Trade/other name(s): Eloxatin
Why would this drug be used?
Oxaliplatin is used together with 5-fluorouracil and leucovorin to treat colorectal cancer.
How does this drug work?
Oxaliplatin is a platinum-compound chemotherapy drug that acts as an alkylating agent. It stops the growth of cancer cells, which causes the cells to die.
Before taking this medicine
Tell your doctor…
- If you are allergic to anything, including medicines, dyes, additives, or foods.
- If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
- If you have taken oxaliplatin or other platinum-containing medicines before. Your doctor will want to watch you more closely for certain side effects.
- If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine.
- If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could affect the baby.
- If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
- About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.
Interactions with other drugs
If taken with other medicines that can harm the kidneys, like aminoglycosides (a type of antibiotic that is usually given in the vein, such as gentamicin, tobramycin, amikacin, streptomycin, and others), there is a higher risk of kidney damage with this drug.
Any drugs or supplements that interfere with blood clotting can raise the risk of bleeding during treatment with oxaliplatin. These include:
- vitamin E
- non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and many others
- warfarin (Coumadin)
- ticlopidine (Ticlid)
- clopidogrel (Plavix)
Note that many cold, flu, fever, and headache remedies contain aspirin or ibuprofen. Ask your pharmacist if you aren't sure what's in the medicines you take.
Interactions with foods
No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.
Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.
How is this drug taken or given?
Oxaliplatin is given as an injection in a vein over a period of 2 hours. It is often given at the same time as a vitamin-like drug called leucovorin. It is usually followed by an injection of 5-fluorouracil, then a continuous infusion of 5-fluorouracil over 22 hours. This is repeated the next day without the oxaliplatin. It is important not to eat ice chips or drink anything cold before, during, or for 5 days after getting the oxaliplatin. The dose depends on how much you weigh, your blood counts, and the side effects of the medicine.
This drug can cause severe allergic reactions in some people while the drug is being given. Symptoms can include feeling faint or dizzy (due to low blood pressure), rash, hives, itching, headache, coughing, trouble breathing, trouble swallowing, sudden cough, flushed face, sweating, chest pain, or swelling of the face, tongue, eyes, or throat. Tell your doctor or nurse right away if you notice any of these symptoms.
Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs such as the liver. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it completely. Keep all your appointments for lab tests and doctor visits.
This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.
This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
This drug may lower your red blood cell count. If this occurs, it is usually a few months after starting treatment. A low red blood cell count (known as anemia) can cause shortness of breath, or make you to feel weak or tired all the time. Your doctor may give you medicines to help prevent or treat this condition, or you may need to get blood transfusions.
You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor. If vomiting continues, call your doctor or nurse.
Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.
This drug may change the sensation in your mouth, tongue, throat, eyes, hands or feet, causing pain, numbness, tingling, or burning. The problem usually goes away within 2 weeks of treatment but is made worse by cold. Avoid being exposed to cold for 5 days after each dose of oxaliplatin. Drink warm liquids; no ice, cold drinks, frozen desserts, or ice packs. Use gloves if you need to touch anything cold or reach into the freezer. If it is cold outside, dress warmly and cover exposed skin, don't touch metal objects with bare hands, and have your car heated before getting in. Avoid ice or ice packs. If it's warm out, don’t set air conditioners at very low temperatures.
This drug may damage certain nerves in the body, and lead to a problem called peripheral neuropathy. This can cause numbness, weakness, pain, burning, or tingling, (usually in the hands or feet), and sometimes constipation. These symptoms can sometimes worsen to include trouble walking or holding things in your hands. Let your doctor know right away if you notice this. If your symptoms are severe enough, this drug may need to be stopped or the dose reduced. In some people, nerve damage is permanent.
This drug can cause a condition known as hand-foot syndrome, in which a person may have pain, numbness, tingling, reddening, or swelling in the hands or feet. Peeling, blistering, or sores on the skin in these areas are also possible. Let your doctor know right away if you notice any of these symptoms.
Tell your doctor or nurse if you have trouble doing everyday things like buttoning your clothes, writing, swallowing, walking, or talking.
Rarely, people develop lung problems which can get worse. Call your doctor if you notice cough or trouble breathing. Your doctor may need to stop your treatment.
Very rarely, people can get a brain condition called reversible posterior leukoencephalopathy (RPLS). Tell your doctor right away if you notice headache, confusion or changes in thinking, seizure, blurred vision, or loss of vision.
Avoid pregnancy during and for at least a few months after treatment, since exposure to the drug can harm the fetus. Talk with your doctor about this.
Possible side effects
Should you have any of the following side effects, talk to your doctor or nurse. They can help you understand these side effects and help you deal with them.
- numbness and tingling in hands and/or feet due to nerve irritation*
- numbness of lips
- abdominal pain
- mouth sores
- tiredness (fatigue)
- increase in lab results suggesting changes in liver function (Your doctor will discuss the significance of this finding with you, if any.)
- trouble walking*
- low white blood cell count with increased risk of infection*
- low platelet count with increased risk of bleeding*
- trouble swallowing or breathing*
- poor tolerance to cold temperatures*
- loss of appetite
- dehydration (too much water loss, causing thirst, low urine output, dry mouth)
- allergic reaction with rash, itching, flushed face, swelling lips or tongue, or sudden cough*
- abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any.)
- scarring or fibrosis of the lungs*
- vision problems, including blindness, which go away after treatment
- kidney damage (may be permanent)
- reduced liver function or liver damage
- death due to allergic reaction, lung damage, bleeding in the brain, or other cause
*See "Precautions" section for more detailed information.
There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.
Yes – first approved in 2002
Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.
Last Revised: 09/26/2012