Key points
- Docetaxel is a chemotherapy drug usually given once every 3 weeks as a one-hour drip [1].
- It is used for breast, lung, spread prostate, stomach and head and neck cancer [1].
- In prostate cancer that had spread and no longer responded to hormone therapy, docetaxel helped men live longer than an older drug did [2].
- The main risks: low white blood cells and infection, allergic reactions, swelling and numbness of the hands and feet; a steroid tablet (such as dexamethasone) must be taken as directed before each infusion [1].
- Women should avoid pregnancy for 2 months, and men (with a partner who could become pregnant) for 4 months, after the last dose [1].
What is this drug and how does it work?
For physicians
Docetaxel, known by the brand name Taxotere, is an anticancer drug from the taxane group. It binds tubulin and over-stabilises microtubules (the internal skeleton of the cell needed for cell division); as a result the cell cannot divide and cancer cell division stops [1].
It was first approved in the United States in 1996 [1]. Docetaxel is always given as an intravenous infusion at a treatment centre and has no oral form [1].
Which cancers is it used for?
Your doctor may prescribe this drug for:
- Breast cancer [1, 3]
- Non-small cell lung cancer [1]
- Prostate cancer [1, 2, 4, 6]
- Cancer of the stomach and the junction with the oesophagus [1, 7, 8]
- Head and neck cancer (squamous cell) [1]
Whether it suits you depends on the type and stage of your cancer and your test results. Details of each use are in the section for doctors.
For physicians
| Cancer | Setting |
|---|---|
| Breast cancer | Locally advanced or metastatic after failure of prior chemotherapy (monotherapy) [1] |
| Breast cancer | Adjuvant treatment after surgery in node-positive disease, with doxorubicin and cyclophosphamide (TAC regimen) [1, 3] |
| Non-small cell lung cancer | Advanced or metastatic after failure of platinum chemotherapy (monotherapy), or first line with cisplatin [1] |
| Prostate cancer | Metastatic castration-resistant, with prednisone [1, 2] |
| Prostate cancer | Metastatic hormone-sensitive, with androgen deprivation therapy (ADT); this use is not in the docetaxel FDA label and is based on trials and guidelines [4, 6] |
| Gastric and gastro-oesophageal junction cancer | Advanced, without prior chemotherapy, with cisplatin and fluorouracil (TCF) [1, 7] |
| Gastric and gastro-oesophageal junction cancer | Perioperative treatment in the FLOT regimen (outside the FDA label) [8] |
| Head and neck cancer (squamous cell) | Induction treatment of locally advanced disease, with cisplatin and fluorouracil [1] |
The choice of regimen depends on the type and stage of the cancer and each patient's situation and should be decided by an oncologist.
| Cancer | Key evidence |
|---|---|
| Breast cancer (adjuvant, TAC) | TAX316: 5-year disease-free survival 75% vs 68% with FAC and a 30% lower risk of death [3] |
| Non-small cell lung cancer | TAX317, TAX320 and TAX326 trials in the FDA label [1] |
| Castration-resistant prostate cancer | TAX327: median survival 18.9 vs 16.5 months with mitoxantrone; hazard ratio for death 0.76 [2] |
| Hormone-sensitive prostate cancer | CHAARTED: median survival 57.6 vs 44.0 months (hazard ratio 0.61) [4]; ARASENS: adding darolutamide to ADT and docetaxel, hazard ratio for death 0.68 [5]; ESMO 2026 recommends triplet therapy for high-volume disease [6] |
| Advanced gastric cancer (TCF) | V325: median time to progression 5.6 vs 3.7 months and median survival 9.2 vs 8.6 months [1, 7] |
| Resectable gastric cancer (FLOT) | FLOT4: median overall survival 50 vs 35 months with ECF/ECX; hazard ratio 0.77 [8] |
| Head and neck cancer (squamous cell) | TAX323 and TAX324 trials in the FDA label [1] |
How it is taken and dosing
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Treatment regimens and doses: index8 regimens
Docetaxel is given in a hospital or chemotherapy clinic by the treatment team, as an intravenous infusion of about 1 hour, usually once every 3 weeks [1]. A blood test (blood counts and liver tests) is done before each dose; if the neutrophil count (a type of white blood cell) is below 1500 per cubic millimetre, the infusion is not given [1].
It is very important to take the steroid tablets (usually dexamethasone) exactly as your doctor directs, starting the day before the infusion; this reduces fluid retention and allergic reactions. If you have missed any of these tablets, tell the treatment team before the infusion [1]. The number of cycles depends on the type of cancer, and you should never stop or move treatment on your own.
