Which statement about paclitaxel treatment is true?

• A. Paclitaxel is mixed in a mineral-oil-like solvent that can cause infusion-related hypersensitivity reactions; premedication with corticosteroids, diphenhydramine, and H2 antagonists is recommended; it is an irritant and potential vesicant
• B. Paclitaxel requires no premedication
• C. Paclitaxel should be given after platinum-containing medications to prevent myelosuppression
• D. Paclitaxel does not require any specific infusion precautions

Answer: (A)

Premedication and solvent-related hypersensitivity define how paclitaxel is safely given. Paclitaxel is formulated with a solvent that can trigger infusion-related hypersensitivity reactions, so patients typically receive a premedication regimen before the infusion: a corticosteroid to blunt immune activation, an H1 antihistamine to counteract histamine release, and an H2 blocker to reduce additional histamine effects. Because it is an irritant/vesicant, meticulous IV access and careful infusion monitoring are essential, and infusion should be stopped at the first sign of an adverse reaction with prompt supportive treatment. The idea that no premedication is required, that it must be given after platinum-containing drugs to prevent myelosuppression, or that no infusion precautions are needed does not align with the safety practices for paclitaxel.