Drug reference
Treatment of metastatic colorectal cancer (in combination with fluorouracil and folinic acid) | Treatment of colon Immune system and malignant disease cancer after resection of the primary tumour (adjuvant treatment) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)
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Peripheral neuropathy with functional impairment
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NICE decisions ▶Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes’ C) colon cancer (April 2006) NICE TA100 Capecitabine alone or oxaliplatin combined with fluorouracil and folinic acid are options for adjuvant treatment following surgery for stage III (Dukes’ C) colon cancer. www.nice.org.uk/TA100 ▶Irinotecan, oxaliplatin, and raltitrexed for advanced colorectal cancer (August 2005) NICE TA93 A combination of fluorouracil and folinic acid with either Immune system and malignant disease irinotecan or oxaliplatin are options for first-line treatment for advanced colorectal cancer. Irinotecan alone or fluorouracil and folinic acid with oxaliplatin are options for patients who require further treatment subsequently. www.nice.org.uk/TA93
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→Appendix 1: platinum compounds
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▶Common or very common Alopecia. anaemia. appetite decreased. arthralgia. asthenia. chills. conjunctivitis. constipation. cough. decreased leucocytes. dehydration. depression. diarrhoea. dizziness. dyspnoea. electrolyte imbalance. embolism and thrombosis. fever. flushing. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. headache. hiccups. hyperglycaemia. hyperhidrosis. hypersensitivity. hypertension. increased risk of infection. insomnia. meningism. mucositis. nail disorder. nausea. necrosis. nerve disorders. neutropenia. neutropenic sepsis. pain. peripheral neuropathy (dose- limiting). sensation abnormal. skin reactions. stomatitis. taste altered. thrombocytopenia. urinary disorders. vision disorders. vomiting. weight changes ▶Uncommon Metabolic acidosis. nervousness. ototoxicity ▶Rare or very rare Acute kidney injury. acute tubular necrosis. antibiotic associated colitis. deafness. disseminated intravascular coagulation. dysarthria. haemolytic anaemia. hepatic disorders. immuno-allergic thrombocytopenia. nephritis acute interstitial. nodular regenerative hyperplasia. pancreatitis. posterior reversible encephalopathy syndrome (PRES) (with oxaliplatin combination chemotherapy). respiratory disorders. sinusoidal obstruction syndrome. vision loss (reversible on discontinuation) ▶Frequency not known Autoimmune pancytopenia. chest discomfort. dysphagia. extravasation necrosis. gait abnormal. hypersensitivity vasculitis. movement disorders. muscle complaints. muscle contractions involuntary. QT interval prolongation. rhabdomyolysis. throat complaints SIDE-EFFECTS, FURTHER INFORMATION Neurotoxicity is dose limiting. Respiratory symptoms If unexplained respiratory symptoms occur, oxaliplatin should be discontinued until investigations exclude interstitial lung disease and pulmonary fibrosis.
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Effective contraception required during and for 4 months after treatment in women and 6 months after treatment in men.
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Manufacturer advises avoid—toxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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Avoid if creatinine clearance less than 30 mL/minute. Dose adjustments Reduce dose in mild to moderate impairment (consult product literature).
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ▶Oxaliplatin (Non-proprietary) Oxaliplatin 5 mg per 1 ml Oxaliplatin 50mg/10ml concentrate for solution for infusion vials | 1 vial P £146.80–£163.78 (Hospital only) | 1 vial P £155.00 Oxaliplatin 100mg/20ml concentrate for solution for infusion vials | 1 vial P £289.50–£327.98 (Hospital only) | 1 vial P £311.00 Oxaliplatin 200mg/40ml concentrate for solution for infusion vials | 1 vial P £591.26–£655.96 (Hospital only) ANTINEOPLASTIC DRUGS › PODOPHYLLOTOXIN DERIVATIVES
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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