- Premedication: oral dexamethasone 16 mg daily (for example 8 mg twice daily) for 3 days starting 1 day before the infusion; in mCRPC (because of concurrent prednisone), dexamethasone 8 mg at 12, 3 and 1 hours before the infusion [1].
- Conditions to give and contraindications: neutrophils below 1500 per µL, a history of severe hypersensitivity to docetaxel or drugs containing polysorbate 80. Do not give with bilirubin above the upper limit, or AST/ALT above 1.5 times with ALP above 2.5 times [1].
- Monitoring: frequent CBC; bilirubin, AST/ALT and ALP before each cycle; fluid retention, hypersensitivity (even with dexamethasone premedication; stop the infusion immediately for a severe reaction) and neuropathy [1].
- Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, voriconazole, etc.): avoid; if unavoidable, consider a 50% reduction of the docetaxel dose [1].
- Dose modification: the dose-reduction rules for each indication are in that regimen's note [1].
For physicians
Regimens and dosing
Advanced or metastatic breast cancer (FDA label)
After failure of prior chemotherapy, monotherapyCycle length: Every 21 days
After failure of prior chemotherapy, monotherapy
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 60 to 100 mg/m² | IV, 1 hour | Day 1 |
Dose modification: starting at 100, with febrile neutropenia, neutrophils below 500 for more than 1 week or severe/cumulative skin reactions: reduce to 75, and if it persists to 55 mg/m² or discontinue. Peripheral neuropathy grade ≥3: discontinue completely [1].
Adjuvant TAC (FDA label)
Operable node-positive breast cancerCycle length: Every 21 days
Operable node-positive breast cancer
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Doxorubicin | 50 mg/m² | IV | Day 1 |
| Cyclophosphamide | 500 mg/m² | IV | Day 1 |
| 1 hour after AC | |||
| Docetaxel | 75 mg/m² | IV, 1 hour | Day 1 |
NSCLC (FDA label)
Monotherapy after platinum failure; or first line with cisplatinCycle length: Every 21 days
Monotherapy after platinum failure; or first line with cisplatin
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| After platinum | |||
| Docetaxel | 75 mg/m² | IV, 1 hour | Day 1 |
| First line | |||
| Docetaxel | 75 mg/m² | IV, 1 hour | Day 1 |
| First line, immediately after docetaxel | |||
| Cisplatin | 75 mg/m² | IV, 30 to 60 minutes | Day 1 |
The 100 mg/m² dose in previously treated patients was associated with more haematological toxicity, infection and treatment-related deaths [1].
Dose modification: monotherapy: after febrile neutropenia, neutrophils below 500 for more than 1 week, severe skin reaction or grade 3–4 non-haematological toxicity, hold until resolved and resume at 55. With cisplatin: platelet nadir below 25,000, febrile neutropenia or serious non-haematological toxicity: reduce to 65, then 50 [1].
Docetaxel + prednisone (FDA label)
Metastatic castration-resistant prostate cancerEach drug’s schedule in the table
Metastatic castration-resistant prostate cancer
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 75 mg/m² | IV, 1 hour | Day 1, every 21 days |
| Prednisone | 5 mg twice daily | Oral | Continuous |
Dose modification: febrile neutropenia, neutrophils below 500 for more than 1 week, severe skin reaction or moderate neurosensory symptoms: reduce from 75 to 60; if it persists, discontinue [1].
Docetaxel + ADT (CHAARTED trial)
Metastatic hormone-sensitive prostate cancer (outside the FDA label)Each drug’s schedule in the table
Metastatic hormone-sensitive prostate cancer (outside the FDA label)
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 75 mg/m² | IV | Day 1, every 21 days |
| Androgen deprivation therapy (ADT) | As scheduled | Continuous |
Dose from the CHAARTED trial [4]. In ARASENS, darolutamide 600 mg twice daily was added to ADT and docetaxel [5].
Evidence: ARASENS (2022), CHAARTED (E3805) (2015)
TCF: docetaxel + cisplatin + fluorouracil (FDA label)
Advanced gastric or junctional adenocarcinoma, no prior chemotherapyCycle length: Every 21 days
Advanced gastric or junctional adenocarcinoma, no prior chemotherapy
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 75 mg/m² | IV, 1 hour | Day 1 |
| Cisplatin | 75 mg/m² | IV, 1 to 3 hours | Day 1 |
| Fluorouracil | 750 mg/m² daily | Continuous 24-hour infusion | Days 1 to 5 |
Antiemetics and hydration for cisplatin are mandatory [1].
