AC-T
Adriamycin, Cyclophosphamide, followed by Taxol (Paclitaxel)
AC-T (dose-dense) is a common breast cancer regimen. Four cycles of AC are given every 2 weeks, followed by four cycles of Taxol every 2 weeks.
14 days
Cycle length
8 cycles
Typical course
6
Side effects tracked
Common Side Effects
Nausea and vomiting (AC phase)
days 1–5 of AC cycles
Tip: AC is one of the most nausea-inducing regimens. Take all prescribed anti-nausea medications proactively, even if you feel okay.
Hair loss
weeks 2–3 of first cycle
Tip: Complete hair loss is expected with AC-T. Cold cap therapy may be an option — discuss with your team before starting.
Fatigue
cumulative throughout all 8 cycles
Tip: Plan for significant fatigue, especially in the Taxol phase. Gentle walking can help.
Neuropathy (Taxol phase)
cumulative with Taxol cycles
Tip: Report worsening tingling or numbness immediately. Taxol neuropathy can sometimes be permanent if not caught early.
Neutropenia
days 7–12 each cycle
Tip: Neulasta/G-CSF injection the day after each infusion is standard. Fever is always an emergency.
Joint and muscle aches (Taxol)
days 3–5 of Taxol cycles
Tip: Aching in bones and muscles (often called "bone pain") is common after Taxol/Neulasta. Claritin (loratadine) started the day before infusion can help.
Critical Days in the Cycle
Day 1 — Infusion Day
Watch for
- •Reaction to Taxol (flushing, chest tightness, back pain)
When to call:
Any reaction during Taxol infusion — tell staff immediately, it is manageable if caught early.
Day 3 — Bone Pain (Taxol cycles)
Watch for
- •Joint aches
- •Bone pain from Neulasta
When to call:
Severe unmanageable pain — call for guidance on pain management.
Day 8 — Nadir
Watch for
- •Fever
- •Infection signs
When to call:
Fever ≥100.4°F — go to the ER immediately, do not wait for a callback. Neutropenic fever emergency.
Frequently Asked Questions
What's the difference between the AC and Taxol phases?
AC (Adriamycin + Cyclophosphamide) causes more nausea and hair loss. The Taxol phase causes more neuropathy, muscle aches, and fatigue but less nausea. Most patients find the AC phase harder at the time, but the Taxol phase's fatigue is cumulative.
Why does Claritin help with bone pain after Taxol?
Loratadine (Claritin) appears to reduce the bone pain caused by Neulasta (G-CSF), which stimulates bone marrow to produce white blood cells. Taking Claritin starting the day before infusion and continuing for 5–7 days can significantly reduce this side effect.
When should I call the oncology team?
For fever ≥100.4°F during nadir — go to the ER immediately, do not wait for a callback. Call the team for: severe vomiting (can't keep fluids down), Taxol infusion reaction, severe neuropathy (new numbness affecting walking), or severe bone pain not controlled with prescribed medications.
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