Cabazitaxel is a type of chemotherapy. You might have it as a treatment for prostate cancer that has spread (advanced prostate cancer).
How cabazitaxel works
Cabazitaxel works by stopping cancer cells from separating into two new cells. This blocks the growth of the cancer.
How you have cabazitaxel
You have cabazitaxel as a drip into your bloodstream (intravenously).
Into your bloodstream
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
When you have cabazitaxel
You have cabazitaxel in cycles of treatment. Each cycle is a 3 week period. This means that you have a cabazitaxel drip once every 3 weeks.
You also take steroids (prednisolone) as tablets every morning, after breakfast.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.
When to contact your team
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Risk of infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising and bleeding
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Loss of appetite and weight loss
You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually returns to normal a few weeks after your treatment finishes.
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis). Let your doctor or nurse know straight away if you suddenly become breathless or develop a cough.
Diarrhoea or constipation
Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Hair loss (complete hair loss)
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Joint or back pain
You might have pain in your back or joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
Blood in your urine
This can be caused by different reasons, including infection. Tell your doctor if you see blood in your urine or have any pain.
Tiredness and weakness
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- allergic reaction – you have medicine before you have cabazitaxel to reduce the risk of a reaction. Tell your doctor straight away if you feel short of breath, itchy, hot or shivery, or have a rash
- blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
- an irregular or very fast heart rate – tell your doctor or nurse if you feel dizzy, short of breath or tired or your heart feels like it’s pounding or fluttering, or you have any chest pain
- numbness, tingling or a burning feeling in the hands and feet
- dizziness or feeling like you or everything around you is spinning – don’t drive or operate heavy machinery if you feel dizzy
- changes to your blood pressure
- tummy problems which include pain, feeling bloated, burping or heart burn
- dry or sore mouth or throat
- swollen veins in or around your anus (called piles or haemorrhoids) which can be painful and may bleed slightly when you open your bowels - a cream from your pharmacist can help. Tell your doctor or nurse straight away if you have a lot of bleeding
- feeling pain in muscles or having muscle spasms
- feeling pain or having difficulty passing urine, or leaking urine (incontinence) - your kidneys not working properly (renal failure)
- swelling, usually in arms and legs (oedema)
- skin changes such as dry or red skin, feeling flushed, hot or cold
- mood changes such as feeling confused or anxious
- high blood sugar levels
- low potassium levels in your blood
- watery eyes or redness and inflammation of the eye (conjunctivitis)
- ringing in your ears (tinnitus)
Rare side effects
This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- inflammation of the bladder - this can happen if you've had radiotherapy to the area in the past . Tell your doctor or nurse if you have pain when passing urine or see blood
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, foods and drinks
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
St John’s wort
St John’s wort is a herbal remedy used as a complementary therapy for mild to moderate depression. Let your doctor know if you are taking this.
Cabazitaxel contains a small amount of alcohol, equal to 14ml of beer or 6ml of wine. This medicine may be harmful for people with alcohol problems.
Loss of fertility
You may not be able to father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you want to have a baby in the future. You may be able to store sperm before starting treatment.
Contraception and pregnancy
This treatment might harm a baby developing in the womb. It is important not to father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
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.