Why do I need a take a granulocyte colony-stimulating factor (G-CSF)?

Some people are at higher risk for becoming very ill from infections. This includes people who are age 65 years and older, are receiving a higher dose of Jevtana (cabazitaxel), or have other serious health conditions. If this is you, then your provider might start you on a [granulocyte colony-stimulating factor (G-CSF)](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/granulocyte-colony-stimulating-factor). G-CSFs, such as [Neulasta (pegfilgrastim)](https://www.goodrx.com/neulasta/what-is) or [Neupogen (filgrastim)](https://www.goodrx.com/neupogen/what-is), trigger your bone marrow to make more WBCs to help you fight infections. Ask your provider if you're not sure whether you need to receive a G-CSF.

Jevtana

cabazitaxel

Used for Prostate Cancer

Jevtana (cabazitaxel) is medication used to treat prostate cancer that has spread to other areas of the body. It’s typically only used if your cancer didn’t respond to castration or another chemotherapy called docetaxel (Taxotere). Jevtana (cabazitaxel) is a chemotherapy that's given as an infusion into the veins by a healthcare provider. It’s only infused once every 3 weeks, but you’ll have to take a daily oral steroid during your treatment.

Reviewed by:

Lauren Morton, PharmD, BCPS

Connie Zheng, PharmD

Last reviewed on September 29, 2022

What is Jevtana (cabazitaxel)?

What is Jevtana (cabazitaxel) used for?

Prostate cancer that has spread to other areas of the body (used in combination with prednisone)

How Jevtana (cabazitaxel) works

Jevtana (cabazitaxel) is a type of anticancer medication called a microtubule inhibitor. It interferes with the way cells divide and multiply, especially in fast-growing cells, like cancer cells. When this happens, the cells can no longer divide and grow.

Are you looking for information on docetaxel (Taxotere) or paclitaxel (Taxol) instead?

Drug facts

Common Brands	Jevtana
Drug Class	Anticancer agent
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Jevtana

Drug Class

Anticancer agent

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Jevtana (cabazitaxel)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Please note: In clinical trials, people who reported these side effects were also taking prednisone daily

Low red blood cell count (up to 100%)
Low white blood cell count (up to 96%)
Low platelet count (48%)
Fatigue (up to 53%)
Diarrhea (up to 47%)
Nausea (up to 34%)
Pain in bones, joints, and muscles (27%)
Vomiting (up to 22%)
Constipation (up to 20%)
Weakness or lack of energy (up to 20%)

Less Common Side Effects

Lower appetite
Infection
Nerve pain in arms or legs
Stomach pain
Back pain
Trouble gaining weight, low appetitie
Blood in the urine

Jevtana (cabazitaxel) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Serious allergic reaction: rash, trouble breathing, or lightheadedness
Serious infections: repeated fevers, chills, sweating, trouble breathing, cough, sore throat, severe diarrhea, stomach pain, vomiting, painful or frequent urination
Lung problems: cough, trouble breathing, shortness of breath, chest pain
Kidney problems: bloody urine, urinating less, or swelling
Stomach problems: stomach pain or tenderness, constipation that can’t be relieved, diarrhea, or fever
Stomach bleeds: throwing up blood, bloody or black and tarry stool (or change in the color of your stool)

Source: DailyMed

The following Jevtana (cabazitaxel) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Black, tarry stools

