Oxaliplatin

DEA Class; Rx

Common Brand Names; Eloxatin

  • Antineoplastics, Alkylating; 
  • Antineoplastics, Platinum Analog

Non cell-cycle specific, platinum-based alkylating agent
Used for the treatment of colorectal cancer, in combination with fluorouracil and leucovorin
Acute or delayed neuropathy can occur; avoid the topical application of ice, as cold temperatures may exacerbate acute neuropathy

Indicated in combination with infused 5-fluorouracil/leucovorin for adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor and also for treatment of advanced colorectal cancer

Hypersensitivity to oxaliplatin, other platinum compounds

Pregnancy

  • Peripheral neuropathy (76%)
  • Anemia (64%)
  • Nausea (64%)
  • Fatigue (61%)
  • Diarrhea (46%)
  • Vomiting (37%)
  • Abdominal pain (31%)
  • Constipation (31%)
  • Thrombocytopenia (30%)
  • Fever (25%)
  • Anorexia (20%)
  • Leukopenia (13%)
  • Dyspnea (13%)
  • Cough (11%)

Caution in renal impairment, elderly, neuropathy, neurotoxic agents

For 3-4 days, avoid contact with ice/cold food/objects, avoid breathing cold air

Avoid contact with aluminum needles or equipment

Avoid pregnancy

Pulmonary fibrosis may occur

Concomitant use with fluorouracil may increase gastrointestinal effects

Grade 3 or 4 neutropenia reported in patients with colorectal cancer treated in combination with 5-flurouracil (5-FU) and leucovorin; delay oxaliplatin therapy until neutrophils are at 1.5 x 10^9/L; withhold oxaliplatin for sepsis or septic shock; reduce dose after recovery from Grade 4 neutropenia or febrile neutropenia

Cardiovascular toxicity reported; ECG monitoring recommended if therapy initiated in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities; correct hypokalemia or hypomagnesemia prior to initiating oxaliplatin and monitor these electrolytes periodically during therapy; avoid oxaliplatin in patients with congenital long QT syndrome

Reversible posterior leukoencephalopathy syndrome (RPLS, also known as PRES, Posterior Reversible Encephalopathy Syndrome) reported in clinical trials and postmarketing experience

Based on direct interaction with DNA, therapy can cause fetal harm when administered to a pregnant woman; available human data do not establish presence or absence of major birth defects or miscarriage related to use of drug; advise a pregnant woman of potential hazard to fetus

There are no data on presence of drug or its metabolites in human or animal milk, effects on breastfed infant or on milk production

The suggested maximum tolerated dose (MTD) for oxaliplatin is dependent on performance status, other chemotherapy agents or radiation given in combination, and disease state. The dosing of oxaliplatin may vary from protocol to protocol. If questions arise, clinicians should consult the appropriate references to verify the dose.

Adults

130 mg/m2 IV.

Elderly

130 mg/m2 IV.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Oxaliplatin 

powder for injectable solution

  • 50mg/vial
  • 100mg/vial
  • 200mg/vial

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