Dose-dependent myelosuppression, particularly neutropenia, may occur with mono- or combination therapy. Neutropenic fever and infection have been reported. The risk for neutropenia is increased with hepatic dysfunction, especially when used in combination with capecitabine. Due to the ethanol content in the diluent, may cause cognitive impairment. Diluent contains Cremophor^®^ EL, which is associated with hypersensitivity reactions (medications for the treatment of reaction should be available for immediate use; must premedicate all patients with an H~1~ antagonist and an H~2~ antagonist before treatment). Peripheral (sensory and motor) neuropathy occurs commonly; may require dose reductions, treatment delays or discontinuation. Use with caution in patients with pre-existing neuropathy. The incidence of MI, ventricular dysfunction and supraventricular arrhythmias is higher when ixabepilone is used in combination with capecitabine (as compared to capecitabine alone)(consider discontinuing ixabepilone in patients who develop cardiac ischemia or impaired cardiac function). Patients with diabetes may have an increased risk for severe peripheral neuropathy. Increased risk of toxicity and neutropenia-related mortality, combination therapy with capecitabine is contraindicated in patients with AST or ALT >2.5 times ULN or bilirubin >1 times ULN. Use (as monotherapy) is not recommended if AST or ALT >10 times ULN or bilirubin >3 times ULN; use caution in patients with AST or ALT >5 times ULN; data is limited. In mono- and combination therapy, toxicities and serious adverse reactions are increased with hepatic dysfunction; dosage reductions are necessary.