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

blood in the urine or stools

burning, numbness, tingling, or painful sensations

chest pain

chills

cough

difficult or labored breathing

difficult or painful urination

fever

lower back or side pain

pale skin

pinpoint red spots on the skin

rapid weight gain

sore throat

sores, ulcers, or white spots on the lips or in the mouth

swollen glands

tightness in the chest

unsteadiness or awkwardness

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

weakness in the arms, hands, legs, or feet

Less common

Blurred vision

confusion

decreased urination

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

fainting

fast, slow, or irregular heartbeat

lightheadedness

rapid breathing

sunken eyes

sweating

thirst

wrinkled skin

Incidence not known

Blue lips, fingernails, or skin

burning feeling in the chest or stomach

fast breathing

frequent urination

general feeling of discomfort or illness

indigestion

lower abdominal cramping

nausea

severe constipation

stomach pain or upset

tenderness in the stomach area

thickening of bronchial secretions

vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Belching

change in taste

constipation

cracked lips

decreased weight

diarrhea

difficulty with swallowing

hair loss

headache

heartburn

indigestion

lack or loss of strength

loss of appetite

stomach discomfort

thinning of the hair

weight loss

Less common

Back pain

difficulty with moving

muscle pain, spasm, or stiffness

pain in the joints

pain, itching, burning, swelling, or a lump under your skin where the needle is placed

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Pros and cons of Jevtana (cabazitaxel)

Pros

Can be used in prostate cancer that has spread to other areas of the body
Only given every 3 weeks
Helps people with prostate cancer live longer and improve pain

Cons

Raises your risk of infections, bleeding, or bruising
Need to take additional pretreatment medications to lower the risk of serious allergic reactions
Need to take a daily steroid pill during treatment

Pharmacist tips for Jevtana (cabazitaxel)

Stay on track with your infusions. You can set calendar reminders or use an app that can help remind you to stay on schedule. If you miss an infusion appointment, contact your prescriber to discuss how to get back on track.
Each Jevtana (cabazitaxel) infusion appointment can take a couple of hours because it includes the time it takes to check in, get the infusion, and monitor for side effects, so make sure you have what you need to be comfortable during that time. Wear sleeves that are easy to roll up, bring a water bottle to help you stay hydrated, and bring a snack. You also might need to arrange for rides home, so go through a checklist a few days before each appointment to help you stay organized.
Jevtana (cabazitaxel) can cause an allergic reaction (e.g., rash, trouble breathing, feeling faint) within minutes of starting your infusion. Let your provider know if you start to have these symptoms so that you can be treated immediately.
As part of your Jevtana (cabazitaxel) treatment, you’ll also need to take daily steroid. If you miss a dose of your steroid, let your provider know.
It’s important to stay hydrated while you’re taking Jevtana (cabazitaxel). This can help lower your risk of dehydration or certain kidney problems. It can also help replace fluids you might have lost if you have diarrhea.
Certain medications, like clarithromycin or voriconazole (Vfend), might change the levels of Jevtana (cabazitaxel) in your body and raise your risk of side effects. Tell your provider and pharmacist about all the medications you take, including supplements and over-the-counter medications. Before starting any new medications, make sure your provider knows you're taking Jevtana (cabazitaxel). When taking some medication, they might need to change your Jevtana (cabazitaxel) dose.
If you're an older adult, you're more likely to get serious infections from Jevtana (cabazitaxel) treatment. Let your provider know if you experience any symptoms of infections, like fever, cough, painful urination, or muscle aches.
Taking Jevtana (cabazitaxel) can raise your risk of infection. Sometimes, fever can be the only sign of an infection. Because of this you should monitor your temperature at home frequently, especially if you feel warm, flushed, chilled, or not well. Let your provider know if you develop any fever.
To lower your chance of developing an infection, wash your hands often. Avoid crowded places and people who are sick. To prevent getting sick from tainted foods, please wash raw fruits and vegetables before you eat, and cook your food thoroughly.
If your partner is able to become pregnant, use appropriate birth control measures, such as condoms or birth control pills, while you’re taking Jevtana (cabazitaxel), and for 3 months after your last dose. It’s possible for Jevtana (cabazitaxel) to cause birth defects or pregnancy loss in female partners of males who are taking this medication. Talk with your provider if you have questions about birth control options for you and your partner.

Common questions about Jevtana

The whole Jevtana infusion process can take at least an hour and a half. Before you receive Jevtana, your provider will give you medications, such as antihistamines, corticosteroids, and nausea medications, to ease potential infusion-related side effects. This will take about 30 minutes. Then, your provider will give you the Jevtana infusion, which can take about an hour. But the length of time to complete the infusion depends on how well you tolerate the medication. If you’re experiencing an allergic reaction (e.g., rash, trouble breathing, feeling faint), your provider might need to temporarily slow down or stop the infusion to manage your symptoms. This will make the infusion take longer to finish.

