Nab-paclitaxel (Abraxane) (2023)

Nab-paclitaxel is a chemotherapy drug and is also known by its brand name, Abraxane. It combines the chemotherapy drug paclitaxel with a protein called albumin.

It is a treatment for:

  • breast cancer that has spread
  • pancreatic cancer that has spread
  • non small cell lung cancer

You usually have it if you have had an allergic reaction to paclitaxel.

How it works

It works by stopping cancer cells separating into two new cells, so it blocks the growth of the cancer.

How you have it

You have nab-paclitaxel as a drip into your bloodstream (intravenously) which lasts about 30 minutes.

Drugs into your bloodstream

You havethe treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula)into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

Depending on your type of cancer you might have nab-paclitaxel treatment every 3 weeks. Or you might have it once a week for 3 weeks and then have a rest from treatment for a week.


You have blood tests before and during yourtreatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

How often and how severe the side effects are can vary from person to person. They also depend on what othertreatments you're having.

When to contact your team

Your doctor,nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

(Video) Paclitaxel vs Nab-Paclitaxel in Metastatic TNBC

  • you have severe side effects
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better.

Contact your advice line immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

Each of these effects happens in more than 10 out of 100 people (more than 10%). You might have one or more of them. They include:

Increased risk of getting an infection

Increased risk of getting an infectionis due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact youradvice line urgently if you think you have an infection.

Breathlessness and looking pale

You might be breathlessand lookpale due to a drop in red blood cells. This is calledanaemia.

Bruising, bleeding gums or nosebleeds

This is due to a drop in thenumber ofplatelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair.Your hair will usually grow back once treatment has finished butit is likely to be softer. It may grow backa different colour or be curlier than before.

Skin rash

Skinproblemsincludea skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse willtell you what products you can use on your skin to help.

(Video) GI Chemotherapy Education – GA/GemNab: Gemcitabine and Nab-paclitaxel (Abraxane®)

Numbness or tingling in the fingers or toes

Numbness or tingling in fingers or toesis often temporary and can improve after youfinish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.

Aching muscles or joints

You might feel some pain from yourmuscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Feeling or being sick

Feeling or being sickis usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniquescan allhelp.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.


Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or ifyou can't drink to replace the lost fluid. Orif it carries on for more than 3 days.

Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plentyto replace the fluid lost.


Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor, nurse or pharmacist if you are constipated for more than 3 days. They can prescribe a laxative.

Sore mouth

Mouth sores and ulcerscan be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep the mouth moist. Tell your doctor or nurse if you have ulcers.

Loss of appetite

You might lose your appetite for various reasons whilst having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Tiredness and weakness (fatigue)

Tiredness and weakness (fatigue)can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

High temperature

If you get a high temperature, let your healthcare teamknow straight away. Ask them if you can take paracetamol to help loweryour temperature.

(Video) Schedules for Gemcitabine, Nab-Paclitaxel for Pancreatic Cancer

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and10%). You might have one or more of them. They include:

  • dehydration
  • low potassium levels in the blood
  • difficulty sleeping (insomnia)
  • depression
  • headaches
  • taste changes
  • dizziness
  • heart problems
  • tummy (abdominal) pain
  • indigestion
  • nail changes
  • skin changes
  • anxiety
  • blurred vision, dry or watery eyes
  • hot flushes
  • high blood pressure
  • fluid build up (oedema)
  • stuffy nose
  • sore throat
  • breathlessness and cough

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (fewer than 1%). You might have or more of them. They include:

  • allergic reaction
  • changes in blood sugar levels
  • changes in mineral levels in the blood
  • ear problems
  • dry mouth
  • low blood pressure
  • sensitivity to sun
  • passing urine more often or pain when passing urine
  • pain at the site of your cancer
  • difficulty swallowing
  • swelling and redness at drip site

Coping with side effects

We have more information about side effects and tips on how to cope with them.

  • Read more about how to cope with side effects

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.


This drug contains sodium (salt). You mightneed to take account of this if you are on a controlled sodium diet. Tell your doctor if you are on a low salt diet.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant during treatment and for 1 monthafterwards.

It is important not to father a child during treatment and for 6 months afterwards.


You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able tostore spermbefore starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.


It is not knownwhetherthis drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

(Video) Nab-Paclitaxel Plus Gemcitabine in Advanced Pancreatic Cancer

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having thisdrugif you need treatment for anything else, including teeth problems.


Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacisthow long you should avoid live vaccinations.

In the UK, live vaccines includerubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

  • other vaccines, but they might not give you as much protection as usual
  • the flu vaccine (as an injection)
  • the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system Nab-paclitaxel (Abraxane) (1) recovers from treatment.

  • Find out more about the COVID-19 vaccine and cancer

Contact with others who have had immunisations-You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to changetheir nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC)website.

(Video) SEQUENCE: nab-paclitaxel/gemcitabine with modified FOLFOX in pancreatic cancer

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

This page is due for review. We will update this as soon as possible.


1. Nab-Paclitaxel in Metastatic Breast Cancer
2. Nab-Paclitaxel in Non-Small Cell Lung Cancer
3. Nab-Paclitaxel and Gemcitabine Vs
4. The Role of Nab-Paclitaxel in Treating TNBC
(Targeted Oncology)
5. Abraxane Mechanism of Action on Vimeo
6. Study of preoperative treatment with nab-paclitaxel and pembrolizumab in HR+ breast cancer
(Dana-Farber Cancer Institute)
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