When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to paclitaxel or polyoxyl 35 castor oil or if you are pregnant.

How to Use This Medicine:
Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• You may also receive other medicines to help prevent allergic reactions and nausea or vomiting from paclitaxel.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines and foods can affect the way this drug works. Tell your doctor if you are also using atazanavir, buspirone, carbamazepine, clarithromycin, eletriptan, felodipine, gemfibrozil, indinavir, itraconazole, ketoconazole, lovastatin, midazolam, nefazodone, nelfinavir, repaglinide, rifampin, ritonavir, rosiglitazone, saquinavir, sildenafil, simvastatin, telithromycin, or triazolam.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding or if you have liver disease, heart disease, or heart rhythm problems. Also tell your doctor if you had an allergic reaction to cyclosporin or teniposide.
• This medicine may cause the following problems:
  
  • Severe allergic reaction
  • Heart rhythm problems
  • High blood pressure
  • Severe reaction where the needle is placed (may happen up to 10 days later)
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Cancer medicine can cause nausea or vomiting, sometimes even after you receive medicine to prevent these effects. Ask your doctor or nurse about other ways to control any nausea or vomiting that might happen.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Fast, slow, or uneven heartbeat
• Fever, chills, cough, sore throat, and body aches
• Lightheadedness, dizziness, or fainting
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Severe redness, pain, swelling, or peeling where the needle is placed
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Hair loss
• Mild nausea, vomiting, diarrhea
• Mild redness, tenderness, swelling, or color changes where the needle is placed
• Muscle, bone, or joint pain
• Sores or white patches on your lips, mouth, or throat

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088