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Cremophor EL: the drawbacks and advantages of vehicle selection for drug formulation
Author(s): Gelderblom H, Verweij J, Nooter K, Sparreboom A
Source: EUROPEAN JOURNAL OF CANCER    Volume: 37    Issue: 13    Pages: 1590-1598    Published: SEP 2001  
Times Cited: 208     References: 75     
Abstract: Cremophor EL (CrEL) is a formulation vehicle used for various poorly-water soluble drugs, including the anticancer agent paclitaxel (Taxol). In contrast to earlier reports, CrEL is not an inert vehicle, but exerts a range of biological effects, some of which have important clinical implications. Its use has been associated with severe anaphylactoid hypersensitivity reactions, hyperlipidaemia, abnormal lipoprotein patterns, aggregation of erythrocytes and peripheral neuropathy. The pharmacokinetic behaviour of CrEL is dose-independent, although its clearance is highly influenced by duration of the infusion. This is particularly important since CrEL can affect the disposition of various drugs by changing the unbound drug concentration through micellar encapsulation. In addition, it has been shown that CrEL, as an integral component of paclitaxel chemotherapy, modifies the toxicity profile of certain anticancer agents given concomitantly, by mechanisms other than kinetic interference. A clear understanding of the biological and pharmacological role of CrEL is essential to help oncologists avoid side-effects associated with the use of paclitaxel or other agents using this vehicle. With the present development of various new anticancer agents, it is recommended that alternative formulation approaches should be pursued to allow a better control of the toxicity of the treatment and the pharmacological interactions related to the use of CrEL. (C) 2001 Elsevier Science Ltd. All rights reserved.
Document Type: Review
Language: English
Reprint Address: Gelderblom, H (reprint author), Rotterdam Canc Inst, Dept Med Oncol, Daniel Den Hoed Klin, NL-3075 EA Rotterdam, Netherlands
Addresses:
1. Rotterdam Canc Inst, Dept Med Oncol, Daniel Den Hoed Klin, NL-3075 EA Rotterdam, Netherlands
2. Univ Rotterdam Hosp, NL-3075 EA Rotterdam, Netherlands
Publisher: PERGAMON-ELSEVIER SCIENCE LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND
Subject Category: Oncology
IDS Number: 466TC
ISSN: 0959-8049
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