Paclitaxel
- Medical Review: Meghan O'Regan Coleman, DNP, RN, CRNP-BC, AOCNP, ACHPN
Paclitaxel (Taxol) is a type of chemotherapy that treats all stages of breast cancer. It is made from the bark of the Pacific yew tree and belongs to a class of drugs called taxanes.
Below, you can learn about how paclitaxel works, the types of breast cancer it treats, treatment timing, and side effects.
How paclitaxel works
Paclitaxel works by damaging the microtubules that are the “skeleton” of the cancer cells. This stops the cancer cells from dividing normally, and results in the stalled growth and death of the cancer cells.
It is cell-cycle specific, which means it attacks the cells during specific points in their growth.
Who gets paclitaxel
Paclitaxel may be used as a part of chemotherapy treatment regimens for most types of invasive breast cancer, including triple-negative breast cancer, to lower the risk of the breast cancer coming back after surgery. It can also be used with targeted therapy, such as trastuzumab (Herceptin), to treat HER2-positive breast cancers.
Sometimes paclitaxel is given alone to treat metastatic breast cancer.
How paclitaxel is given
Paclitaxel is given intravenously (into a vein).
It is usually given in several cycles, with a treatment given on one day followed by a period of “off” days. The exact schedule depends on the regimen and dose used. It is often given weekly, every 2 weeks, or every 3 weeks.
To treat early-stage breast cancer, paclitaxel is usually given as part of a regimen with other chemotherapy medicines:
- A common combination in breast cancer is AC-T (Adriamycin and Cytoxan followed by Taxol).
- Paclitaxel can also be given with other chemotherapy medicines such as carboplatin (Paraplatin), or with monoclonal antibodies such as trastuzumab (Herceptin).
Paclitaxel can be given as part of neoadjuvant (before surgery) treatment or as part of adjuvant (after surgery) treatment. An entire course of chemotherapy for breast cancer usually takes from 3 to 6 months.
In some cases, your doctor may recommend a dose-dense schedule, which means medicines are given with less time between treatments than in a standard chemotherapy treatment plan. For example, a common treatment regimen is dose-dense doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) every 2 weeks for four cycles followed by paclitaxel (Taxol) every 2 weeks for four cycles.
For metastatic breast cancer, paclitaxel is usually given weekly in low doses, to limit side effects. It can also be given every 3 weeks.
Your doctor will recommend a number of cycles you can expect to have as part of your cancer treatment plan.
Side effects and things to remember
Before starting paclitaxel, tell your doctor about any medicines you are taking, including vitamins, herbal supplements, and over-the-counter medicines.
Also, tell your doctor about any existing or previous health problems.
It’s important to know that the taxane chemotherapies docetaxel (Taxotere) and paclitaxel have been reported to cause permanent hair loss in some people. Research shows that this is more likely with docetaxel. Scalp cooling has been shown to reduce the risk of temporary and permanent hair loss for people undergoing chemotherapy, including taxane chemotherapy. Talk with your care team about ways to manage this risk.
Paclitaxel can cause an allergic reaction, and so can another ingredient given with it called Cremophor. Your doctor may give you medicine to prevent the reaction on the day that you get treatment.
Be sure to get emergency medical help if you have any signs of an allergic reaction, such as:
- Hives or red skin rash
- Difficulty breathing
- Faintness
- Swelling of your face, lips, tongue, or throat
Other side effects of paclitaxel may include:
- Diarrhea
- Menopausal symptoms
- Mouth sores
- Neuropathy (numbness or tingling in the hands and feet)
- Neutropenia (low level of a type of white blood cell)
- Vomiting
- Weakness and fatigue
- Bone pain or muscle pain
- Rash
Paclitaxel can temporarily affect how your body makes blood cells, which can decrease your blood cell counts. This is called bone marrow suppression. Your doctors will test your blood counts regularly. The blood cell count changes can include a decrease in:
- Red blood cells, which carry oxygen in your body to help give you energy
- White blood cells, which fight infection in your body
- Platelets, which help clot the blood to stop bleeding
Talk to your doctor, pharmacist, or nurse about all your side effects so that they can help you manage them. You can also visit the side effects section for more information.
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Reviewed and updated: June 11, 2026
Reviewed by: Meghan O'Regan Coleman, DNP, RN, CRNP-BC, AOCNP, ACHPN
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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.