Care During Chemotherapy and Beyond
Trade Name: Eloxatin
Oxaliplatin is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.
Oxaliplatin is classified as an "alkylating agent." For more detail, see "How
Oxaliplatin Works" section below.
What Oxaliplatin Is Used For:
- Oxaliplatin is used to treat colon or rectal cancer that has spread (metastasized),
it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).
Note: If a drug has been approved for one use, physicians sometimes elect
to use this same drug for other problems if they believe it might be helpful.
How Oxaliplatin Is Given:
- It is given by infusion into the vein (intravenous, IV).
- There is no pill form of Oxaliplatin.
- The amount of Oxaliplatin you will receive depends on many factors, including your
height and weight, your general health or other health problems, and the type of
cancer you have. Your doctor will determine your dosage and schedule.
Important things to remember about Oxaliplatin side effects:
- Most people do not experience all of the Oxaliplatin side effects listed.
- Oxaliplatin side effects are often predictable in terms of their onset and duration.
- Oxaliplatin side effects are almost always reversible and will go away after treatment
- There are many options to help minimize or prevent Oxaliplatin side effects.
- There is no relationship between the presence or severity of Oxaliplatin side effects
and the effectiveness of Oxaliplatin.
Oxaliplatin Infusion Related Side Effects:
- The feeling of difficulty swallowing, shortness of breath, jaw spasm, abnormal tongue sensation and
feeling of chest pressure. This has been reported rarely (<5%). It
generally starts within hours of Oxaliplatin infusion and often occurs upon exposure
to cold. Avoiding exposure to cold (see self-care tips below) helps to prevent
this adverse reaction. Future Oxaliplatin infusions may be given over a longer
time frame to help reduce the incidence.
The following Oxaliplatin side effects are common (occurring in greater than 30%)
for patients taking Oxaliplatin:
- Peripheral neuropathy
- Numbness and tingling and cramping of the hands or feet often triggered by cold. This
symptom will generally lessen or go away between treatments, however as the number
of treatments increase the numbness and tingling will take longer to lessen or go
away. Your health care professional will monitor this symptom with you and
adjust your dose accordingly.
- Nausea and vomiting
- Mouth sores
- Low blood counts - Your
white and red blood cells and platelets may temporarily decrease. This can
put you at increased risk for infection, anemia and/or bleeding.
- Loss of appetite
The following are less common Oxaliplatin side effects (occurring in 10-29%) for
patients receiving Oxaliplatin:
- Generalized pain
- Temporary increases in blood tests measuring liver function (see liver problems).
- Allergic reaction: a rare side effect, however, call for help immediately if you
suddenly have difficulty breathing, your throat feels like it is closing, or chest
pain. Other signs of allergic reaction include rash, hives, sudden cough,
or swelling of the lips or tongue.
This list includes common and less common side effects for individuals taking Oxaliplatin.
Side effects that are very rare, occurring in less than 10% of patients, are not
listed here. However, you should always inform your health care provider if
you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience
any of the following symptoms:
- Fever of 100.4° F (38° C), chills (possible signs of infection)
- Shortness of breath, chest pain or discomfort, jaw pain, pain or tingling in your
The following symptoms require medical attention, but are not emergency situations.
Contact your health care provider within 24 hours of noticing any of the following:
- Nausea (interferes with ability to eat and unrelieved with prescribed medications)
- Vomiting (vomiting more than 4-5 times in a 24-hour period)
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools or urine
- Diarrhea (4-6 episodes in a 24-hour period)
- Severe abdominal pain
- Mouth sores (painful redness, swelling or ulcers)
- Signs of infection such as redness or swelling, pain on swallowing, coughing up
mucous, or painful urination.
- Severe numbness, pain in your joints or muscles (arthralgias or myalgias).
- Constipation unrelieved by laxative use.
- Extreme fatigue (unable to carry on self-care activities).
- Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst,
dry mouth, dark and decreased amount of urine, or dizziness.
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Oxaliplatin treatment, make sure you tell your doctor about any
other medications you are taking (including over-the-counter, vitamins, or herbal
remedies). Do not take aspirin or products containing aspirin unless your
doctor permits this.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking Oxaliplatin.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Oxaliplatin may be hazardous to
the fetus. Women who are pregnant or become pregnant must be advised of the
potential hazard to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking Oxaliplatin.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking Oxaliplatin.
- While receiving treatment with Oxaliplatin: avoid cold temperatures and cold objects.
- Cover your skin, mouth and nose if you must go outside in cold temperatures.
- Do not drink cold drinks or use ice cubes in drinks.
- Do not put ice or ice packs on your body.
- Other ways to reduce the side effects caused by cold:
- Cover yourself with a blanket while you receive your Oxaliplatin infusion.
- Do not breathe deeply when exposed to cold air.
- Wear warm clothing in cold weather at all times. Cover your mouth and nose
with a scarf, mask or a pull-down cap (ski cap) to warm the air that goes to your
- Do not take things from the freezer or refrigerator without wearing gloves.
- Drink fluids warm or at room temperature.
- Always drink through a straw.
- Do not use ice chips if you have nausea or a sore mouth. Call your health
- Be aware that metals are cold to touch especially in the winter. Wear gloves
to touch cold objects including your house door, car door, or mailbox.
- Do not run the air conditioner on high either in the house or car in hot weather.
- If your body gets cold, warm-up the affected part with warm water.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your
fluid intake, and maintain good nutrition. This will decrease your chances of being
constipated, and prevent dehydration.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed
with 8 ounces of water.
- You may be at risk of infection so try to avoid crowds or people with colds and
those not feeling well, and report fever or any other signs of infection immediately
to your healthcare provider.
- Wash your hands often.
- Use an electric razor and soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated
doses. You should discuss this with your healthcare provider.
- Keep your bowels moving. Your health care provider may prescribe a stool softener
to help prevent constipation that may be caused by Oxaliplatin.
- Acetaminophen or ibuprofen may help relieve discomfort from fever, headache and/or
generalized aches and pains. However, be sure to talk with your doctor before
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- In general, drinking alcoholic beverages should be avoided. You should discuss
this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you
are taking Oxaliplatin, to monitor side effects and check your response to therapy.
Periodic blood work to monitor your complete blood count (CBC) as well as the function
of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Oxaliplatin Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they
work to kill cancer. Although these drugs are divided into groups, there is
some overlap among some of the specific drugs. The following are the types
Oxaliplatin is classified as an alkylating agent. Alkylating agents are most
active in the resting phase of the cell. These drugs are cell-cycle non-specific.
There are several types of alkylating agents.
- Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil,
Melphalan, and Ifosfamide.
- Ethylenimines: Thiotepa and Hexamethylmelamine.
- Alkylsulfonates: Busulfan.
- Hydrazines and Triazines: Altretamine, Procarbazine, Dacarbazine and Temozolomide.
- Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are
unique because, unlike most chemotherapy, they can cross the blood-brain barrier.
They can be useful in treating brain tumors.
- Metal salts: Carboplatin, Cisplatin, and Oxaliplatin.
Note: We strongly encourage you to talk with your health care professional about
your specific medical condition and treatments. The information contained in this
website is meant to be helpful and educational, but is not a substitute for medical
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org