Oxaliplatin Accord Healthcare (Oxaliplatin)

Oxaliplatin is a platinum‑based chemotherapy drug that interferes with DNA replication in several cancer types.

• Colorectal cancer: improves the efficacy of combination regimens and helps achieve tumour shrinkage.
• Gastric cancer: used as part of multimodal treatment protocols.
• Pancreatic cancer: contributes to disease control when combined with other agents.
• Ovarian cancer: employed in platinum‑sensitive treatment strategies.
• Esophageal cancer: added to multidrug regimens to enhance response rates.
• Small‑cell lung cancer: incorporated into combination chemotherapy for better outcomes.

• Oxaliplatin forms reactive platinum‑DNA adducts that cause intra‑ and interstrand cross‑links, disrupting DNA replication and transcription. The resulting DNA damage triggers cell‑cycle arrest and apoptosis, preferentially affecting rapidly dividing tumor cells while sparing most normal tissues.

Oxaliplatin may elicit a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Nausea and vomiting: mild to moderate gastrointestinal upset.
• Peripheral neuropathy: tingling or numbness, often dose‑related.
• Diarrhoea: loose stools that may require supportive care.
• Fatigue: generalized tiredness during treatment cycles.
• Thrombocytopenia: reduced platelet count, increasing bleeding risk.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: anaphylaxis or bronchospasm.
• Acute neurotoxicity: sudden onset of muscle cramps or spasms.
• Hematologic toxicity: neutropenia or anemia requiring intervention.
• Hepatotoxicity: elevated liver enzymes indicating liver stress.
• Cardiotoxicity: rare arrhythmias or chest discomfort.
• Renal impairment: decreased kidney function in susceptible patients.

When using Oxaliplatin, clinicians should assess patient suitability and monitor for adverse events throughout therapy.

• Renal function: evaluate baseline creatinine and adjust dosing if impaired.
• Hepatic function: monitor liver enzymes before and during treatment.
• Neuropathy risk: assess pre‑existing peripheral neuropathy and adjust therapy as needed.
• Hematologic monitoring: perform regular complete blood counts to detect cytopenias.
• Pregnancy and lactation: avoid use unless benefits outweigh risks; discuss with obstetric specialist.
• Store at ambient temperature: keep in original container, protect from moisture and light.

Oxaliplatin may interact with other medicines, altering efficacy or safety. Proper review of concomitant drugs is essential.

Major Interactions (Avoid)

• Nephrotoxic agents (e.g., cisplatin, aminoglycosides): increase risk of kidney injury.
• Anticoagulants (warfarin, DOACs): heightened bleeding risk due to thrombocytopenia.

Moderate Interactions (Monitor Closely)

• Antiemetics (5‑HT3 antagonists): may require dose adjustment of anti‑emetic regimen.
• Immunosuppressants (steroids, azathioprine): potential additive bone‑marrow suppression.
• Radiotherapy: combined neurotoxicity risk, especially with peripheral nerve exposure.
• CYP450 inducers/inhibitors: may modestly affect plasma levels, requiring observation.
• Herbal supplements (e.g., St. John’s wort): possible alteration of drug metabolism.