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Platinum chemotherapy Pregnancy: Limited safety information in pregnant women; reproductive toxicity was observed in animal studies. Use should only be considered after appraising the patient of the risk to the foetus and with the patient's consent. Breast-feeding is contraindicated during therapy. Because of potential genotoxic effects, contraception is required during treatment and for 15 months after cessation in women of childbearing potential and for 12 months after cessation in men; men should be advised on sperm conservation before treatment.

Oxaliplatin (Specialist drug)

Brand names: Eloxatin

Oxaliplatin is a specialist intravenous platinum-based cytotoxic agent used mainly in the treatment of colorectal cancer, often in combination with fluoropyrimidines.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 85 mg/m2 (adults only)
Route: Intravenous infusion over 2 to 6 hours, diluted in 250 to 500 mL of 5% glucose solution to a concentration of 0.2 to 0.70 mg/mL, via a central venous line or peripheral vein
Frequency: Repeated every 2 weeks
FOR ADULTS ONLY. Adjuvant setting: 85 mg/m2 every 2 weeks for 12 cycles (6 months). Metastatic colorectal cancer: 85 mg/m2 every 2 weeks until disease progression or unacceptable toxicity. The dose given should be adjusted according to tolerability. Oxaliplatin must ALWAYS be administered before fluoropyrimidines, i.e. before 5-fluorouracil. Oxaliplatin was mainly used in combination with continuous-infusion 5-fluorouracil-based regimens; for the two-weekly schedule, regimens combining bolus and continuous infusion 5-fluorouracil were used. 0.70 mg/mL is the highest concentration used in clinical practice for an 85 mg/m2 dose. Only 5% glucose is to be used as diluent (not sodium chloride). Hyperhydration is not required. Discontinue administration immediately in the event of extravasation. No specific dose adaptation is required for elderly patients. No specific dose adjustment for abnormal liver function tests was performed during clinical development. There is no relevant indication for use in children; efficacy of single-agent oxaliplatin in paediatric solid tumours has not been established.

Dose adjustments

Renal

Contraindicated in severe renal impairment (creatinine clearance less than 30 mL/min) and must not be administered. In mild to moderate renal impairment the recommended dose remains 85 mg/m2.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Known history of hypersensitivity to oxaliplatin or to any of the excipients
  • Breast-feeding
  • Myelosuppression prior to starting the first course - baseline neutrophils below 2 x 10^9/L and/or platelet count below 100 x 10^9/L
  • Peripheral sensitive neuropathy with functional impairment prior to the first course
  • Severely impaired renal function (creatinine clearance less than 30 mL/min)

Side effects

  • Peripheral sensory neuropathy (acute and dose-cumulative), sensory disturbance, dysgeusia
  • Diarrhoea, nausea, vomiting and mucositis
  • Neutropenia, thrombocytopenia, anaemia, leukopenia and lymphopenia
  • Allergy/allergic reactions
  • Anorexia and hyperglycaemia
  • Rare: reversible posterior leukoencephalopathy syndrome (RPLS/PRES), neutropenic sepsis, haemolytic anaemia

Interactions

  • Medicinal products with a known potential to prolong the QT interval: avoid coadministration - QT prolongation and ventricular arrhythmias can occur with oxaliplatin (US labelling)
  • Nephrotoxic medicinal products: avoid coadministration - platinum species are eliminated primarily by the kidney and their clearance may be decreased (US labelling)
  • Oral anticoagulants: prolonged prothrombin time and INR, occasionally with haemorrhage, reported with oxaliplatin plus fluorouracil/leucovorin - increase monitoring frequency (US labelling)

Clinical monograph

How it works

It forms platinum-DNA adducts that produce inter- and intra-strand cross-links, inhibiting DNA replication and transcription and triggering apoptosis.

Prescribing in practice

  • It causes a characteristic cumulative sensory peripheral neuropathy and an acute cold-induced neuropathy; patients must avoid exposure to cold during and shortly after infusion to prevent triggering laryngopharyngeal dysaesthesia.
  • Severe hypersensitivity and anaphylactic reactions can occur, so administer with resuscitation facilities available.
  • Myelosuppression and diarrhoea are common, and the risk increases when combined with fluorouracil.

Monitoring

Monitor full blood count, renal and liver function, and assess neurological symptoms before each cycle.

Counselling the patient

  • Avoid cold drinks, cold food and exposure of skin to cold air or water for a few days after each infusion.
  • Report numbness, tingling or difficulty with fine tasks, and any breathing difficulty or rash during infusion.

Evidence & guidelines

Use in colorectal cancer is supported by NICE guidance and pivotal trials of oxaliplatin-fluoropyrimidine combination regimens.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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