Oxaliplatino Kabi (Oxaliplatin)

Oxaliplatin is a platinum‑based chemotherapeutic that interferes with DNA replication in malignant cells.

• Colorectal cancer: used in combination regimens to shrink tumours and prolong survival.
• Gastric cancer: part of multi‑drug protocols to improve response rates.
• Pancreatic cancer: incorporated into neoadjuvant or adjuvant therapy to reduce recurrence risk.

• Oxaliplatin forms reactive platinum complexes that covalently bind to DNA bases, creating intra‑ and interstrand cross‑links that block DNA synthesis and trigger apoptosis in rapidly dividing cancer cells. The drug’s activity is independent of the p53 pathway and is enhanced by cellular uptake via copper transporters.

Oxaliplatin may cause a range of adverse reactions, from mild to life‑threatening.

Common Side Effects

• Nausea and vomiting: often mild to moderate and manageable with anti‑emetics.
• Peripheral neuropathy: tingling or numbness, typically dose‑related and reversible after treatment cessation.
• Diarrhoea: may require supportive care and hydration.
• Fatigue: generalised tiredness experienced during therapy cycles.
• Thrombocytopenia: reduced platelet count, increasing bleeding risk.
• Neutropenia: lowered neutrophil levels, raising infection susceptibility.

Serious or Rare Side Effects

• Severe hypersensitivity reactions: anaphylaxis or bronchospasm requiring immediate medical intervention.
• Acute pulmonary toxicity: rare lung inflammation presenting with dyspnoea.
• Cardiac arrhythmias: uncommon but potentially serious rhythm disturbances.
• Hemolytic‑uremic syndrome: extremely rare microangiopathic complication.
• Renal failure: acute kidney injury in predisposed patients.
• Secondary malignancies: long‑term risk of therapy‑related leukaemia.

Oxaliplatin requires careful monitoring and patient education before and during therapy.

• Renal function: assess creatinine clearance before each cycle and adjust if impaired.
• Hepatic function: evaluate liver enzymes, especially in patients with metastasis.
• Neuropathy risk: monitor for sensory changes; dose modify if severe.
• Pregnancy and lactation: avoid use; discuss contraception and breastfeeding cessation.
• Drug interactions: review concomitant medications for potential additive toxicities.
• Storage: Store below 25°C: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Aminoglycoside antibiotics: may increase risk of ototoxicity and nephrotoxicity.
• High‑dose vitamin C infusions: can reduce platinum‑drug activity by chelation.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): heightened bleeding risk due to thrombocytopenia.
• NSAIDs: may exacerbate renal impairment.
• Anticonvulsants (e.g., carbamazepine): potential for altered drug clearance.
• Radiotherapy: concurrent use may amplify neuro‑toxicity.
• Herbal supplements (e.g., St. John’s wort): possible induction of metabolic pathways affecting drug levels.