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GU Cabazitaxel (21D1) (3536 VER: 9-20-17)

GU Cabazitaxel (21D1) (3536 VER: 9-20-17) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Preprinted Paper Orders


VER: 9-25-17 (3536 VER: 9-20-17) Page 1 of 3
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority Contact: CCKM@uwhealth.org
Title: Cabazitaxel
Disease Group: Genitourinary
Disease: Prostate Cancer (Advanced)

Therapy: cabazitaxel 20 to 25 mg/m2 IV Day 1
prednisone 5 mg by mouth twice daily

Cycle Length: 21 days Course: 10 cycles

NOTE: 20 mg/m2 is the standard dose

Reference(s): DeBono J, et al. J Clin Oncol 2010;28(15 suppl): Abstract 4508
DeBono JS, et al. J Clin Oncol 2016;34(15_suppl): Abstract 5008

Allergies:  NKDA  Other ____________________________

Height _________cm Weight __________kg BSA ________m
2


Cycle _______ Starting with:  Day 1 (date) ___________

Pre labs:
• Obtain CBC without DIFF, ANC, Creatinine, Total Bilirubin, AST, PSA (Total, diagnostic)
 Other:



Treatment Conditions:
• Verify Informed consent obtained Day 1 of each cycle.
• Verify pretreatment labs have been obtained: ANC, Platelets, Creatinine, Total Bilirubin, AST
• Hold and notify provider for: ANC ≤ 1500/µL or Platelets ≤ 75K/µL or Creatinine Clearance less than 30
mL/min or Total Bilirubin ≥ 1.5 mg/dL or AST ≥ 1.5 X ULN

Nursing Procedure, Assessment and Monitoring:
• Monitor vital signs every 15 minutes for the first and second dose. If previous doses, tolerated, monitor vital
signs every 30 minutes for all subsequent infusions.
• Flush/Line Care per Institution standards

Hydration/Fluids: sodium chloride 0.9% IV to establish line and for flushing

Premedications/Antiemetics: (May substitute formulary equivalent)
Give 30 minutes prior to cabazitaxel:
• dexamethasone (Decadron) 10 mg IV once.
• diphenhydramine (Benadryl) 25 mg IV once.
• ranitidine (Zantac) 50 mg IV once.

Give prior to chemotherapy (*indicates preferred antiemetic regimen):
 *ondansetron (Zofran) 16 mg by mouth once. PO preferred – may give 8 mg IV if unable to tolerate PO.
 Other:



VER: 9-25-17 (3536 VER: 9-20-17) Page 2 of 3
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority Contact: CCKM@uwhealth.org
Treatment Medications for Day 1: (in order of administration)
Dose modifications from previous day/cycle?  No  Yes – list which drugs and indicate dose reduction below:




• cabazitaxel (Jevtana) __________mg (______ mg/m2, range 20 to 25 mg/m2) IV once over 60 minutes via
non-PVC tubing and 0.22 micron non-PVC in-line filter.
Hypersensitivity reaction to cabazitaxel can occur. For first and second dose, patient should be treated in a
location to optimize emergency care. RN to stay at patient’s bedside for a minimum of 15 minutes for first
dose. RN to do the same for second dose if adverse reaction during first dose.


• See Take Home Medication section for prednisone

Other Orders for Day 1:





Take Home Medications - (Prescribe Cycle 1, Day 1: Review for adequate supply during treatment)
• prednisone (Deltasone) 5 mg tablet, Disp. #60, Refills: 11
Take 1 tablet (5 mg) by mouth two times daily.

• ondansetron (Zofran) 8 mg tablet, Disp. #30, Refills: 5
Take 1 tablet (8 mg) by mouth every 8 hours as needed for nausea/vomiting.

 Other:




VER: 9-25-17 (3536 VER: 9-20-17) Page 3 of 3
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority Contact: CCKM@uwhealth.org
Follow Up
• Chemotherapy: Day 1 every 21 days

• Labs:
Cycle 1, Day 8 and 15: CBC, ANC (DIFF if done locally)
 Other:







• Procedures/Imaging/Scans:

















• Other Orders:











MD Signature_________________________________________ Pager______________
Date __________________Time___________________

Order Verification:
RN Signature: __________________________ Date: ___________ Time: __________ Pager #: ________
RPh Signature: _________________________ Date: ___________ Time: __________ Pager #: ________