Oksaliplatin Kalceks (Oxaliplatin)

Oxaliplatin is a platinum‑based chemotherapeutic used in the treatment of gastrointestinal malignancies.

• Colorectal cancer: used in combination regimens (e.g., FOLFOX) to improve progression‑free and overall survival.
• Gastric cancer: incorporated into combination therapy to enhance response rates in advanced disease.
• Pancreatic cancer: employed in selected protocols to increase tumor control and survival outcomes.

• Oxaliplatin forms reactive platinum complexes that bind to DNA, creating intra‑ and interstrand cross‑links which inhibit DNA replication and transcription. The resulting DNA damage triggers cell‑cycle arrest and apoptosis in rapidly dividing tumor cells. Its activity is enhanced by the diaminocyclohexane carrier ligand, which facilitates cellular uptake and contributes to the drug’s cytotoxic profile.

Oxaliplatin is associated with a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Nausea and vomiting
• Peripheral neuropathy (tingling or numbness)
• Fatigue
• Diarrhea
• Neutropenia (low white blood cells)

Serious or Rare Side Effects

• Severe allergic reactions (anaphylaxis)
• Pulmonary toxicity (interstitial pneumonitis)
• Febrile neutropenia (infection with low neutrophils)
• Thrombocytopenia (low platelets)
• Hepatic dysfunction (elevated liver enzymes)
• Tumor lysis syndrome (rare)

When using oxaliplatin, several precautionary measures should be observed to minimize risks.

• Renal function monitoring: assess serum creatinine and creatinine clearance before and during therapy.
• Hepatic function monitoring: check liver enzymes and bilirubin regularly.
• Neuropathy assessment: evaluate for signs of peripheral neuropathy and adjust dose if needed.
• Hypersensitivity risk: be prepared to manage acute infusion reactions with emergency medications.
• Pregnancy and lactation: avoid use in pregnant or breastfeeding women unless benefits outweigh risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Oxaliplatin may interact with other medicines, affecting safety or efficacy.

Major Interactions (Avoid)

• Nephrotoxic agents (e.g., cisplatin, aminoglycosides): increase risk of kidney damage.
• Neurotoxic drugs (e.g., vincristine, paclitaxel): exacerbate peripheral neuropathy.
• Myelosuppressive chemotherapy (e.g., cyclophosphamide): heighten risk of severe bone‑marrow suppression.
• High‑dose folinic acid: may potentiate oxaliplatin toxicity.
• Anticoagulants (e.g., warfarin): increased bleeding risk due to thrombocytopenia.

Moderate Interactions (Monitor Closely)

• NSAIDs (e.g., ibuprofen): may affect renal function.
• ACE inhibitors or ARBs: monitor blood pressure and renal parameters.
• Proton pump inhibitors: possible alteration of drug absorption (though limited for IV).
• Antiepileptic drugs (e.g., carbamazepine): may affect hepatic metabolism.
• Live attenuated vaccines: consider timing due to immunosuppression.