The Basics
What is Docetaxel?
Used alone or in combination with other medications to treat certain types of breast, lung, prostate, stomach, and head and neck cancers.
Brand names for Docetaxel
Taxotere
How Docetaxel is classified
Antineoplastic Agents
Docetaxel During Pregnancy
Docetaxel pregnancy category
Category DNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Docetaxel while pregnant
Based on findings in animal reproduction studies and its mechanism of action, TAXOTERE cancause fetal harm when administered to a pregnant woman [see Clinical Pharmacology (12.1)].Available data from case reports in the literature and pharmacovigilance with docetaxel use inpregnant women are not sufficient to inform the drug-associated risk of major birth defects,miscarriage, or adverse maternal or fetal outcomes. TAXOTERE contains alcohol which caninterfere with neurobehavioral development [see Clinical Considerations]. In animalreproductive studies, administration of docetaxel to pregnant rats and rabbits during the period oforganogenesis caused an increased incidence of embryo-fetal toxicities, including intrauterinemortality, at doses as low as 0.02 and 0.003 times the recommended human dose based on bodysurface area, respectively . Advise pregnant women and females of reproductivepotential of the potential risk to a fetus.The estimated background risk of major birth defects and miscarriage for the indicatedpopulations is unknown. All pregnancies have a background risk of birth defect, miscarriage, orother adverse outcomes. In the U.S. general population, the estimated background risk of majorbirth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%,respectively.
Taking Docetaxel While Breastfeeding
What are recommendations for lactation if you're taking Docetaxel?
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.[1] No information is available on the clinical use of docetaxel during breastfeeding. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[2] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant. The manufacturer recommends that breastfeeding be discontinued during docetaxel therapy and for 1 week after the last dose.
Maternal / infant drug levels
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.[1] No information is available on the clinical use of docetaxel during breastfeeding. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[2] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant. The manufacturer recommends that breastfeeding be discontinued during docetaxel therapy and for 1 week after the last dose.
Possible effects of Docetaxel on milk supply
A telephone follow-up study was conducted on 74 women who received cancer chemotherapy at one center during the second or third trimester of pregnancy to determine if they were successful at breastfeeding postpartum. Only 34% of the women were able to exclusively breastfeed their infants, and 66% of the women reported experiencing breastfeeding difficulties. This was in comparison to a 91% breastfeeding success rate in 22 other mothers diagnosed during pregnancy, but not treated with chemotherapy. Other statistically significant correlations included: (1) mothers with breastfeeding difficulties had an average of 5.5 cycles of chemotherapy compared with 3.8 cycles among mothers who had no difficulties; and (2) mothers with breastfeeding difficulties received their first cycle of chemotherapy on average 3.4 weeks earlier in pregnancy. Of the 9 women who received a taxane-containing regimen, 7 had breastfeeding difficulties.[3]
Possible alternatives to Docetaxel
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. 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. Stopenski S, Aslam A, Zhang X et al. After chemotherapy treatment for maternal cancer during pregnancy, is breastfeeding possible? Breastfeed Med. 2017;12:91-7. PMID: 28170295
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
