Human PXR-activator of low or medium potency, most likely limited capacity for significant CYP-induction. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Docetaxel is a semisynthetic taxane similiar to paclitaxel, manufactured from a taxane precursor derived from the needles of the European yew tree. Taxus baccata.

Docetaxel is an antineoplastic agent used alone or in combination with other cytostatics in the treatment of cancers such as breast cancer, lung cancer, and prostate cancer. It is administered as an intravenous infusion. Common adverse reactions of docetaxel that can be confused with an acute porphyric attack are nausea, vomiting, diarrhoea/obstipation, abdominal pain, myalgia, peripheral sensoric and/or motoric neuropathy. Side effects such as nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.

Docetaxel is extensively metabolized via CYP3A4. Synold (2001) found that docetaxel did not activate human PXR. In another study docetaxel was observed to moderately activate PXR, but there was no significant induction of CYP3A4 observed in human administration (Harmsen, 2009). Zhou (2007) reports docetaxel as a weak inhibitor of CYP 3A4. Interactions with CYP metabolism of other drugs in clinical use are not systematically studied.

Docetaxel is used uneventfully to treat breast cancer in 2 women with VP, and used uneventfully to treat cancer of the uterus in one woman with AIP (Thiery-Vuillemin, 2008).

Uneventful use reported in 1 patient with acute porphyria.