Yes, Jevtana is a chemotherapy that targets and kills cancer cells in your body. Chemotherapy isn't a first-choice option for prostate cancer, but only used in people with advanced prostate cancer. Advance prostate cancer typically no longer responds well to preferred treatment options, such as hormone therapy, surgery, and radiation. Talk with your provider to learn more about the different treatment options for your prostate cancer.

Yes, Jevtana can weaken your immune system and put you at serious risks for infections. Jevtana works by killing cancer cells. But as a side effect, it also ends up killing the healthy cells in your body, including your white blood cells (WBCs). WBCs are the cells in your body that helps you fight infection. When your WBC levels drop too low, you're more likely to get seriously sick from infections. Because of this, your provider will order blood tests regularly to check your WBC counts (as well as other blood cell counts). You'll likely need to get blood draws weekly when you first start Jevtana. Ask your provider if you're not sure about how often you need to get blood work done.

Some people are at higher risk for becoming very ill from infections. This includes people who are age 65 years and older, are receiving a higher dose of Jevtana, or have other serious health conditions. If this is you, then your provider might start you on a granulocyte colony-stimulating factor (G-CSF). G-CSFs, such as Neulasta (pegfilgrastim) or Neupogen (filgrastim), trigger your bone marrow to make more WBCs to help you fight infections. Ask your provider if you're not sure whether you need to receive a G-CSF.

Maybe. Some animal studies showed that Jevtana can cause male sex organs to become smaller, which might affect your ability to have a child. Talk to your provider if you have concerns about fertility.

If you have liver problems, your body might have a harder time getting rid of Jevtana. This causes higher levels of Jevtana in your body and can raise your risk for more side effects. Let your provider know if you have problems with your liver, you’ll need to be monitored more closely. Depending on how severe your liver problems are, you might need to take the medication at a lower dose, or you might not be able to receive Jevtana entirely.

Risks and warnings for Jevtana (cabazitaxel)

Jevtana (cabazitaxel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Dangerously low blood cell counts

Risk factors: Age ≥ 65 years | Poor health | History of low white blood cell count with fever | Poor nutrition | Other serious illnesses | Previous intensive radiation treatment | Jevtana (cabazitaxel) dose of 25 mg/m²

Warning Icon Jevtana (cabazitaxel) can cause your red blood cell (RBC), white blood cell (WBC), and platelet counts to drop. When these cells are lower than expected, you’re at risk for developing infections, bleeding, or bruising. In very serious cases, some people taking Jevtana (cabazitaxel) have developed deadly infections. Because of the risk of infections, your provider might give you a medication called granulocyte colony-stimulating factors (G-CSF) that helps your body make more WBCs before you start Jevtana (cabazitaxel). Examples of G-CSF include Neupogen (filgrastim) and Neulasta (pegilgrastim).

Your provider will closely monitor your blood counts through lab work while you’re receiving Jevtana (cabazitaxel). Your provider will monitor your blood counts each week during your first cycle and before you start another cycle. If your blood counts are too low, you might have to skip or delay your infusion, or consider a different medication. Let your provider know as soon as possible if you experience fever, chills, or bleeding and bruising that doesn’t stop or go away. This might mean you need to stop receiving Jevtana (cabazitaxel) infusions.

Serious allergic reaction

Risk factors: Polysorbate 80 allergy | Previous allergic reaction to Jevtana (cabazitaxel)

Warning Icon Some people have experienced an allergic reaction within minutes of starting their Jevtana (cabazitaxel) infusion. These reactions typically happened during their first or second infusion. Your provider will give you medications, such as an antihistamine (e.g., diphenhydramine (Benadryl)) or steroid {e.g., dexamethasone), before your infusion to lower your risk for these reactions. If you do experience a reaction, your provider can stop the infusion and give you medications to help alleviate your symptoms. They might also switch you to another medication to treat your cancer. Let your provider know immediately if during your infusion you experience a rash, trouble breathing, or lightheadedness.

