Adult Dosing
Colon carcinoma, stage III
- Dosing may vary; consult current institutional protocol
- 85 mg/m2 IV infusion q2 wks x 6 months
- Info: In combination with leucovorin and 5-FU; premedicate with antiemetics incl. 5HT3 antagonists with or without dexamethasone; for pts who have undergone complete tumor resection
Colorectal CA, advanced
- Dosing may vary; consult current institutional protocol
- 85 mg/m2 IV infusion q2 wks
- Info: In combination with leucovorin and 5-FU; premedicate with antiemetics incl. 5HT3 antagonists with or without dexamethasone
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Grade 3/4 hypersensitivity, including anaphylactic/anaphylactoid reactions may occur in 2-3% of colon cancer patients. These fatal allergic reactions such as rash, urticaria, erythema, pruritus, and, rarely, bronchospasm and hypotension may occur within minutes of administration and at any cycle, and are similar in nature and severity to those reported with other platinum-containing compounds. Urticaria, pruritus, flushing of the face, diarrhea associated with oxaliplatin infusion, shortness of breath, bronchospasm, diaphoresis, chest pains, hypotension, disorientation and syncope may occur in association with hypersensitivity reactions. Manage these reactions with standard epinephrine, corticosteroid, antihistamine therapy, and may require withdrawal of treatment. Drug-related deaths from anaphylaxis may occur
- An acute, reversible, primarily peripheral, sensory neuropathy of early onset may occur within hrs or 1-2 of dosing; these events may resolve within 14 days, and may frequently reoccur with further dosing. Precipitation or exacerbation of symptoms may occur on exposure to cold temperature or cold objects and they are usually present as transient paresthesia, dysesthesia and hypoesthesia in the hands, feet, perioral area, or throat. Jaw spasm, abnormal tongue sensation, dysarthria, eye pain, and a feeling of chest pressure may also occur. Acute neurotoxicity, acute syndrome of pharyngolaryngeal dysesthesia may also occur. Avoid ice (mucositis prophylaxis) during the infusion of this drug. A persistent (>14 days) primarily peripheral, sensory neuropathy may also include deficits in proprioception which may interfere with daily activities
- Pulmonary toxicity may occur which may be fatal. Discontinue therapy on development of unexplained respiratory symptoms such as non-productive cough, dyspnea, crackles, or radiological pulmonary infiltrates until further pulmonary investigation excludes interstitial lung disease or pulmonary fibrosis
- Hepatotoxicity may occur. Consider hepatic vascular disorders and if appropriate investigate in case of abnormal LFTs results or portal hypertension, which may not be explained by liver metastases
- Fetal harm may occur on administration to a pregnant woman. Advise Women of child bearing potential to avoid becoming pregnant while receiving treatment with this drug
- Monitor WBC count with differential, hemoglobin, platelet count, and blood chemistries (including ALT, AST, bilirubin and creatinine) before each cycle. Prolong prothrombin time and INR occasionally associated with hemorrhage may occur in patients who received oxaliplatin plus 5-fluorouracil/leucovorin while on anticoagulants. Closer monitoring is essential in patients receiving oxaliplatin plus 5-fluorouracil/leucovorin and requiring oral anticoagulants
- Monitor WBC with differential, Hgb, platelet count, and blood chemistries (ALT, AST, bilirubin, and creatinine) before each cycle
Cautions: Use cautiously in
- Renal impairment
- Pre-existing neuropathy
- Concurrent use of neurotoxic drugs
- Geriatric patients
Supplemental Patient Information
- Instruct patients to report bleeding from any site, fever, sore throat, signs of local infection, or symptoms suggestive of anemia promptly
Pregnancy Category:D
Breastfeeding: It is not known whether oxaliplatin or its metabolites are excreted in breastmilk. Due to the potential for possible serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