Dose modification: complicated neutropenia despite G-CSF: 75 → 60 → 45; grade 4 thrombocytopenia: 75 → 60. Next cycle only with neutrophils above 1500 and platelets above 100,000. Grade 3 diarrhoea: first occurrence reduce fluorouracil by 20%, second occurrence reduce docetaxel by 20%; grade 4: first occurrence reduce both by 20%, second occurrence discontinue. AST/ALT above 2.5 to 5 times with ALP ≤2.5 times (or AST/ALT above 1.5 to 5 times with ALP above 2.5 to 5 times): reduce docetaxel by 20%; AST/ALT or ALP above 5 times: discontinue [1].
Perioperative FLOT (FLOT4 trial)
Resectable gastric or junctional cancer cT2 or higher or cN+ (outside the FDA label)Cycle length: Every 14 days
Resectable gastric or junctional cancer cT2 or higher or cN+ (outside the FDA label)
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Docetaxel | 50 mg/m² | IV | Day 1 |
| Oxaliplatin | 85 mg/m² | IV | Day 1 |
| Leucovorin | 200 mg/m² | IV | Day 1 |
| Fluorouracil | 2600 mg/m² | 24-hour infusion | Day 1 |
Doses from the FLOT4 trial [8].
Evidence: FLOT4 (2019)
TPF induction for head and neck cancer (FDA label)
Locally advanced squamous cell carcinoma of the head and neckCycle length: Every 21 days
Locally advanced squamous cell carcinoma of the head and neck
Before prescribing: Shared safety points| Drug | Dose | Route | Schedule |
|---|---|---|---|
| TAX323 (then radiotherapy) | |||
| Docetaxel + cisplatin | 75 + 75 mg/m² | IV, 1 hour each | Day 1 |
| TAX323 | |||
| Fluorouracil | 750 mg/m² daily | Continuous infusion | Days 1 to 5 |
| TAX324 (then chemoradiotherapy) | |||
| Docetaxel + cisplatin | 75 + 100 mg/m² | IV (cisplatin over 30 minutes to 3 hours) | Day 1 |
| TAX324 | |||
| Fluorouracil | 1000 mg/m² daily | Continuous infusion | Days 1 to 4 |
Antiemetics, hydration before and after cisplatin, and prophylactic antibiotics for neutropenic infection [1].
Dose modification: complicated neutropenia despite G-CSF: 75 → 60 → 45; grade 4 thrombocytopenia: 75 → 60. Next cycle only with neutrophils above 1500 and platelets above 100,000. Grade 3 diarrhoea: first occurrence reduce fluorouracil by 20%, second occurrence reduce docetaxel by 20%; grade 4: first occurrence reduce both by 20%, second occurrence discontinue. AST/ALT above 2.5 to 5 times with ALP ≤2.5 times (or AST/ALT above 1.5 to 5 times with ALP above 2.5 to 5 times): reduce docetaxel by 20%; AST/ALT or ALP above 5 times: discontinue [1].
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Side effects
The most common side effects:
- Hair loss and tiredness in more than half of patients [1].
- Anaemia and low white blood cells, which raise the risk of infection [1].
- Nausea, diarrhoea, mouth sores and changes in taste [1].
- Numbness and tingling of the hands and feet and nail changes [1].
- Swollen legs (fluid build-up); the steroid tablet before each infusion is there to reduce this and allergic reactions [1].
For physicians
Common adverse reactions
The frequency of adverse reactions depends on the type of cancer, the dose and the partner drugs. The table below is based on the FDA label and data from 332 prostate cancer patients in the TAX327 trial who received docetaxel 75 mg/m² every 3 weeks with prednisone [1]. Across all uses, the most common adverse reactions include infections, cytopenias, alopecia, dysgeusia, dyspnoea, constipation, anorexia, nail changes, fluid retention, asthenia, nausea, diarrhoea, stomatitis and myalgia [1].
| Adverse reaction | Any grade | Grade 3 or 4 |
|---|---|---|
| Anaemia | 67% | 5% |
| Alopecia | 65% | — |
| Fatigue | 53% | 5% |
| Neutropenia | 41% | 32% |
| Nausea | 41% | 3% |
| Infection | 32% | 6% |
| Diarrhoea | 32% | 2% |
| Sensory neuropathy (numbness and tingling) | 30% | 2% |
| Nail changes | 30% | 0% |
| Treatment-emergent fluid retention | 24% | 1% |
| Stomatitis or pharyngitis | 20% | 1% |
| Dysgeusia | 18% | 0% |
Source: Table 9 of the FDA label [1]. Febrile neutropenia in this group was 3%; at higher doses (100 mg/m² in breast cancer), grade 4 neutropenia occurred in 85% and febrile neutropenia in about 12% of patients [1].
Serious side effects
These are less common but serious; tell your team early if you notice any sign of them:
- Infection with low white blood cells: a temperature of 38 °C or chills [1].
- A severe allergic reaction, mostly with the first and second infusions: flushing, shortness of breath, dizziness or itching; tell the nurse straight away [1].
