Abraxane® is a chemotherapy drug that can be used to treat breast cancer that has spread (secondary breast cancer). It may also be used to treat other types of cancer in a research trial. It's also known as nab-paclitaxel.
This information should ideally be read with our general information about chemotherapy and your type of cancer.
You'll need to see your hospital doctor regularly while you have this treatment so they can monitor the effects of the chemotherapy.
Abraxane is made up of the chemotherapy drug paclitaxel that is bound up or enclosed in a special protein called albumin, which is found in human blood. This makes it easier to give than paclitaxel, and there’s also less risk of an allergic reaction. Abraxane is usually given when other chemotherapy drugs are no longer working and treatment with an anthracycline chemotherapy drug, such as epirubicin, is unsuitable.
Abraxane may be given as a drip (infusion), which usually takes about 30 minutes, in one of the following ways:
through a fine tube (cannula) inserted into a vein, usually in the back of the hand
through a fine, plastic tube that is inserted under the skin and into a vein near the collarbone (central line)
into a fine tube that is inserted into a vein in the crook of your arm (PICC line).
Chemotherapy is usually given as a course of several sessions (or cycles) of treatment over a few months. Your doctor or chemotherapy nurse will discuss the length of your treatment with you and the number of cycles you are going to have. The normal interval between cycles of Abraxane is three weeks.
Each person’s reaction to chemotherapy is different. Some people have very few side effects while others may experience more. The side effects described here will not affect everyone who has Abraxane.
We have outlined the most common side effects but haven’t included those that are rare and therefore unlikely to affect you. If you notice any effects that aren’t listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
Risk of infection
Abraxane can reduce the number of white blood cells, which help fight infection. White blood cells are produced by the bone marrow. If the number of your white blood cells is low you'll be more prone to infections. A low white blood cell count is called neutropenia.
Neutropenia begins seven days after treatment, and your resistance to infection is usually at its lowest 10-14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.
Contact your doctor or the hospital straight away if:
your temperature goes above 38˚C (100.4˚F)
you suddenly feel unwell, even with a normal temperature.
You'll have a blood test before having more chemotherapy to check the number of white blood cells. Occasionally, your treatment may need to be delayed if the number of your blood cells (blood count) is still low.
Bruising or bleeding
Abraxane can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You may need to have a platelet transfusion if your platelet count is low.
Abraxane can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion if the number of red blood cells becomes too low.
Feeling tired is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
Feeling sick (nausea) or being sick (vomiting)
Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea or vomiting. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.
Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
This usually starts 2-3 weeks after the first dose of Abraxane, although it may happen earlier. Hair usually falls out completely but it may just thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary, and your hair will start to grow back once treatment the treatment has finished. Your hair may grow back straighter, curlier, finer or a slightly different colour than it was before treatment. Your nurse can give you advice about coping with hair loss.
Loss of appetite
Some people lose their appetite while they’re having chemotherapy. This can be mild and may only last a few days. If it doesn’t improve you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight. You might find our section on eating well useful.
Numbness or tingling in the hands or feet
This is due to the effect of Abraxane on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or similar fiddly tasks.
Tell your doctor if you notice any numbness or tingling in your hands or feet. It's important to report your symptoms to your doctor as they may be controlled by slightly lowering the dose of the drug.
This side effect usually improves slowly, a few months after the treatment has finished. Sometimes symptoms can persist; talk to your doctor if this happens.
Abraxane can cause a rash or dry skin, which may be itchy. Your doctor can prescribe medicine to help with this.
Aching or pain in joints and muscles
You may have this a few days after you're given Abraxane. It doesn't usually last long, and your doctor can prescribe painkillers or anti-inflammatory drugs to help.
Constipation or diarrhoea
Abraxane can cause constipation or diarrhoea. Constipation can usually be helped by drinking plenty of fluids, eating more fibre and doing some exercise. You may need to take medicine (laxatives) to help. Your doctor can prescribe these or you can buy them at a pharmacy.
Diarrhoea can usually be easily controlled with medicine, but tell your doctor if it’s severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help reduce the risk of this happening. Some people find sucking on ice soothing.
Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections. You may find our section on mouth care during chemotherapy helpful
Fever and chills
These may occur from the time your treatment is given, but they don’t usually last long. Your doctor may prescribe medicines to reduce these effects.
Less common side effects
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Rarely, Abraxane can cause you to feel breathless for a short while. Contact your doctor if this happens.
Changes in blood pressure
Some people may experience this when the drug is being given. Your blood pressure will be checked regularly during treatment. Tell your doctor or nurse if you feel faint or dizzy.
Changes in heart rate
Abraxane can cause your heart rate to change. Sometimes it may increase your heart rate. Rarely, Abraxane can cause a temporary slowing of the heart rate known as bradycardia. These changes usually don't cause any harm.
Abraxane may cause an inflammation of the lining of the eyelids (conjunctiva) that makes your eyes feel sore, red and itchy. Rarely, treatment can cause blurred vision. Let your doctor know so they can prescribe soothing eye drops if necessary.
The colour of your nails may change. They may become darker and white lines may appear on them. These usually grow out over several months once the treatment has finished. Some people have pain in the nail bed at the base of the nail but this is rare.
Treatment with Abraxane may cause changes in the way your liver works, although it will return to normal when the treatment finishes. You're very unlikely to notice any problems, but your doctor will take regular blood samples to check your liver is working properly.
Let your doctor know if you develop any pain in your tummy (abdomen) pain. It can usually be controlled with mild painkillers.
Some people find that Abraxane causes headaches. Let your doctor know if you have headaches or feel dizzy. Your doctor or nurse can give you painkillers to relieve headaches.
Some people can have an allergic reaction to Abraxane while it’s being given. Signs of this can include skin rashes and itching, a high temperature, shivering, dizziness, a headache and breathlessness. Usually you'll be given steroid tablets to take at home the day before treatment to reduce the chance of this happening. It’s important to take the steroid tablets as you have been directed. Instead of steroid tablets, you may be given a steroid by injection into a vein (intravenously) 30-60 minutes before the Abraxane. Other drugs, such as antihistamines, may also be injected into a vein before your treatment to prevent an allergic reaction.
You'll be closely monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these symptoms. If you do have a reaction, it can be treated quickly.
Some people have hot flushes when Abraxane is being given. If you have hot flushes, you may find our section on managing menopausal symptoms helpful.
Anxiety and restlessness
Abraxane may cause anxiety and restlessness. Let your doctor know if either of these symptoms occur.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
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Abraxane can cause pain at the place where the injection is given or along the vein. If you feel pain, tell your nurse or doctor straight away so that they can check the site. They may give the drug more slowly or flush it through with more fluid to reduce pain.
Risk of developing a blood clot
Cancer can increase the risk of developing a blood clot (thrombosis), and chemotherapy may increase this risk further.
A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it’s important to tell your doctor straight away if you notice any of these symptoms. Most clots can be treated with drugs that thin the blood. The doctor or nurse can give you more information.
Some medicines, including those you can buy in a shop or chemist, can be harmful to take when you're having chemotherapy. Tell your doctor about any medicines you're taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Your ability to become pregnant or father a child may be affected by having this treatment. It's important to discuss fertility with your doctor before starting treatment.
It's not advisable to become pregnant or father a child while having Abraxane as it may harm the developing baby. It’s important to use effective contraception while having this drug and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner, it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after chemotherapy.
There's a potential risk that chemotherapy drugs may be present in breast milk. Women are advised not to breastfeed during chemotherapy and for a few months afterwards.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you're having chemotherapy treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. Your chemotherapy nurse or doctor will give you details of who to contact for advice. This should include ‘out-of hours’ contact details if you need to call someone at evenings, overnight or at the weekend.
This fact sheet has been compiled using information from a number of reliable sources, including:
Sweetman, et al. The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
electronic Medicines Compendium (eMC). www.medicines.org.uk (accessed October 2011).
British National Formulary. 62nd edition. 2011. British Medical Association and Royal Pharmaceutical Society of Great Britain.
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