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Nab-paclitaxel (Abraxane®) for pancreatic cancer

There are different chemotherapy drugs used to treat pancreatic cancer. Nab-paclitaxel (Abraxane®) is a chemotherapy drug that is used with another chemotherapy drug called gemcitabine. This may be a treatment option for people with advanced pancreatic cancer.

Nab-paclitaxel with gemcitabine may be used if you can’t have FOLFIRINOX, or gemcitabine together with capecitabine (GemCap).

Nab-paclitaxel with gemcitabine may cause more side effects than gemcitabine alone, so you need to be well enough to deal with the possible side effects. The side effects of chemotherapy can be managed. 

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Each hospital may do things slightly differently, and treatment will vary depending on your cancer. Speak to your doctor or nurse about your treatment.

How is nab-paclitaxel given? 

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

Nab-paclitaxel with gemcitabine is given in a four-week cycle. This means that you will have nab-paclitaxel and gemcitabine once a week for three weeks, and then have a break from treatment for a week. This break allows your body to recover between treatments. The number of chemotherapy cycles you have will depend on how the treatment is working and how chemotherapy affects you. Your chemotherapy team can tell you more about this.

Nab-paclitaxel and gemcitabine are given as an infusion into a vein – you may hear an infusion called a ‘drip’. You will have the infusion of these drugs through a cannula.

Nab-paclitaxel and gemcitabine will normally be given on the same day. You will have an infusion of nab-paclitaxel first, which takes 30 minutes. After this, you will have gemcitabine, which also takes 30 minutes. 

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, and you may not get all of the side effects mentioned here. Your chemotherapy team should tell you about possible side effects and how they are managed. Ask them any questions you have. You can also speak to our specialist nurses on our free Support Line.  

Your chemotherapy team should give you an emergency number to call if you are unwell, or if you need information about any side effects. Your nurse will explain when to use this number. If you haven’t been given a number, ask your nurse about this.

Common side effects

Infection. Nab-paclitaxel can increase your risk of getting an infection. An infection is an emergency if you are having chemotherapy, and needs to be treated straight away. Read more about the signs of an infection, and how they are treated.      

Bowel problems. If you have runny poo (diarrhoea) more than four times a day, tell your chemotherapy team. They can give you medicines to help, or they can lower the dose of nab-paclitaxel until the diarrhoea is better. We have tips on dealing with diarrhoea.

You may also have trouble emptying your bowels (constipation). If this happens, drink lots of water and try to eat foods that are high in fibre, such as fruit and vegetables. Speak to your doctor about medicines that can help.

Fatigue (extreme tiredness). Fatigue is a common side effect of nab-paclitaxel. It isn’t the same as feeling tired. Fatigue can make you feel weak and have problems concentrating. Some people find that the fatigue starts a few hours to a few days after having chemotherapy, and starts to get better after a few days. There are things that you can do to help with fatigue. We have tips on coping with it.

Nab-paclitaxel may also make you feel dizzy. Feeling tired and dizzy may affect your ability to drive. If you have these side effects, talk to your doctor about driving.

Feeling or being sick (nausea or vomiting). This is a common side effect of nab-paclitaxel. You will normally be given anti-sickness medicines before your chemotherapy starts. If these medicines don’t help, speak to your chemotherapy team about changing to a different medicine. We have tips on coping with feeling and being sick.

Hair loss. Nab-paclitaxel may cause your hair to thin, or you may lose some hair  – but it should grow back once your treatment stops.

Tingling and numbness in your fingers and toes. Nab-paclitaxel can affect the nerves in your hands and feet, which can cause tingling and numbness (peripheral neuropathy). This normally gets better after your treatment, but for some people it may never go away. Talk to your chemotherapy team if you have any tingling or numbness in your fingers or toes.

Bruising and bleeding. Nab-paclitaxel can lower the number of platelets in your blood – this is called thrombocytopenia. This can cause you to bruise more easily than normal, and you may be more likely to have nosebleeds or bleeding gums. Speak to your chemotherapy team straight away about any of these side effects.

Loss of appetite. During your treatment you may not feel like eating, and you may start to lose weight. Try eating small meals often. If your appetite doesn’t get better after a few days, tell your doctor or dietitian. We have tips on dealing with a loss of appetite.

Sore mouth and mouth ulcers. Nab-paclitaxel can make your mouth sore, or cause mouth ulcers which can be painful. Tell your chemotherapy team about any problems you have with your mouth. They can make sure you don’t have a mouth infection, and give you a mouthwash which should help.  

Anaemia (feeling tired or dizzy). Nab-paclitaxel can lower the number of red blood cells in your blood. This is called anaemia, and can make you feel tired, dizzy, or short of breath.

Wheezing or feeling short of breath. Nab-paclitaxel can cause wheezing, a cough, a high temperature or shortness of breath. If this happens, tell your chemotherapy team straight away. They can arrange for you to have tests to check how your lungs are working.

Swelling (oedema). Some people have swelling in their feet, ankles, legs, fingers or face. This is because of a build-up of fluid, which is called oedema. This normally gets better by itself. If you have swelling in your feet, it may help to have your legs up on a cushion when you are sitting down. Your doctor may also be able to give you medicines to help.

Joint and muscle pain. Nab-paclitaxel can cause problems with your joints, such as swelling or pain. Your muscles may also feel weak or stiff. Tell your chemotherapy team if you have these side effects. They can give you painkillers. Make sure that you check your temperature before taking any painkillers. If you have a high temperature, tell your chemotherapy team. 

Headaches. Nab-paclitaxel can cause headaches. Tell your chemotherapy team if you have headaches – they can give you painkillers such as paracetamol or ibuprofen to help.

Sore, itchy eyes. Nab-paclitaxel can cause sore, itchy or watery eyes. Your chemotherapy team may need to give you some eye drops. Some people get blurred vision when taking nab-paclitaxel, but this isn’t common.

Less common side effects

  • Risk of a blood clot in a vein. Nab-paclitaxel can increase your risk of a blood clot in a vein, but this is not very common. If you have any pain or swelling in one of your arms or legs, or you feel very short of breath, call your chemotherapy team on the emergency number. Or phone an ambulance. A blood clot is serious if it isn’t treated.
  • Heart problems. Nab-paclitaxel can cause heart palpitations or an irregular heartbeat. Palpitations are when you feel your heartbeat more than usual. It is important to tell your chemotherapy team straight away if you get this, or go to A&E and tell them that you are having chemotherapy.

Speak to your doctor or nurse if you feel anything unusual, or if you would like more information. You can also speak to our specialist nurses on our Support Line.

Read more information

Read about how chemotherapy is given.

Read about managing the side effects of chemotherapy.

Read about coping with chemotherapy.

Read about other chemotherapy drugs for pancreatic cancer.

Updated August 2019

Review date August 2021