Oxaliplatin Accord Healthcare (Oxaliplatin)

Oxaliplatin is used primarily for colorectal cancer treatment pathways.

• Colorectal cancer: enhances survival when combined with fluoropyrimidine‑based regimens.
• Gastric cancer: used in combination protocols for advanced disease.
• Pancreatic cancer: contributes to tumour response in multi‑drug regimens.
• Ovarian cancer: employed as part of combination therapy for recurrent disease.

• Oxaliplatin exerts cytotoxic effects by forming platinum‑DNA adducts that disrupt DNA replication and transcription, leading to apoptosis of rapidly dividing cancer cells. The drug’s diaminocyclohexane carrier ligand enhances cellular uptake and tumor selectivity, distinguishing it from older platinum agents.

Oxaliplatin may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Peripheral neuropathy: tingling or numbness, often dose‑related.
• Nausea and vomiting: may require anti‑emetic prophylaxis.
• Diarrhoea: can be self‑limiting or require supportive care.
• Fatigue: generalised tiredness common during treatment cycles.
• Thrombocytopenia: reduced platelet count, monitored with blood tests.
• Elevated liver enzymes: transient rise in transaminases.

Serious or Rare Side Effects

• Severe peripheral neuropathy: may become irreversible.
• Acute allergic reactions: including rash, bronchospasm, or anaphylaxis.
• Hematologic toxicity: profound neutropenia or anemia.
• Cardiac events: rare cases of arrhythmia or myocardial ischaemia.
• Renal impairment: acute kidney injury in susceptible patients.
• Severe gastrointestinal toxicity: including colitis or intestinal perforation.

When using Oxaliplatin, clinicians should observe several safety measures.

• Renal function: assess baseline creatinine and adjust if impaired.
• Hepatic function: monitor liver enzymes before each cycle.
• Neuropathy risk: evaluate pre‑existing neuropathy and adjust dosing.
• Hematologic monitoring: perform regular CBC to detect cytopenias.
• Pregnancy and lactation: avoid use unless benefits outweigh risks.
• Storage: Store below 25°C: keep in the original container, protect from moisture and light.

Oxaliplatin can interact with several concomitant medications, requiring careful management.

Major Interactions (Avoid)

• Nephrotoxic agents: concurrent use may exacerbate renal toxicity.
• Anticoagulants: increased risk of bleeding due to thrombocytopenia.
• Live vaccines: immunosuppression may reduce vaccine efficacy.

Moderate Interactions (Monitor Closely)

• Anti‑emetics: certain serotonin‑receptor antagonists may affect drug clearance.
• CYP450 inducers: may alter plasma levels of supportive care drugs.
• High‑dose folinic acid: can modify toxicity profile.