Drug reference

Oxaliplatin

Platinum · Antineoplastic

PlatinumAntineoplastic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

Avoid - toxicity in animal studies

FDA category + note

Top interactionssee all 12 →

Live VaccinesContraindicatedDatabase
AdalimumabSevereDatabaseDDInter
AmiodaroneSevereDatabaseDDInter
AmisulprideSevereDatabaseDDInter

Mechanism

Oxaliplatin is a third-generation platinum compound carrying a 1,2-diaminocyclohexane (DACH) carrier ligand. Like cisplatin, it forms platinum-DNA adducts causing intrastrand cross-links, but the bulky DACH ligand produces adducts that are not recognized by the mismatch repair (MMR) system — making oxaliplatin effective against cisplatin-resistant tumors with MMR deficiency, particularly colorectal cancer. Its dose-limiting toxicity is a cumulative peripheral sensory neuropathy rather than the nephrotoxicity and ototoxicity seen with cisplatin.

Indications

Recurrent or metastatic squamous cell cancer of the head and neck (in combination with platinum-based chemotherapy)colorectal cancer (in combination with 5FU)gastric cancerColorectal cancerGastroesophageal cancersPancreatic cancers

Dosing

Adult: with paclitaxel for the treatment of adult patients with platinum-resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who received no more than two prior chemotherapy regimens and who have not received prior therapy with bevacizumab or other vascular endothelial growth factor (VEGF) inhibitors or VEGF receptor-targeted agents.…

Pharmacokinetics

Onset

not specified

Peak effect

not specified

Bioavailability

—

Protein binding

not specified

Metabolism

not specified

Excretion

—

Contraindications

Pregnancy
Breastfeeding

Side effects

Common

peripheral neuropathy (dose-limiting toxicity)acute peripheral neuropathy (triggered by exposure to cold liquids, manifests as paresthesias or dysesthesias in extremities, mouth, and throat)cumulative dose-related peripheral neuropathy (similar to cisplatin, with dysesthesias, ataxia, and numbness of the extremities)mild to moderate hematological toxicitynausea (well controlled with serotonin [5HT3] receptor antagonists)DiarrhoeaAcute allergic reactionsPeripheral neuropathy (sensory paresthesias)Acute neuropathy triggered by cold

Serious

Pulmonary hypertension
Renal thrombotic microangiopathy
Necrotising fasciitis (usually secondary to wound healing complications, gastro-intestinal perforation or fistula formation)
Congestive heart failure
Posterior reversible encephalopathy syndrome (presenting as seizures, headache, altered mental status, visual disturbance or cortical blindness, with or without hypertension)
Osteonecrosis of the jaw
leukemia (months to years after administration)
pulmonary fibrosis (months to years after administration)
acute allergic response (urticaria, hypotension, bronchoconstriction)
Myelosuppression

Pregnancy & lactation

Pregnancy

Avoid - toxicity in animal studies

Lactation

Manufacturer advises avoid breastfeeding during and for at least 6 months after treatment

Drug interactions

Live Vaccines

Contraindicated

Database

Risk of severe, disseminated, or fatal infection from the live vaccine.

Live vaccines are contraindicated during oxaliplatin treatment and for at least 3-6 months after cessation of therapy, depending on the degree and duration of immunosuppression. Inactivated vaccines may be considered, but the immune response may be attenuated.

Adalimumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Amiodarone

Severe

Database

Drug interaction classified as: synergy.

Source: DDInter

Amisulpride

Severe