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HIGHLIGHTS of PRESCRIBING INFORMATION These Highlights Do Not Include All the Information Needed to Use DOCETAXEL Safely And

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HIGHLIGHTS of PRESCRIBING INFORMATION These Highlights Do Not Include All the Information Needed to Use DOCETAXEL Safely And HIGHLIGHTS OF PRESCRIBING INFORMATION • HRPC: 75 mg/m2 with 5 mg prednisone twice a day continuously (2.3) • GC: 75 mg/m2 followed by cisplatin 75 mg/m2 (both on day 1 only) followed by fluorouracil 750 These highlights do not include all the information needed to use DOCETAXEL safely and 2 effectively. See full prescribing information for DOCETAXEL. mg/m per day as a 24-hr IV (days 1–5), starting at end of cisplatin infusion (2.4) • SCCHN: 75 mg/m2 followed by cisplatin 75 mg/m2 IV (day 1), followed by fluorouracil 750 DOCETAXEL injection, for intravenous use mg/m2 per day as a 24-hr IV (days 1–5), starting at end of cisplatin infusion; for 4 cycles (2.5) Initial U.S. Approval: 1996 • SCCHN: 75 mg/m2 followed by cisplatin 100 mg/m2 IV (day 1), followed by fluorouracil 1000 mg/m2 per day as a 24-hr IV (days 1–4); for 3 cycles (2.5) For all patients: • Premedicate with oral corticosteroids (2.6) WARNING: TOXIC DEATHS, HEPATOTOXICITY, NEUTROPENIA, HYPERSENSITIVITY • Adjust dose as needed (2.7) REACTIONS, and FLUID RETENTION See full prescribing information for complete boxed warning. ———————————— DOSAGE FORMS AND STRENGTHS ———————————— • Treatment-related mortality increases with abnormal liver function, at higher doses, • Injection: One-vial Docetaxel: Single-dose vials 20 mg/mL, 80 mg/4 mL and 160 mg/8 mL (3) and in patients with NSCLC and prior platinum-based therapy receiving Docetaxel at 100 mg/m2 (5.1) ——————————————— CONTRAINDICATIONS ——————————————— • Hypersensitivity to docetaxel or polysorbate 80 (4) • Avoid use of Docetaxel if bilirubin > ULN, or if AST and/or ALT >1.5 × ULN 3 concomitant with alkaline phosphatase >2.5 × ULN. LFT elevations increase risk of • Neutrophil counts of <1500 cells/mm (4) severe or life-threatening complications. Obtain LFTs before each treatment cycle ————————————— WARNINGS AND PRECAUTIONS ————————————— (5.2) 3 • Second primary malignancies: In patients treated with Docetaxel-containing regimens, monitor • Do not administer Docetaxel to patients with neutrophil counts <1500 cells/mm . for delayed AML, MDS, NHL, and renal cancer. (5.7) Obtain frequent blood counts to monitor for neutropenia (4, 5.3) • Cutaneous reactions: Reactions including erythema of the extremities with edema followed by • Severe hypersensitivity, including fatal anaphylaxis, has been reported in patients desquamation may occur. Severe cutaneous adverse reactions have been reported. Severe who received dexamethasone premedication. Severe reactions require immediate skin toxicity may require dose adjustment or permanent treatment discontinuation. (5.8) discontinuation of docetaxel and administration of appropriate therapy (5.5) • Neurologic reactions: Reactions including paresthesia, dysesthesia, and pain may occur. • Contraindicated if history of severe hypersensitivity reactions to Docetaxel or to Severe neurosensory symptoms require dose adjustment or discontinuation if persistent. (5.9) drugs formulated with polysorbate 80 (4) • Eye disorders: Cystoid macular edema (CME) has been reported and requires treatment • Severe fluid retention may occur despite dexamethasone (5.6) discontinuation. (5.10) • Asthenia: Severe asthenia may occur and may require treatment discontinuation. (5.11) • Embryo-fetal toxicity: Can cause fetal harm. Advise patients of the potential risk to a fetus and to use effective contraception. (5.12, 8.1, 8.3) —————————————— INDICATIONS AND USAGE —————————————— • Alcohol content: The alcohol content in a dose of Docetaxel injection may affect the central Docetaxel is a microtubule inhibitor indicated for: nervous system. This may include impairment of a patient’s ability to drive or use machines • Breast Cancer (BC): single agent for locally advanced or metastatic BC after chemotherapy immediately after infusion. (5.13) failure; and with doxorubicin and cyclophosphamide as adjuvant treatment of operable • Tumor lysis syndrome: Tumor lysis syndrome has been reported. Patients at risk should be node-positive BC (1.1) well hydrated and closely monitored during treatment. (5.14) Non-small Cell Lung Cancer (NSCLC) • : single agent for locally advanced or metastatic ——————————————— ADVERSE REACTIONS ——————————————— NSCLC after platinum therapy failure; and with cisplatin for unresectable, locally advanced or metastatic untreated NSCLC (1.2) Most common adverse reactions across all Docetaxel indications are infections, neutropenia, anemia, febrile neutropenia, hypersensitivity, thrombocytopenia, neuropathy, dysgeusia, dyspnea, • Castration-Resistant Prostate Cancer (CRPC): with prednisone in metastatic castration- resistant prostate cancer (1.3) constipation, anorexia, nail disorders, fluid retention, asthenia, pain, nausea, diarrhea, vomiting, mucositis, alopecia, skin reactions, and myalgia. (6) • Gastric Adenocarcinoma (GC): with cisplatin and fluorouracil for untreated, advanced GC, including the gastroesophageal junction (1.4) Squamous Cell Carcinoma of the Head and Neck (SCCHN) To report SUSPECTED ADVERSE REACTIONS, contact sanofi-aventis U.S. LLC at 1-800- • : with cisplatin and fluorouracil 633-1610 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. for induction treatment of locally advanced SCCHN (1.5) ——————————————— DRUG INTERACTIONS ——————————————— ————————————— DOSAGE AND ADMINISTRATION ————————————— • Cytochrome P450 3A4 inducers, inhibitors, or substrates: May alter docetaxel metabolism. (7) Administer in a facility equipped to manage possible complications (e.g., anaphylaxis). Administer intravenously (IV) over 1 hr every 3 weeks. PVC equipment is not recommended. Use only a ———————————— USE IN SPECIFIC POPULATIONS ———————————— 21-gauge needle to withdraw Docetaxel from the vial. • Lactation: Advise women not to breastfeed. (8.2) • BC locally advanced or metastatic: 60 mg/m2 to 100 mg/m2 single agent (2.1) • Females and Males of Reproductive Potential: Verify pregnancy status of females prior to • BC adjuvant: 75 mg/m2 administered 1 hour after doxorubicin 50 mg/m2 and cyclophosph- initiation of Docetaxel. (8.3) amide 500 mg/m2 every 3 weeks for 6 cycles (2.1) • NSCLC: after platinum therapy failure: 75 mg/m2 single agent (2.2) See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling • NSCLC: chemotherapy-naive: 75 mg/m2 followed by cisplatin 75 mg/m2 (2.2) Revised: 05/2021 FULL PRESCRIBING INFORMATION: CONTENTS* 5.3 Hematologic Effects WARNING: TOXIC DEATHS, HEPATOTOXICITY, NEUTROPENIA, HYPERSENSITIVITY 5.4 Enterocolitis and Neutropenic Colitis REACTIONS, and FLUID RETENTION 5.5 Hypersensitivity Reactions 1 INDICATIONS AND USAGE 5.6 Fluid Retention 1.1 Breast Cancer 1.2 Non-small Cell Lung Cancer 5.7 Second Primary Malignancies 1.3 Prostate Cancer 5.8 Cutaneous Reactions 1.4 Gastric Adenocarcinoma 5.9 Neurologic Reactions 1.5 Head and Neck Cancer 5.10 Eye Disorders 2 DOSAGE AND ADMINISTRATION 5.11 Asthenia 2.1 Breast Cancer 5.12 Embryo-Fetal Toxicity 2.2 Non-small Cell Lung Cancer 5.13 Alcohol Content 2.3 Prostate Cancer 5.14 Tumor Lysis Syndrome 2.4 Gastric Adenocarcinoma 6 ADVERSE REACTIONS 2.5 Head and Neck Cancer 6.1 Clinical Trials Experience 2.6 Premedication Regimen 6.2 Postmarketing Experience 2.7 Dosage Adjustments during Treatment 2.8 Administration Precautions 7 DRUG INTERACTIONS 2.9 Preparation and Administration 8 USE IN SPECIFIC POPULATIONS 2.10 Stability 8.1 Pregnancy 3 DOSAGE FORMS AND STRENGTHS 8.2 Lactation 4 CONTRAINDICATIONS 8.3 Females and Males of Reproductive Potential 5 WARNINGS AND PRECAUTIONS 8.4 Pediatric Use 5.1 Toxic Deaths 8.5 Geriatric Use 5.2 Hepatic Impairment 8.6 Hepatic Impairment 1 10 OVERDOSAGE 14.4 Castration-Resistant Prostate Cancer 11 DESCRIPTION 14.5 Gastric Adenocarcinoma 12 CLINICAL PHARMACOLOGY 14.6 Head and Neck Cancer 12.1 Mechanism of Action 15 REFERENCES 12.3 Pharmacokinetics 16 HOW SUPPLIED/STORAGE AND HANDLING 13 NONCLINICAL TOXICOLOGY 16.1 How Supplied 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility 16.2 Storage 14 CLINICAL STUDIES 16.3 Handling and Disposal 14.1 Locally Advanced or Metastatic Breast Cancer 17 PATIENT COUNSELING INFORMATION 14.2 Adjuvant Treatment of Breast Cancer 14.3 Non-small Cell Lung Cancer (NSCLC) *Sections or subsections omitted from the full prescribing information are not listed FULL PRESCRIBING INFORMATION every 3 weeks. A dose of 100 mg/m2 in patients previously treated with chemotherapy was associated with increased hematologic toxicity, infection, and treatment-related mortality in randomized controlled trials [see Boxed Warning, Dosage and Administration (2.7), Warnings and WARNING: TOXIC DEATHS, HEPATOTOXICITY, NEUTROPENIA, HYPERSENSITIVITY Precautions (5), Clinical Studies (14)]. REACTIONS, and FLUID RETENTION • For chemotherapy-naive patients, docetaxel was evaluated in combination with cisplatin. The recommended dose of docetaxel is 75 mg/m2 administered intravenously over 1 hour immediately Treatment-related mortality associated with Docetaxel therapy is increased in patients 2 with abnormal liver function, in patients receiving higher doses, and in patients with followed by cisplatin 75 mg/m over 30–60 minutes every 3 weeks [see Dosage and Administration non-small cell lung carcinoma and a history of prior treatment with platinum-based (2.7)]. chemotherapy who receive Docetaxel as a single agent at a dose of 100 mg/m2 [see 2.3 Prostate Cancer • For metastatic castration-resistant prostate cancer, the recommended dose of docetaxel is 75 Warnings and Precautions (5.1)]. 2 Avoid the use of Docetaxel in patients with bilirubin > upper limit of normal (ULN), or to mg/m every 3
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