Peripheral sensory neuropathy (acute and cumulative):
Dose-limiting toxicity.
Acute neuropathy is cold-induced and may occur during or shortly after infusion (laryngopharyngeal dysaesthesia, dysphagia, dyspnoea sensation).
Chronic cumulative neuropathy may be persistent or irreversible.
Delay or discontinue if persistent Grade ≥2 neuropathy.
Myelosuppression:
Neutropenia, thrombocytopenia, and anaemia are common.
Risk of febrile neutropenia and sepsis.
Monitor CBC before each cycle and delay treatment if counts are low.
Hypersensitivity reactions:
May occur during any cycle, including severe anaphylaxis.
Stop infusion immediately if rash, bronchospasm, hypotension, or angio-oedema occurs.
QT prolongation and cardiac events:
QT interval prolongation, arrhythmias, myocardial infarction reported.
Increased risk with electrolyte imbalance or QT-prolonging drugs.
ECG monitoring recommended in high-risk patients.
Pulmonary toxicity:
Interstitial lung disease and pulmonary fibrosis reported (rare but potentially fatal).
Stop treatment if unexplained respiratory symptoms develop.
Haemolytic-uraemic syndrome (HUS):
Rare but life-threatening (acute renal failure, thrombocytopenia, haemolytic anaemia).
Discontinue permanently if suspected.
Pregnancy and fertility:
Contraindicated in pregnancy and breastfeeding.
May cause irreversible infertility, particularly in men.
Effective contraception required during treatment and for ≥4 months (women) and ≥6 months (men) after therapy.
Generic name: Oxaliplatin
Brand name: OXALIPLATIN PCH®
Drug class: Platinum-based antineoplastic (alkylating-like agent)
Formulation: Concentrate for solution for intravenous infusion
Strengths: 50 mg / 100 mg (5 mg/mL)
Mechanism of Action:
Oxaliplatin forms platinum-DNA crosslinks, inhibiting DNA replication and transcription, leading to apoptosis. It is non-cross-resistant with cisplatin and carboplatin and demonstrates synergistic activity with fluoropyrimidines.
Colorectal Cancer:
Adjuvant treatment of Stage III (Dukes’ C) colon cancer following complete surgical resection, in combination with 5-fluorouracil (5-FU) and folinic acid.
First-line treatment of metastatic colorectal cancer, in combination with 5-FU and folinic acid (e.g. FOLFOX regimen).
Treatment of advanced colorectal cancer, including cancer of the colon and rectum, in combination chemotherapy regimens.
Recommended adult dose:
85 mg/m² IV infusion every 2 weeks
Administration details:
IV infusion over 2–6 hours
Administer with folinic acid, followed by 5-fluorouracil
Avoid cold exposure during and after infusion
Duration of treatment:
Adjuvant setting: Maximum 6 months
Metastatic disease: Continue until disease progression or unacceptable toxicity
Renal impairment:
Contraindicated in severe renal impairment
Use cautiously with dose adjustment in moderate impairment
Neuropathy:
Persistent Grade 2 → dose reduction
Grade 3 or persistent symptoms → discontinue
Haematologic toxicity:
Delay treatment if neutrophils <1.5 ×10⁹/L or platelets <75–100 ×10⁹/L
Severe diarrhoea, mucositis, infection:
Delay or reduce dose based on severity
Use with caution or avoid:
QT-prolonging drugs (e.g. amiodarone, sotalol, quinidine)
Statins, SSRIs, lithium, antipsychotics (↑ risk of rhabdomyolysis)
Anticoagulants — increased bleeding risk
Live vaccines — contraindicated
Other myelosuppressive agents — additive toxicity
Hypersensitivity to oxaliplatin or other platinum compounds
Severe renal impairment
Pre-existing peripheral neuropathy with functional impairment
Severe bone marrow suppression
Pregnancy and breastfeeding
Baseline and before each cycle:
CBC with differential
Renal and hepatic function tests
Neurological examination
Electrolytes (especially potassium, magnesium)
ECG in patients with cardiac risk factors
| Frequency | Adverse Effect | Management |
|---|---|---|
| Very common (>10%) | Peripheral neuropathy, neutropenia, nausea, vomiting, diarrhoea, fatigue | Dose modification, antiemetics, supportive care |
| Common (1–10%) | Thrombocytopenia, mucositis, abdominal pain, hypertension | Monitoring, symptomatic treatment |
| Serious (<5%) | Anaphylaxis, QT prolongation, interstitial lung disease, sepsis | Immediate discontinuation, urgent management |
| Long-term | Persistent neuropathy, infertility, secondary malignancies | Monitoring, counselling |
Elderly: Similar efficacy; increased toxicity risk — monitor closely
Renal impairment: Contraindicated if severe
Hepatic impairment: Use with caution
Pregnancy/Lactation: Contraindicated
Paediatrics: Not indicated
Continue until:
Completion of planned adjuvant therapy, or
Disease progression in metastatic setting, or
Unacceptable toxicity
Stop immediately if:
Severe or persistent neuropathy
Anaphylaxis
Haemolytic-uraemic syndrome
Interstitial lung disease or severe cardiac events
https://pi-pil-repository.sahpra.org.za/wp-content/uploads/2023/03/pil-oxaliplatin.pdf
| Trade Name | |
|---|---|
| Drug Class | Platinum-containing Antineoplastic Agents |
| Cost | |
| Company | |
|---|---|
| Drug Rep | Admin |
| Indications | Colon Cancer |
| Dosage |