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Common side effects include:

• nausea and vomiting
• loss of appetite
• change in taste
• thinned or brittle hair
• pain in the joints of the arms or legs lasting two to three days
• changes in the color of the nails 
• tingling in the hands or toes. 

More serious side effects such can include:

• unusual bruising or bleedingpain/redness/swelling at the injection site
• change in normal bowel habits for more than two days
• fever, chills, cough, sore throat
• difficulty swallowing
• dizziness
• shortness of breath
• severe exhaustion
• skin rash
• facial flushing
• female infertility by ovarian damage
• chest pain

Several of these side effects are associated with the excipient (the liquid used to carry the drug) used, Cremophor EL, a polyoxyethylated castor oil.

Allergies to drugs such as cyclosporine, teniposide and drugs containing polyoxyethylated castor oil may indicate increased risk of adverse reactions to paclitaxel. Dexamethasone is given prior to beginning paclitaxel treatment to mitigate some of the side effects. 

Leuprolide, a gonadotropin-releasing hormone analog may prevent ovarian damage, according to studies carried out in mice.

There are many effective strategies for the treatment of cancer for drugs derived from natural products. Nature and evolution have provided us with excellent strategies for cancer from compounds that have developed naturally. Sixty per cent of drugs approved for cancer treatment have a natural origin. Drugs such as taxol, irinotecan and trebetacan and many others have found their way into mainstream treatment for cancer. Just because these drugs are derived from natural compounds does not mean that they are not less toxic. Some of them do have significant side effects, which is a feature that renders them potent for cancer treatment.

Taxol is a plant derived drug used in chemotherapy across a wide range of cancers including: breast, ovarian, lung, bladder, prostrate. Side effects include: hair loss, diarrhea, low blood count, peripheral neuropathy, and nausea and mouth ulcers.  

Irinotecan is an example of a plant derived compound, which is a chemotherapy drug mainly treating cancer of the colon and rectum. Side effect include: diarrhea and extreme suppression of the immune system.

Trabectedin is a relatively new drug, which has not yet been widely approved, for the treatment of advanced sarcomas in patients who have failed on conventional therapy