Prophylaxis for Paclitaxel Hypersensitivity Reactions

OBJECTIVE: To evaluate clinical literature supporting the prophylactic use of single-dose intravenous dexamethasone to prevent hypersensitivity reactions (HSRs) to paclitaxel infusion. DATA SOURCES: Clinical literature accessed through MEDLINE (from 1986 to 2000). DATA SYNTHESIS: Prophylaxis for paclitaxel-related HSRs generally includes repeated dexamethasone doses beginning 12 hours before paclitaxel, and administration of diphenhydramine plus a histamine2-receptor antagonist 30 minutes before infusion of paclitaxel. Singe-dose intravenous dexamethasone administered with ancillary medications 30 minutes before infusion of paclitaxel has been used to prevent regimen-related HSRs. CONCLUSIONS: Single-dose intravenous dexamethasone can be used in combination with appropriate ancillary medications to prevent paclitaxel-related HSRs.