Serious stomach problems

Risk factors: Previous radiation around the pelvis | Low WBC count | Older adults | Taking other medications that can damage your gut | Stomach ulcers, bleeding, or scar-like tissue

Jevtana (cabazitaxel) can cause nausea, vomiting, or severe diarrhea, which can sometimes be deadly. Because of this, your provider might give you an anti-nausea medication (e.g., promethazine (Phenergan) or ondansetron (Zofran)) before your Jevtana (cabazitaxel) infusion. They might also give you medications to help the diarrhea or a fluid infusion to re-hydrate you. If serious stomach problems occur, your provider might lower your dose or have you stop taking Jevtana (cabazitaxel).

Jevtana (cabazitaxel) can also put you at risk for serious stomach bleeds. Let your provider know if you experience stomach pain or tenderness, black or tarry stool, or blood in your vomit.

Kidney failure and bladder problems

Risk factors: Radiation around the pelvis | Dehydration | Serious blood infection | Blockage in your urinary system

Taking Jevtana (cabazitaxel) can cause certain kidney and bladder problems, like kidney failure, blood in your urine, or a bladder infection (cystitis). Cystitis occurs more commonly in people who had previously received pelvic radiation. Kidney failure most commonly happens in people with serious blood infections (sepsis), dehydration, or a blockage in their urinary system. Your provider will monitor you for signs of kidney or bladder problems while taking Jevtana (cabazitaxel). Let your provider know if you experience bloody urine, urinate less, or swelling as these can be signs of kidney or bladder problems. If these happen your provider might have you stop taking Jevtana (cabazitaxel).

Lung problems

Rarely, Jevtana (cabazitaxel) can cause serious lung problems. Let your provider know if you develop new or worsening breathing problems, including trouble breathing, chest pain, cough, or fever. Your provider might tell you to stop taking Jevtana (cabazitaxel) while they figure out what’s causing the lung problems.

Harm to unborn baby

Jevtana (cabazitaxel) might cause harm to an unborn baby or raise the risk for miscarriage (pregnancy loss). If your partner is able to become pregnant, you and your partner should use birth control while you’re taking Jevtana (cabazitaxel) and for at least 3 months after your last dose. Your partner should tell their provider right away if they become pregnant during this time.

Jevtana (cabazitaxel) dosage

Typical dosage for Jevtana (cabazitaxel)

Your provider will calculate your dose of Jevtana (cabazitaxel) using your body surface area (BSA, in units of m²), which takes into account your body weight and height.

The typical dose is 20 mg/m² infused through the veins once every 3 weeks. In addition, you’ll also take prednisone 10 mg by mouth once daily throughout [drug] treatment.

Your dose might be different if you have liver problems.

Interactions between Jevtana (cabazitaxel) and other drugs

Jevtana (cabazitaxel) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Jevtana (cabazitaxel). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Measles Virus Vaccine, Live
Mumps Virus Vaccine, Live
Rotavirus Vaccine, Live
Rubella Virus Vaccine, Live
Varicella Virus Vaccine, Live
Zoster Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adenovirus Vaccine
Atazanavir
Bacillus of Calmette and Guerin Vaccine, Live
Boceprevir
Ceritinib
Cholera Vaccine, Live
Clarithromycin
Cobicistat
Conivaptan
Delavirdine
Dengue Tetravalent Vaccine, Live
Idelalisib
Indinavir
Influenza Virus Vaccine, Live
Itraconazole
Ketoconazole
Lopinavir
Nefazodone
Nelfinavir
Poliovirus Vaccine, Live
Posaconazole
Ritonavir
Saquinavir
Smallpox Vaccine
Telaprevir
Telithromycin
Tipranavir
Typhoid Vaccine, Live
Voriconazole
Yellow Fever Vaccine

Jevtana (cabazitaxel) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Jevtana (cabazitaxel) will not be safe for you to take.