Each hospital may do things slightly differently, and treatment will vary depending on your cancer. Speak to your doctor or nurse about your treatment.
There are different chemotherapy drugs used to treat pancreatic cancer. Nab-paclitaxel (Abraxane®) is a chemotherapy drug that is used with another chemotherapy drug called gemcitabine (Gemzar®). This may be a treatment option for people with advanced pancreatic cancer.
Nab-paclitaxel with gemcitabine may be used if you can’t have FOLFIRINOX, or gemcitabine and capecitabine (GemCap). It is an option for people who haven’t had any chemotherapy yet.
Nab-paclitaxel with gemcitabine may cause more side effects than gemcitabine alone, so you need to be well enough to deal with the possible side effects.
There are ways to manage the side effects of chemotherapy.
You will have your chemotherapy at the hospital as an outpatient. This means that you will go into hospital for treatment, but you will not need to stay overnight.
Nab-paclitaxel with gemcitabine is given in a four week cycle . This means that you will have nab-paclitaxel and gemcitabine once a week for three weeks, and then have a break for one week. The break allows your body to recover between treatments.
Diagram showing how gemcitabine and nab-paclitaxel are given
The number of cycles you have will depend on how the treatment is working and how chemotherapy affects you. Your chemotherapy team can tell you more about this.
Nab-paclitaxel and gemcitabine are given as an infusion into a vein. You may hear an infusion called a ‘drip’. You will have the infusion through a cannula.
Nab-paclitaxel and gemcitabine will normally be given on the same day. You will have nab-paclitaxel first, which takes 30 minutes. After this, you will have gemcitabine, which also takes 30 minutes. The cannula will be flushed out between each drug.
Nab-paclitaxel can cause side effects. These can affect everyone differently, and you may not get all the side effects mentioned here. Your chemotherapy team should give you information about any possible side effects and how they are managed. Ask them any questions you have. You can also speak to our specialist nurses on our free Support Line.
Your chemotherapy team should give you a 24 hour emergency number to call if you are unwell or have any signs of infection. Or if you need information about any side effects. Your oncology specialist nurse or chemotherapy nurse will explain when to use this number. If you haven’t been given a number, ask them about this .
Nab-paclitaxel can increase your risk of getting an infection. An infection is an emergency if you are having chemotherapy and needs to be treated straight away. Signs of an infection include:
Call the 24 hour emergency number your chemotherapy team will have given you if you have signs of an infection. You should phone if you have any of these symptoms or feel suddenly unwell, even if your temperature is normal or low.
Read more about infections and how they are treated.
If you have diarrhoea, try to drink as much water as you can manage. Call the 24 hour emergency number if you are finding it hard to drink enough fluids or have diarrhoea more than four times a day. They can give you medicines to control the diarrhoea, or they can lower the dose of nab-paclitaxel until it is better. We have tips on dealing with diarrhoea.
You may also have constipation (when you find it harder to poo). Drink as much water as you can manage and try to eat foods that are high in fibre, such as fruit and vegetables. Speak to your doctor about medicines that can help. Gentle exercise may also help.
Fatigue is a common side effect of nab-paclitaxel. It isn’t the same as feeling tired. Fatigue can make you feel weak and have problems concentrating. Some people find that the fatigue starts a few hours to a few days after having chemotherapy and starts to get better a few days later. See how the chemotherapy affects you and work out how much activity you can manage. There are things that can help with fatigue. Read our tips for coping with fatigue.
Nab-paclitaxel may also make you feel dizzy. Feeling tired and dizzy may affect your ability to drive. You might want to get someone else to drive you until you know if you are affected.
This is a common side effect of nab-paclitaxel but you will be given anti-sickness medicines to stop you feeling or being sick. If these don’t help, call the emergency number. You may be able to change to a different medicine.
We have tips for coping with feeling and being sick.
Nab-paclitaxel may cause hair loss, but it should grow back once your treatment stops. Read more about hair loss and things that can help.
Nab-paclitaxel can affect the nerves in your hands and feet, which can cause tingling and numbness (peripheral neuropathy). This normally gets better after your treatment. It can be worse in the cold, so wrap up warm if you are going outside. It’s important to tell your chemotherapy team about any tingling or numbness, so it does not become a long term problem.
Nab-paclitaxel can lower the number of platelets in your blood. This is called thrombocytopenia. You may bruise more easily than normal, and you may be more likely to have nosebleeds or bleeding gums. If you have a nosebleed that does not stop after five minutes, call the emergency number.
During your treatment you may not feel like eating, and you may start to lose weight. Try eating small meals often. If your appetite doesn’t get better after a few days, tell your doctor or dietitian. We have tips on dealing with appetite loss.
Nab-paclitaxel can make your mouth sore, or cause mouth ulcers which can be painful. Tell your chemotherapy team about any mouth problems you have. They can make sure you don’t have a mouth infection and give you a mouthwash to help. You should also tell them if you have white spots in your mouth. This is a sign of oral thrush, which is normally easy to treat.
Nab-paclitaxel can lower the number of red blood cells in your blood. This is called anaemia, and can make you feel tired, dizzy, or short of breath. If you have these symptoms, call the 24 hour emergency number. If your red blood cell level is very low, you may need to be given a blood transfusion through a drip.
Nab-paclitaxel can cause wheezing, a cough, a high temperature or shortness of breath. If this happens, call the 24 hour emergency number. You may need to have tests to check how your lungs are working.
Some people have swelling in their feet, ankles, legs, fingers or face. This is because of a build-up of fluid, which is called oedema. If you have swelling in your feet, it may help to have your legs up on a cushion when you are sitting down. Your doctor may also be able to give you medicines to help.
Nab-paclitaxel can cause problems with your joints, such as swelling or pain. Your muscles may also feel weak or stiff. You can take painkillers to help. Make sure that you check your temperature before taking any paracetamol or ibuprofen. If the painkillers don’t help or you have a high temperature, call the 24 hour emergency number straight away.
Nab-paclitaxel can increase your risk of a blood clot in a vein, but this is not very common. If you have any pain or swelling in an arm or leg, or you feel very short of breath, call the 24 hour emergency number straight away. Or phone an ambulance and tell them you are having chemotherapy. A blood clot can be serious if it’s not treated .
Nab-paclitaxel can cause heart palpitations or an irregular heartbeat. Palpitations are when you feel your heartbeat more than usual. Call the 24 hour emergency number straight away if you get this. If you have chest pain, go straight to A&E and tell them you are having chemotherapy.
Nab-paclitaxel can cause headaches. Tell your chemotherapy team if you have headaches. Painkillers such as paracetamol or ibuprofen can help. Make sure that you check your temperature before taking paracetamol or ibuprofen. If you have a high temperature, call the 24 hour emergency number straight away.
Nab-paclitaxel can cause sore, itchy or watery eyes. Tell your chemotherapy team if this happens, as they may need to give you some eye drops. Some people get blurred vision when having nab-paclitaxel, but this is not common.
Nab-paclitaxel can cause changes to your nails. You may get ridges or lines across them or they may break more easily. Your chemotherapy team can give you advice on looking after your nails. Your nails will usually go back to normal once they grow after treatment ends.
Speak to your doctor or nurse if you feel anything unusual, or if you would like more information.
You can also speak to our specialist nurses on our Support Line for information on nab-paclitaxel or side effects.
You can download our fact sheet: Nab-paclitaxel (Abraxane®) for pancreatic cancer.
Updated May 2024
Review date October 2026