Paclitaxel and Doxorubicin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Doxorubicin
Paclitaxel
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increase in exposure of DOXOrubicin and its metabolites
Interaction Deep Dive
A significant increase in DOXOrubicin exposure (at least 50%) has been reported when DOXOrubicin hydrochloride liposome was administered to patients who were concomitantly treated with PACLitaxel after receiving 4 weeks of PACLitaxel alone2. Therefore, if using concomitantly, administer DOXOrubicin hydrochloride liposome prior to PACLitaxel. Although this interaction has not been formally studied with DOXOrubicin hydrochloride injection, the potential for the same reaction is possible 1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Systemic exposure to DOXOrubicin was significantly increased when coadministered with PACLitaxel. Nineteen cancer patients were enrolled in an open-label, drug interaction study as part of 2 parallel clinical phase I trials of DOXOrubicin hydrochloride liposome combined with either PACLitaxel or DOCEtaxel. The aim of the study was to explore alterations in the pharmacokinetics of DOXOrubicin when combined with PACLitaxel or DOCEtaxel. The patients had a median age of 65 years, normal kidney and liver function, and a variety of solid tumors. Ten of the 19 outpatients were treated with DOXOrubicin hydrochloride liposome together with PACLitaxel after receiving 4 weeks of PACLitaxel alone. Patients received DOXOrubicin hydrochloride liposome 30 mg/m(2) or 35 mg/m(2) together with weekly PACLitaxel 70 mg/m(2). The mean increase in the DOXOrubicin AUC was 80% (median increase 54%) (p=0.002; 95% CI, 23% to 136%). DOXOrubicin clearance was reduced by a mean of -71% (p=0.013; 95% CI, -8% to -133%) when combined with PACLitaxel. The elimination half-life of DOXOrubicin was prolonged (67 hours for DOXOrubicin alone versus 116 hours for DOXOrubicin plus PACLitaxel) but did not reach statistical significance (p=0.1) 2.
Common questions
Can I take Paclitaxel and Doxorubicin together?
Increase in exposure of DOXOrubicin and its metabolites Always confirm with your pharmacist or prescriber before making any change.
How serious is the Paclitaxel and Doxorubicin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Paclitaxel or Doxorubicin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: Doxorubicin hydrochloride intravenous injection, doxorubicin hydrochloride intravenous injection. Pfizer Labs (per Dailymed), New York, NY, 2024. DailyMed
- Briasoulis E, Karavasilis V, Tzamakou E, et al: Interaction pharmacokinetics of pegylated liposomal doxorubicin (Caelyx) on coadministration with paclitaxel or docetaxel. Cancer Chemother Pharmacol 2004; 53(5):452-457. PubMed
Keep reading about Doxorubicin
Keep reading about Paclitaxel
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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