Oxaliplatine (Oxaliplatin)

Oxaliplatin is a platinum‑based chemotherapy that acts on the DNA replication pathway of cancer cells.

• Colorectal cancer: improves survival and reduces tumour burden in metastatic and adjuvant settings.
• Gastric cancer: used in combination regimens to enhance response rates.
• Pancreatic cancer: contributes to disease control when combined with other agents.
• Ovarian cancer: part of multi‑drug protocols for advanced disease.
• Small‑cell lung cancer: employed in salvage therapy protocols.
• Esophageal cancer: added to chemoradiation regimens for locally advanced disease.

• Oxaliplatin forms reactive platinum complexes that covalently bind to DNA, creating intra‑ and interstrand cross‑links that inhibit DNA synthesis and trigger apoptosis in rapidly dividing tumor cells. The drug’s diaminocyclohexane carrier ligand enhances its cytotoxic activity and tumor selectivity.

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 changes in hepatic function tests.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: anaphylaxis‑like symptoms requiring immediate medical attention.
• Acute pulmonary toxicity: breathlessness or infiltrates on imaging.
• Hemolytic‑uremic syndrome: rare renal and hematologic complication.
• Severe neutropenia: marked drop in neutrophils leading to infection risk.
• Cardiotoxicity: arrhythmias or myocardial injury in susceptible patients.
• Secondary malignancies: potential long‑term risk of therapy‑related cancers.

When handling Oxaliplatin, clinicians should observe specific safety measures and patient monitoring guidelines.

• Renal function: assess creatinine clearance before and during therapy.
• Hepatic function: monitor liver enzymes and bilirubin regularly.
• Neuropathy risk: evaluate baseline sensory function and adjust dose if neuropathy develops.
• Hematologic monitoring: perform complete blood counts prior to each cycle.
• Pregnancy and lactation: avoid use; discuss risks with reproductive‑health specialists.
• Storage: Store at ambient temperature: keep in original container, protect from light and moisture.

Oxaliplatin can interact with several drug classes, affecting efficacy or toxicity.

Major Interactions (Avoid)

• Nephrotoxic agents (e.g., cisplatin, aminoglycosides): increase risk of renal injury.
• Anticoagulants (warfarin, direct oral anticoagulants): heighten bleeding potential.
• Live vaccines: immunosuppression may reduce vaccine effectiveness.

Moderate Interactions (Monitor Closely)

• CYP450 inducers (rifampicin, carbamazepine): may alter plasma levels of concomitant drugs.
• Antiemetics (5‑HT3 antagonists): adjust dosing to manage nausea.
• NSAIDs: monitor for additive platelet dysfunction.