If you’re living with breast cancer, you may end up on a chemotherapy drug called paclitaxel, available as a brand-name formulation Abraxane and previously also sold in the U.S. as Taxol. Paclitaxel is highly effective at treating certain types of breast cancer and may be used alone or in combination with other medications.

Like any medication, paclitaxel can have side effects. While not everyone will experience every side effect, some are more common than others. Here’s what you need to know about common side effects and how to manage them when you’re taking paclitaxel.

What Is Paclitaxel?

Paclitaxel is a chemotherapy drug used to destroy certain types of breast cancer cells. It’s also used as a treatment for some other types of cancer. Paclitaxel is usually given every three weeks when used to treat breast cancer, though your oncologist will tell you what treatment regimen is best for you based on the type of breast cancer you have, its stage, and how you’ve responded to other medications.

Paclitaxel must be given intravenously, often through a chemo port placed in your chest. It may irritate that vein, so you must let medical staff know if you experience pain while being treated. Some people have an allergic reaction to paclitaxel and may need to receive another medication to counter this allergy.

What Are the Side Effects of Paclitaxel?

Paclitaxel can have a wide variety of side effects. They vary from person to person. The most frequent side effects include:

• Alopecia (whole-body hair loss)
• Easy bruising and bleeding, especially in the gums or the nose
• Increased risk of infections
• Leukopenia (decreased number of healthy white blood cells in the body)
• Anemia (lower numbers of red blood cells)
• Nausea with or without vomiting
• Neuropathy (peripheral-nerve damage that can cause shooting, sharp, or burning sensations in your body)
• Muscle and joint pain
• Mouth ulcers (sores)
• Rashes and other skin reactions
• Exhaustion or fatigue
• Hypotension (low blood pressure)
• Brain fog or difficulty concentrating

If you experience any side effects, tell your health care provider. While some effects are to be expected during chemotherapy treatment, your medical team should monitor their severity and may perform additional testing to track some reactions.

Some people find that certain side effects show up several days after treatment, like one MyBCTeam member who said: “On treatment day I am usually zapped of energy and have tummy pains and diarrhea. The next I am usually OK-ish, just fatigued, but my face blazes red hot.”

You may want to track your symptoms so you can know what to expect every time. However, there’s no standard set of side effects for paclitaxel to expect on certain days after receiving treatment.

How To Manage Side Effects of Paclitaxel

There’s a variety of ways to manage the side effects from paclitaxel so you can continue receiving the benefits of treatment without feeling bad all the time. These can also help you maintain your mental health and well-being during treatment.

1. Eat Very Small Meals

If you experience nausea and/or vomiting, try eating and drinking small amounts throughout the day, rather than eating large meals. One MyBCTeam member shared, “I found that small, snack size meals worked better.”

Keeping a small amount of food on your stomach all the time can help alleviate some of these symptoms, without overwhelming the digestive system with a whole meal.

2. Rest as Needed

If you’re exhausted after your treatment, make sure you take time to rest. This helps your body to heal and fight your cancer. As one team member said, “After about the fourth treatment, I was very tired for a few days, but I just rested when I needed to.”

If you have things that you must do, try to pace yourself so you don’t overdo it.

3. Take Nausea Medication

Most people who take paclitaxel get a prescription for an anti-nausea medication. You should ask for one of these if your doctor doesn’t offer it. Fill the prescription and have it ready so you can take it at the first sign of an upset stomach. Over time, you will learn when you need it, when you don’t, and how to time the medication so it’s as effective as possible for you. One team member explained, “I have to get the timing of the anti-nausea just right.”

You may not want to add more medicines to your regimen but, as one MyBCTeam member said, “Take the nausea pills if you need to!”

If your medication doesn’t work, call your oncology team. They should be able to prescribe a different one that might work better.

4. Get Painkillers for Joint, Muscle, and Bone Pain

If you experience joint, muscle, or bone pain, call your doctor to find out which painkillers they can prescribe or recommend to help. You may need to try several of them to figure out what will work for you. Take the medication regularly, especially after you figure out which days bring the worst bone pain for you. That way, you might be able to head it off before it starts.

Warm water, heating pads, cold packs, and other solutions may also help lower the inflammation in your body that can cause pain. Chemo ports are prone to infection, so make sure to ask your doctor about precautions you should take when getting it wet or applying objects directly to it.

5. Choose a Hair Loss Solution

If you are concerned about hair loss while on paclitaxel, come up with a plan for how you want to handle it when it starts. You may want to:

• Wear a cool cap to limit hair loss.
• Cover your scalp with something comfortable, like a hat, headband, or bandana.
• Buy a wig or two that you will wear until your hair grows back.

Fortunately, alopecia caused by paclitaxel is generally reversible, and hair usually regrows after three to six months.

Some people choose to donate their hair before they lose it. One team member who chose this said: “My hair was long enough to be cut and donated, so I did that. It made me feel better to think I beat cancer to the punch, giving it away before cancer could take it!!”

6. Use a Medicated Mouthwash

If you get bad mouth or throat sores from paclitaxel, get a prescription for a medicated mouthwash. This should help treat the sores you have and prevent them in the future. Use it as prescribed to get the best results.

7. Talk to Your Doctor

If you experience side effects that you don’t know how to manage or if they get worse, talk to your doctor. They may know of solutions or therapies to try that you wouldn’t otherwise consider. They are there to support you through your breast cancer journey and can connect you to resources like mental health providers if you need someone to talk to.

Talk With Others Who Understand

On MyBCTeam — the social network for people with breast cancer, and their loved ones — more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Are you wondering how to manage side effects from paclitaxel? Share your experience in the comments below, or start a conversation by posting on your Activities page.