intermittent therapy with an appropriate period of breastfeeding abstinence, but the duration abstinence is not clear. In one case, paclitaxel was detectable in milk for at least a week, but not at 13 days after a dose of 30 mg per square meter. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[2]

Drug levels

Maternal Levels. A woman with a history of treatment for thyroid cancer and recurrence during pregnancy was treated postpartum with paclitaxel and carboplatin. Her intravenous paclitaxel dose was 56.1 mg (20 mg per square meter) weekly for 6 weeks. Whole milk samples were obtained before her 6th dose and at 4, 28, 172, and 316 hours after the dose. The highest milk paclitaxel level was 1.17 mg/L in the 28-hour sample and paclitaxel was undetectable (<80 mcg/L) in the 317 hour sample. Metabolites were not measured. The average milk paclitaxel level over the 317 hour collection period was 0.78 mg/L, resulting in an estimated infant dose of 16.7% of the maternal dose.[3] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Maternal Levels. A woman with a history of treatment for thyroid cancer and recurrence during pregnancy was treated postpartum with paclitaxel and carboplatin. Her intravenous paclitaxel dose was 56.1 mg (20 mg per square meter) weekly for 6 weeks. Whole milk samples were obtained before her 6th dose and at 4, 28, 172, and 316 hours after the dose. The highest milk paclitaxel level was 1.17 mg/L in the 28-hour sample and paclitaxel was undetectable (<80 mcg/L) in the 317 hour sample. Metabolites were not measured. The average milk paclitaxel level over the 317 hour collection period was 0.78 mg/L, resulting in an estimated infant dose of 16.7% of the maternal dose.[3] Infant Levels. Relevant published information was not found as of the revision date.

Possible effects on lactation

Relevant published information was not found as of the revision date.

References

1. Pistilli B, Bellettini G, Giovannetti E et al. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013;39:207-11. PMID: 23199900

2. Urbaniak C, McMillan A, Angelini M et al. Effect of chemotherapy on the microbiota and metabolome of human milk, a case report. Microbiome. 2014;2 :24. PMID: 25061513

3. Griffin SJ, Milla M, Baker TE et al. Transfer of carboplatin and paclitaxel into breast milk. J Hum Lact. 2012;28:457-9. PMID: 23087196

Last Revision Date

20141003

Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Source: LactMed – National Library of Medicine (NLM)

3D Model of the Paclitaxel molecule

MolView – data visualization platform