- Severe fluid build-up: very swollen legs, shortness of breath or a swollen abdomen [1].
- Severe bowel inflammation: abdominal pain with fever or diarrhoea [1].
- Blurred vision, severe numbness, severe weakness, severe skin reactions and a small rise in the risk of leukaemia in later years [1].
For physicians
The FDA label for docetaxel has a boxed warning about treatment-related mortality, hepatic impairment, neutropenia, hypersensitivity reactions and fluid retention [1]:
- Treatment-related mortality: higher in patients with hepatic impairment, with higher doses, and in lung cancer patients with prior platinum chemotherapy who received 100 mg/m² [1].
- Severe neutropenia and infection: requires frequent blood counts [1].
- Severe hypersensitivity: may occur even with steroid premedication (especially with the first and second infusions); patients who had hypersensitivity to paclitaxel need closer monitoring [1].
- Severe fluid retention: reported in 6.5% of breast cancer patients despite premedication (leg swelling, pleural or peritoneal fluid) [1].
- Enterocolitis and neutropenic colitis, which can be fatal [1].
- Second malignancies such as acute myeloid leukaemia (AML) and myelodysplastic syndrome; in TAX316, acute leukaemia occurred in 3 of 744 patients in the TAC arm [1].
- Severe skin reactions (such as Stevens-Johnson syndrome), severe neuropathy (5.5% in metastatic breast cancer), cystoid macular oedema (blurred vision), severe asthenia (14.9%) and tumour lysis syndrome [1].
When should I call my doctor?
Contact your treatment team or go to the emergency department straight away if you have [1]:
- Any fever or chills (check your temperature regularly)
- Abdominal pain or tenderness or diarrhoea, with or without fever
- Signs of allergy during the infusion: flushing, a rash, shortness of breath, facial swelling or dizziness
- Swollen legs, rapid weight gain or shortness of breath
- A severe rash, blistering or peeling skin
- Numbness, tingling or weakness of the hands and feet
- Blurred vision or any other change in your eyesight
- An irregular or fast heartbeat, severe shortness of breath or fainting
- Dark or reduced urine, muscle cramps, confusion or seizures (possible signs of tumour lysis syndrome)
Interactions, pregnancy and precautions
- Other medicines: antifungal drugs such as ketoconazole and the HIV drug ritonavir raise the level of docetaxel in the blood and increase side effects; they should not be taken at the same time. Give your doctor a full list of your medicines and herbal supplements [1].
- Alcohol in the drug: each 100 mg/m² dose contains about 2 g/m² of ethanol; this may affect driving or operating machinery straight after the infusion [1].
- Pregnancy: docetaxel can harm an unborn baby. A pregnancy test is needed before starting; women should use effective contraception during treatment and for 2 months after the last dose, and men with a partner who could become pregnant for 4 months after the last dose [1].
- Breastfeeding: do not breastfeed during treatment and for 1 week after the last dose [1].
- Fertility: this drug may reduce male fertility; talk to your doctor about fertility preservation before starting treatment [1].
Frequently asked questions
Will docetaxel make my hair fall out?
Why do I need to take a steroid tablet before the infusion?
An oral steroid such as dexamethasone reduces how often and how badly fluid retention happens and how severe allergic reactions are. If you have not taken the tablets as planned, be sure to tell the treatment team before the infusion [1].
How many sessions does docetaxel treatment take?
It depends on the type of cancer. For example, adjuvant treatment of breast cancer with the TAC regimen uses 6 three-weekly cycles [1]; in a large study of hormone-sensitive prostate cancer, 6 cycles were given [4]; and in a large study of castration-resistant prostate cancer, up to 10 cycles [1]. Your doctor sets the exact plan.
Will the numbness in my hands and feet go away after treatment?
Can I drive after the infusion?
Docetaxel contains alcohol and may affect alertness straight after the infusion [1]. It is best to bring someone with you on infusion days and not to drive yourself.
Scientific evidence
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Key studies
5 itemsAbiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design
Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial
Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer
Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer
Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer
Clinical guidelines
3 itemsAdvanced and metastatic prostate cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
Breast Cancer, Version 4.2026, NCCN Clinical Practice Guidelines In Oncology
Related cancer types
Treatment regimens (physicians)
References
8 referencesShow all references, 7 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1DOCETAXEL injection, for intravenous use — Prescribing Information
- 2
- 3
- 4
- 5Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer
- 6Advanced and metastatic prostate cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
- 7Phase III Study of Docetaxel and Cisplatin Plus Fluorouracil Compared With Cisplatin and Fluorouracil As First-Line Therapy for Advanced Gastric Cancer: A Report of the V325 Study Group
- 8Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial
This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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