Oxaliplatin Accord Healthcare Ireland (Oxaliplatin)

Oxaliplatin is a platinum‑based agent used in the treatment of cancers that involve the gastrointestinal tract and related metastatic disease.

• Colorectal cancer: improves survival when combined with fluorouracil and leucovorin in adjuvant and metastatic settings.
• Gastric cancer: used as part of combination regimens for advanced disease.
• Pancreatic cancer: contributes to response rates when added to multi‑drug protocols.
• Ovarian cancer: employed in selected regimens for recurrent disease.
• Esophageal cancer: used in combination chemotherapy for locally advanced tumours.
• Small‑cell lung cancer: occasionally incorporated into experimental combination protocols.

• Oxaliplatin forms reactive platinum‑DNA adducts that disrupt DNA replication and transcription, leading to cell‑cycle arrest and apoptosis. The drug preferentially forms intra‑strand cross‑links, interfering with the repair mechanisms of rapidly dividing tumor cells while sparing most normal tissues.

Oxaliplatin may cause 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: watery stools that may require supportive care.
• Fatigue: generalized tiredness affecting daily activities.
• Thrombocytopenia: reduced platelet count increasing bleed risk.
• Elevated liver enzymes: transient rise in ALT/AST.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: anaphylaxis or bronchospasm.
• Persistent neurotoxicity: long‑lasting sensory deficits.
• Myelosuppression: profound neutropenia or anemia.
• Acute pulmonary toxicity: interstitial pneumonitis.
• Renal impairment: acute kidney injury in susceptible patients.
• Cardiotoxicity: rare arrhythmias or myocardial injury.

When handling Oxaliplatin, clinicians should consider several safety and monitoring measures.

• Renal function: assess baseline creatinine and adjust if impaired.
• Hepatic function: monitor liver enzymes before each cycle.
• Neuropathy risk: evaluate baseline peripheral sensation and adjust dose if neuropathy develops.
• Hematologic status: check complete blood count prior to infusion.
• Pregnancy and lactation: avoid use unless benefits outweigh potential fetal risks.
• Storage: Store below 25°C: keep in the original container, protect from light and moisture.

Oxaliplatin may interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Nephrotoxic agents: concurrent use with high‑dose cisplatin or aminoglycosides may worsen kidney injury.
• Anticoagulants: increased bleeding risk when combined with warfarin or direct oral anticoagulants.

Moderate Interactions (Monitor Closely)

• Antiemetics: serotonin‑receptor antagonists may enhance serotonin syndrome risk.
• CYP450 inducers: drugs such as rifampicin could alter oxidative metabolism of supportive agents.
• Immunosuppressants: heightened infection risk when combined with high‑dose steroids.
• Radiotherapy: concurrent treatment may amplify neuro‑toxic effects.
• Herbal supplements: St John’s wort may affect plasma levels of concomitant supportive drugs.