Side effects of docetaxel (Taxotere)
Find out about the side effects of the chemotherapy drug docetaxel for advanced breast cancer.
The side effects might be different if you are having docetaxel alongside other cancer treatments.
Tell your doctor or nurse if you have any side effects so they can help you manage them. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Common side effects
Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them.
Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.
Chemotherapy reduces the number of white blood cells in the blood. This increases your risk of infections. White blood cells help fight infections.
When the level is very low it is called neutropenia (pronounced new-troh-pee-nee-ah).
You have antibiotics if you develop an infection. You might have them as tablets or as injections into the bloodstream (intravenously). To have them into your bloodstream you need to go into hospital.
Chemotherapy makes the level of red blood cells fall (anaemia). Red blood cells contain haemoglobin, which carries oxygen around the body. When the level of red blood cells is low you have less oxygen going to your cells. This can make you breathless and look pale. Tell your doctor or nurse if you feel breathless.
You have regular blood tests to check your red blood cell levels. You might need a blood transfusion if the level is very low. After a transfusion, you will be less breathless and less pale.
You can also feel tired and depressed when your blood count is low and feel better once it is back to normal. The levels can rise and fall during your treatment. So it can feel like you are on an emotional and physical roller coaster.
You might feel very tired during your treatment. It might take 6 months to a year for your energy levels to get back to normal after the treatment ends. A low red blood cell count will also make you feel tired.
You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard. Try to eat a well balanced diet.
Talk to your doctor or nurse if you are finding the tiredness difficult to manage.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. It usually starts gradually within 2 to 3 weeks after treatment begins.
Your hair will grow back once your chemotherapy treatment has finished. This can take several months and your hair is likely to be softer. It can also grow back a different colour or be curlier than before.
Tips
- Ask about getting a wig before you start treatment so you can match the colour and texture of your real hair.
- You could choose a wig for a whole new look.
- Think about having your hair cut short before your treatment starts.
- Some people shave their hair off completely so they don't have to cope with their hair falling out.
- Wear a hairnet at night so you won't wake up with hair all over your pillow.
This affects 8 out of 10 (80%) people treated.
A rash can also be itchy. Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to stop the itching and soothe your skin.
This occurs in about 5 out of 10 (50%) people.
You may have swelling in the face, hands and feet. As well as breathlessness and weight gain. The steroids you have with the drug can help to prevent this effect.
This occurs in 5 out of 10 (50%) people.
You may have discoloured fingernails but they will go back to normal a few months after the treatment ends.
This can happen if you have docetaxel with another drug called capecitabine.
The skin on your hands and feet can become sore, red, and peel. You might also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Tips
- Take medicines that your doctor or nurse can prescribe.
- Keep your hands and feet cool.
- Avoid very hot water.
- Don’t wear tight fitting gloves or socks.
- Moisturise your skin with non perfumed creams.
Your mouth might become sore a few days after you start treatment. It usually clears up gradually 3 to 4 weeks after your treatment ends.
Your nurse can give you mouthwashes to help prevent infection. You have to use these regularly to get the most protection.
Tell your doctor or nurse straight away if your mouth is really sore. They can help to reduce the discomfort. Some people need strong painkillers to help control mouth pain so they can eat and drink.
Tips
- Clean your mouth and teeth gently, use a soft bristled toothbrush.
- Avoid mouthwashes that contain alcohol.
- Use dental floss daily but be gentle so that you don't harm your gums, and don't floss if you have very low platelets.
- Avoid neat spirits, tobacco, hot spices, garlic, onion, vinegar and salty food.
- Moisten meals with gravies and sauces to make swallowing easier.
- Eating fresh or tinned pineapple can keep your mouth fresh and moist.
- Avoid acidic fruits such as oranges, grapefruit or lemons.
This affects about 4 out of every 10 (40%) people.
Tell your doctor or nurse if you have diarrhoea. They can prescribe medicine to help you.
Drink at least 2.5 litres of fluid a day. This helps to keep you hydrated.
Ask your nurse about soothing creams to apply around your back passage (rectum). The skin in that area can get very sore and even break if you have severe diarrhoea.
This occurs in about 4 out of every 10 (40%) people.
Numbness or tingling in fingers and toes can make it difficult to do fiddly things such as doing up buttons. This starts within a few days or weeks and can last for a few months. Rarely, the numbness may be permanent.
Tips
- Keep your hands and feet warm.
- Wear well fitting, protective shoes.
- Take care when using hot water as you may not be able to feel how hot it is and could burn yourself.
- Use oven gloves when cooking and protective gloves when gardening.
- Moisturise your skin at least a couple of times a day.
- Take care when cutting your nails.
A small number of people have an allergic reaction, usually during the first or second treatment.
Symptoms include a skin rash, itching, feeling hot and shivering. Other symptoms include redness of the face, dizziness, a headache, shortness of breath and anxiety.
Your nurse will keep a close eye on you and give you treatment straight away if this happens. They might slow your drip down.
An allergic reaction occurs during the infusion in more than 2 out of 10 (20%) people.
You may have this effect if you have docetaxel with another drug called trastuzumab.
Watery eyes is also called excessive tearing or epiphora (pronounced ep-if-or-ah). It may be due to a blockage in the drainage system of the eye, caused by swelling of the nearby tissues. Or your eyes may make too many tears.
Tell your doctor or nurse if this is a problem. They can prescribe medicines to help reduce swelling.
Some irritants can make the watering worse. These can include dust, pollen or animal hairs. Try to avoid them or wear protective goggles.
Occasional side effects
Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them.
Feeling or being sick can be severe. It can start a few hours after treatment and last for a few days. Anti sickness injections and tablets can control it. Tell your doctor or nurse if you feel sick. You may need to try different anti sickness medicines to find one that works.
Tips
- Avoid eating or preparing food when you feel sick.
- Avoid fried foods, fatty foods or foods with a strong smell.
- Drink plenty of liquid to stop you from getting dehydrated.
- Relaxation techniques help control sickness for some people.
- Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.
- Fizzy drinks help some people when they are feeling sick.
Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men
You may be able to store sperm before starting treatment.
It can take a few months or sometimes years for fertility to return to normal. You can have sperm counts to check your fertility when your treatment is over. Ask your doctor about it.
Women
Chemotherapy can cause an early menopause. This stops you from being able to become pregnant in the future. Talk to your doctor about this before your treatment. It’s sometimes possible to store eggs or embryos before treatment.
Tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site.
You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.
Tell your doctor or nurse if you’re breathless or have a cough. This could be due to an infection, such as pneumonia. Or it could be caused by changes to the lung tissue, making it less flexible.
Docetaxel can make fluid to build up at the back of the eye (called cystoid macular oedema). If you have blurred vision or a black area in the middle of your vision, let your doctor or nurse know.
Women might stop having periods (amenorrhoea) but this may be temporary.
The changes are usually very mild and unlikely to cause symptoms. They will almost certainly go back to normal when treatment is finished.
You have regular blood tests throughout your treatment so your doctor can check this.
You might notice you:
- bruise more easily
- have nosebleeds
- have bleeding gums when you brush your teeth
This is due to a drop in the number of platelets that help clot your blood.
If your platelets get very low you may have lots of tiny red spots or bruises on your arms or legs called petechiae.
You'll have a platelet transfusion if your platelet count is very low. It is a drip of a clear fluid containing platelets. It takes about 15 to 30 minutes. The new platelets start to work right away.
About docetaxel
More information about this treatment
We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.
You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
