Plasma alcohol concentrations in patients following paclitaxel infusion

Paclitaxel is formulated in 50% Cremophor El and 50% ethanol such that patients receiving paclitaxel also receive a significant amount of each of these solvents. The aim of this study was to measure the plasma alcohol levels in patients treated with paclitaxel. A total of 12 patients who were enrolled in phase II trials of non-small-cell lung cancer, breast cancer or ovarian cancer received 175 mg/m2 paclitaxel given as a 3-h infusion. Blood samples were obtained prior to and immediately following the infusion, and plasma ethanol concentrations were measured enzymatically. The dose of ethanol delivered with the paclitaxel ranged from 20.0 to 28.9 ml. No alcohol was detected in pre-dose plasma, but 8 of 12 patients had detectable levels in post-infusion plasma, with 0.033 g/dl being the highest concentration. The elimination rate of alcohol approximates the infusion rate when paclitaxel is given over 3h, resulting in low or undetectable levels in most patients. However, in patients receiving an equivalent dose of paclitaxel given as a 1-h infusion, the plasma alcohol levels will likely be high enough for significant pharmacological effects to occur.