Example orders for Paclitaxel (Taxol) in melanoma

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Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.


Paclitaxel (Taxol)

Published regimens and references can be found on the melanoma page.

Example order set #1

  • Paclitaxel (Taxol) 80 mg/m2 IV over 60 minutes once per day on days 1, 8, 15; use non-DEHP (paclitaxel) tubing

28-day cycles

Supportive medications

  • Dexamethasone (Decadron) 10 mg IV once; 30 minutes prior to chemotherapy
  • Diphenhydramine (Benadryl) 25 to 50 mg (50 mg for first dose of paclitaxel; may be reduced to 25 mg for subsequent doses if tolerated) IV once 30 to 60 minutes prior to chemotherapy
  • Famotidine (Pepcid) 20 mg IV over 15 minutes once; 30 minutes prior to chemotherapy

Hydration:

  • Normal saline IV continuous infusion at 5 mL/H
  • Normal saline 25 to 50 mL IV prn flush before and after chemotherapy

Nursing:

  • Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
  • Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.