Oxaliplatine Fresenius Kabi (Oxaliplatin)

Oxaliplatin is used in chemotherapy regimens targeting gastrointestinal tumor types.

• Colorectal cancer: combined with fluoropyrimidines to inhibit tumor growth and improve survival in metastatic and adjuvant settings.
• Gastric cancer: incorporated into multi‑drug protocols to enhance response rates in advanced disease.
• Pancreatic cancer: used off‑label within combination regimens to augment cytotoxic activity in selected patients.

• Oxaliplatin exerts its antineoplastic effect by forming covalent platinum‑DNA adducts that create intra‑ and interstrand cross‑links, disrupting DNA replication and transcription. The resulting DNA damage triggers cell‑cycle arrest and apoptosis, particularly in rapidly dividing tumor cells. Its diaminocyclohexane carrier ligand enhances cytotoxicity and contributes to a distinct spectrum of activity compared with other platinum compounds.

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

Common Side Effects

• Nausea and vomiting: gastrointestinal upset occurring during or after infusion.
• Peripheral neuropathy: tingling or numbness in hands and feet, often dose‑related.
• Fatigue: generalized tiredness affecting daily activities.
• Myelosuppression: reduced white blood cells, platelets, or red cells.
• Diarrhea: loose stools that may require supportive care.

Serious or Rare Side Effects

• Severe neutropenia with fever: risk of infection requiring urgent medical attention.
• Pulmonary toxicity: acute or chronic lung injury presenting with dyspnea.
• Anaphylactic reactions: sudden hypersensitivity that can be life‑threatening.
• Hepatic dysfunction: elevated liver enzymes or bilirubin indicating liver injury.
• Persistent neuropathy: long‑lasting sensory deficits that may be irreversible.

When using Oxaliplatin, clinicians should observe several precautionary measures to minimize risks.

• Renal function: assess baseline creatinine and monitor during therapy to avoid accumulation.
• Hepatic function: evaluate liver enzymes before each cycle, adjusting dose if impairment is present.
• Pre‑existing neuropathy: avoid or reduce dose in patients with significant peripheral nerve disorders.
• Pregnancy and lactation: contraindicated; avoid use in pregnant or breastfeeding women.
• Concomitant ototoxic drugs: limit use of aminoglycosides or loop diuretics to reduce hearing loss risk.
• Store at ambient temperature: keep in original container, protect from light and moisture, do not freeze.

Oxaliplatin can interact with other medicines, influencing efficacy or toxicity.

Major Interactions (Avoid)

• Nephrotoxic agents (e.g., cisplatin, aminoglycosides): increase risk of kidney injury.
• Ototoxic drugs (e.g., high‑dose furosemide): amplify hearing loss potential.
• High‑dose radiation therapy: may exacerbate tissue toxicity when combined.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin, DOACs): heightened bleeding risk due to thrombocytopenia.
• Myelosuppressive chemotherapy (e.g., 5‑FU, irinotecan): additive bone‑marrow suppression.
• CYP450 modulators (e.g., rifampin, carbamazepine): may alter plasma levels of co‑administered drugs.