Oxaliplatin Pliva (Oxaliplatin)

Oxaliplatin is a platinum‑based chemotherapy agent used in the treatment of cancers that arise from the gastrointestinal tract.

• Colorectal cancer: improves survival when combined with fluorouracil and leucovorin.
• Gastric cancer: used in combination regimens for advanced disease.
• Pancreatic cancer: part of multi‑drug protocols for metastatic disease.

• Oxaliplatin forms reactive platinum‑DNA adducts that cause intra‑strand and cross‑linking of DNA, disrupting replication and transcription. This DNA damage triggers apoptosis in rapidly dividing tumor cells, particularly those of gastrointestinal origin, while sparing most normal tissues.

Oxaliplatin may cause a range of adverse reactions, from mild to severe, that require monitoring during treatment.

Common Side Effects

• Nausea and vomiting: frequent gastrointestinal upset.
• Peripheral neuropathy: tingling or numbness in the hands and feet.
• Diarrhea: loose stools that may require supportive care.
• Fatigue: generalized tiredness during therapy.
• Myelosuppression: reduced blood cell counts.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: rash, bronchospasm, or anaphylaxis.
• Acute neurotoxicity: sudden onset of muscle cramps or difficulty breathing.
• Thrombocytopenia: markedly low platelet counts increasing bleeding risk.
• Neutropenic fever: fever with low neutrophil count indicating infection.
• Renal impairment: decreased kidney function requiring dose adjustment.

When using Oxaliplatin, clinicians must assess patient suitability and monitor for toxicity throughout therapy.

• Renal function: assess baseline creatinine and adjust dose if impaired.
• Hepatic function: monitor liver enzymes and bilirubin before each cycle.
• Pre‑existing neuropathy: evaluate severity; avoid if grade ≥ 2.
• Hematologic status: check complete blood count prior to infusion.
• Concomitant ototoxic drugs: avoid combined use with other agents that affect hearing.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Oxaliplatin can interact with several medicines, altering efficacy or increasing toxicity.

Major Interactions (Avoid)

• Nephrotoxic agents such as cisplatin or aminoglycosides: combined use heightens kidney damage risk.
• High‑dose vitamin C: may reduce platinum‑DNA binding effectiveness.

Moderate Interactions (Monitor Closely)

• Anticoagulants (warfarin, heparin): increased bleeding tendency.
• CYP450 inducers (rifampicin, carbamazepine): may affect plasma levels of co‑administered drugs.
• NSAIDs: can worsen renal impairment when used with Oxaliplatin.
• Immunosuppressants: heightened infection risk when combined with myelosuppression.
• Proton pump inhibitors: may alter gastrointestinal absorption of supportive anti‑emetics.