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Nab-paclitaxel (Abraxane®)

Nab-paclitaxel together with gemcitabine may be an option for some people with pancreatic cancer that has spread from the pancreas to other parts of the body (advanced or metastatic pancreatic cancer). It is also sometimes an option for locally advanced pancreatic cancer

Nab-paclitaxel together with gemcitabine may cause more side effects than gemcitabine alone, so you need to be fit and well enough to cope with them.

Where is nab-paclitaxel available on the NHS?

Nab-paclitaxel is available on the NHS for people with advanced pancreatic cancer in Wales and Scotland. It is available in England and Northern Ireland for people with advanced pancreatic cancer who can't have FOLFIRINOX or GemCap (gemcitabine with capecitabine). 

How is nab-paclitaxel given? 

You will have your chemotherapy as an outpatient in the chemotherapy unit at the hospital, which means you will go in for treatment, but won’t need to stay overnight.

Nab-paclitaxel with gemcitabine is given in a four-week cycle. Both drugs will usually be given on the same day. You will have them once a week for three weeks, and then have one week off. The exact number of cycles will depend on how well the treatment works and how you cope with it. Speak to your doctor about your treatment plan.

Nab-paclitaxel is given through a fine tube (a cannala) that is put into a vein in your arm or hand each time you have treatment. Or you may have it through a central line, such as a PICC line, Hickmann line or a portacath. These are tubes that deliver drugs directly into a large vein in your chest, and stay in place for as long as your chemotherapy lasts.

Nab-paclitaxel chemotherapy cycle

Oxaliplatin With 5 Fu And Folinic Acid Folfox Chemotherapy Cycle


What are the side effects of nab-paclitaxel?  

Nab-paclitaxel can cause side effects but these can affect everyone differently. Your doctor or nurse should give you information about side effects. Make sure you read this, and ask them any questions you may have about the possible side effects, and how to manage them. Knowing what to expect can help you to deal with any side effects.

Common side effects

  • Increased risk of infection. Nab-paclitaxel can increase your risk of getting an infection, because it can cause a drop in the number of your white blood cells. This means your body is less able to fight infection. Signs of an infection include a high temperature, headaches, aching muscles, a cough, sore throat, or feeling shivery and cold.
  • Anaemia (low level of red blood cells). Nab-paclitaxel can lower the number of red blood cells in your blood (anaemia). This can make you feel tired, faint and short of breath. If you are very anaemic, you may need to be given extra red blood cells in a drip (blood transfusion).
  • Hair loss. Nab-paclitaxel may cause your hair to thin or you may lose it altogether. It should grow back gradually once treatment stops. Your nurse can give you advice on dealing with losing your hair.
  • Feeling and being sick (nausea and vomiting). This is a common side effect of nab-paclitaxel but can be controlled with anti-sickness medication. You will usually be given medication before your chemotherapy starts to help control or prevent sickness. If it doesn’t work, tell your doctor or nurse – you should be able to change the medication. Read more about coping with feeling and being sick.
  • Loose watery poo (diarrhoea). If you have diarrhoea make sure you drink plenty of fluids. If you have diarrhoea more than four times a day, tell your doctor or nurse. They may give you medication to control it, or reduce the dose of the chemotherapy drug in future cycles.
  • Tingling and numbness in your fingertips and toes (peripheral neuropathy). This is caused by the effect of nab-paclitaxel on your nerves. It usually improves after treatment finishes, but for some people it may never go away. Talk to your nurse or doctor if you have these symptoms, as the dose of the chemotherapy drug may be stopped or reduced.
  • Sore mouth and mouth ulcers. This can be mild or severe, making eating and drinking difficult. Try to drink lots of fluids, clean your teeth regularly with a soft toothbrush and avoid spicy or citrus foods that might sting your mouth. Your doctor or nurse can give you an anti-bacterial mouthwash which should help. Using painkillers such as paracetamol can also help. Read more about taking paracetamol while on chemotherapy.
  • Fatigue (extreme tiredness). Feeling very tired or exhausted is a common side effect of nab-paclitaxel. People can feel tired or exhausted for much of the time during treatment. There are ways to deal with fatigue. You might want to keep a fatigue diary, so you can see when you have more energy to do things. This may help you to plan activities on the days that you are feeling better, and rest on days when you’re more tired.
  • Bruising and bleeding. Nab-paclitaxel can lower the number of platelets in your blood. Platelets are cells that help blood to clot. You may bruise more easily than normal, or have nosebleeds. You may have blood in your urine but this is less common. Tell your doctor or nurse straight away about any of these side effects, as your dose may need to be reduced.
  • Breathlessness. Nab-paclitaxel can cause some people to develop wheezing, a cough, a high temperature or breathlessness. If this happens contact the medical team immediately, who can arrange for you to have tests to check your lungs.
  • Headaches. Nab-paclitaxel may cause headaches. Tell your doctor or nurse who can give you painkillers or medicine to improve this. You can also take painkillers such as paracetamol or ibuprofen, but make sure that you check your temperature first. If you have a high temperature tell your medical team before taking any painkillers. 
  • Eye problems. Nab-paclitaxel may cause sore or watery eyes. Tell your nurse or doctor if this happens, as you may need antibiotic eye drops. Nab-paclitaxel may also cause blurry vision. If this happens tell your doctor or nurse who will give you advice.
  • Joint and muscle pain. Let your doctor or nurse know if you get this. They can prescribe painkillers.

Less common side effects

  • Risk of a blood clot. Nab-paclitaxel can increase the risk of a blood clot forming in a vein (thrombosis), although this is not very common. If you have pain or swelling in one of your legs or arms, or are very short of breath, phone an ambulance or the emergency contact number you will have been given immediately. A blood clot needs to be treated straight away.
  • Allergic reactions. Nab-paclitaxel may cause an allergic reaction while it’s being given, but this is very rare. Signs of this can include a rash, feeling dizzy, or swelling of the face and hands. If this happens tell your nurse or doctor immediately as any allergic reaction will need to be treated straight away.
  • Heart problems. Nab-paclitaxel can cause palpitations or a fluttering heart. If this happens tell your doctor or nurse as they may prescribe medication. This usually ends after treatment.

We haven’t listed every possible side effect of nab-paclitaxel. Speak to your doctor or nurse for more information if you experience anything unusual. If you are unable to contact your doctor or nurse, contact the medical team on the emergency number that you should have been given.

If you have any questions about nab-paclitaxel or side effects, you can also call our specialist nurses free on our Support Line.

More chemotherapy information

Published May 2017

Last updated August 2017

Review date May 2019

Information Standard