oxaliplatin

ROUTE	ONSET	PEAK	DURATION
IV	unknown	unknown	unknown

Assess for peripheral sensory neuropathy. Acute onset occurs within hr to 1–2 days of dosing, resolves within 14 days, and frequently recurs with further dosing (transient paresthesia, dysesthesia, and hypoesthesia of hands, feet, perioral area, or throat). Symptoms may be precipitated or exacerbated by exposure to cold or cold objects; avoid ice during symptoms. May also cause jaw spasm, abnormal tongue sensation, dysarthria, eye pain, and a feeling of chest pressure. Persistent (>14 days) causes paresthesias, dysethesias, and hypoesthesias, but may also include deficits in proprioception that may interfere with daily activities (walking, writing, swallowing). Persistent neuropathy may occur without prior acute neuropathy and may improve upon discontinuation of oxaliplatin. Adjuvant Therapy:For persistent Grade 2 neurosensory events that do not resolve, reduce dose of oxaliplatin to 75 mg/m². For patients with persistent Grade 3 neurosensory events, consider discontinuing therapy. Do not alter infusional 5-fluorouracil/leucovorin regimen. For Grade 4 neuropathy, discontinue oxaliplatin. Advanced Colorectal Cancer: For persistent Grade 2 neurosensory events that do not resolve, reduce dose to 65 mg/m². For patients with persistent Grade 3 neurosensory events, consider discontinuing therapy. Do not alter infusional 5-fluorouracil/leucovorin regimen. For Grade 4 neuropathy, discontinue oxaliplatin.
Assess for signs of pulmonary fibrosis (nonproductive cough, dyspnea, crackles, radiological; infiltrates). May be fatal. Discontinue oxaliplatin if pulmonary fibrosis occurs.
Monitor for signs of anaphylaxis (rash, hives, swelling of lips or tongue, sudden cough). Epinephrine, corticosteroids, and antihistamines should be readily available.
Monitor for signs and symptoms of reversible posterior leukoencephalopathy syndrome (headache, altered mental functioning, seizures, abnormal vision from blurriness to blindness, associated or not with hypertension).
Monitor ECG in patients with HF, bradyarrhythmias, and electrolyte abnormalities and in patients taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics.
Monitor for signs and symptoms of GI adverse reactions (nausea, vomiting, diarrhea) during therapy. If Grade 3 or 4 GI adverse reactions occur, after recovery, reduce oxaliplatin dose to 75 mg/m² along with dose reduction of fluorouracil to 300 mg/m² as an IV bolus and 500 mg/m² as a 22-hr continuous infusion.

Lab Test Considerations:

Verify negative pregnancy test before starting therapy.Monitor WBC with differential, hemoglobin, platelet count, and blood chemistries (ALT, AST, bilirubin, and serum creatinine) at baseline and before each oxaliplatin cycle. Adjuvant Therapy:For Grade 4 neutropenia or febrile neutropenia, or Grade 3 or 4 thrombocytopenia, hold next dose until neutrophils ≥1.5 × 10⁹/L and platelets ≥75 × 10⁹/L. Reduce dose of oxaliplatin to 75 mg/m² and infusional 5-fluorouracil to 300 mg/m² bolus and 500 mg/m² 22-hr infusion. Advanced Colorectal Cancer:After recovery from grade 3/4 gastrointestinal (despite prophylactic treatment), or grade 4 neutropenia, or febrile neutropenia, or grade 3/4 thrombocytopenia: reduce dose of oxaliplatin to 65 mg/m² and 5-fluorouracil by 20% (300 mg/m² bolus and 500 mg/m² 22-hr infusion). Delay next dose until neutrophils ≥1.5 × 10⁹/L and platelets ≥75 × 10⁹/L.Monitor and correct electrolytes before starting therapy and periodically during therapy.

Implementation ⬆ ⬇

Monitor IV site frequently. Extravasation may result in local pain and inflammation that may be severe and lead to necrosis. If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do not flush the line); remove needle/cannula; elevate extremity. Anti-inflammatory medication, such as high-dose oral dexamethasone, may reduce severity of the inflammatory reaction.
- Correct hypokalemia and hypermagnesemia before starting therapy.
- Premedicate patient with antiemetics with or without dexamethasone. Prehydration is not required.

IV Administration:

Reconstitution: Use only sterile water for injection or D5W to reconstitute powder.Concentration: To obtain final concentration of 5 mg/mL add 10 mL of diluent to 50-mg vial or 20 mL diluent to 100-mg vial. Gently swirl vial to dissolve powder. Diluent: Dilution with D5W (250 or 500 mL) is required prior to administration. Discard unused portion of vial. Solutions diluted in D5W are stable up to 6 hrs at room temperature or up to 24 hr under refrigeration. Solutions diluted for infusion do not require protection from light.
Intermittent Infusion: Protect concentrated solution from light; do not freeze. Diluent: Must be further diluted with 250–500 mL of D5W. Do not use 0.9% NaCl or any other chloride-containing solution for final solution. Do not use aluminum needles or administration sets containing aluminum parts; aluminum may cause degradation of platinum compounds. May be stored in refrigerator for 24 hr or 6 hr at room temperature. Diluted solution is not light-sensitive. Do not administer solutions that are discolored or contain particulate matter.Concentration: 0.2–0.6 mg/mL.
Rate: Administer oxaliplatin simultaneously with leucovorin in separate bags via Y-line over 120 min. Prolonging infusion time to 6 hr may decrease acute toxicities. Infusion times for fluorouracil and leucovorin do not need to change.

Patient/Family Teaching ⬆ ⬇

Explain purpose of oxaliplatin to patient. Advise patient to read Patient Information before starting therapy and periodically during therapy in case of changes.
Inform patients and caregivers of potential for peripheral neuropathy and potentiation by exposure to cold or cold objects. Advise patient to avoid cold drinks, use of ice in drinks or as ice packs, and to cover exposed skin prior to exposure to cold temperature or cold objects. Caution patients to cover themselves with a blanket during infusion, do not breathe deeply when exposed to cold air, wear warm clothing, and cover mouth and nose with a scarf or pull-down ski cap to warm the air that goes to their lungs, 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 for nausea, be aware that most metals (car doors, mailbox) are cold; wear gloves to touch, do not run air conditioning at high levels in house or car, if hands get cold wash them with warm water. Advise health care professional of how you did since last treatment before next infusion.
Instruct patient to notify health care professional immediately if signs of reversible posterior leukoencephalopathy syndrome, low blood cell counts (fever, persistent diarrhea, infection) or if persistent vomiting, signs of dehydration, cough or breathing difficulty, thirst, dry mouth, dizziness, decreased urination, signs of infection (fever, temperature of ≥100.5° F, cough that brings up mucus, chills or shivering, burning or pain on urination, pain on swallowing, sore throat, redness or swelling at intravenous site) or signs of allergic reactions occur.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during therapy and for at least 9 mo after final dose and to avoid breastfeeding during and for 3 mo after final dose. Advise males with female partners of reproductive potential to use effective contraception for 6 mo after final dose. May impair female and male fertility.

Evaluation/Desired Outcomes ⬆ ⬇

Decrease in size and spread of malignancies.

US Brand Names ⬆ ⬇

Code ⬆

NDC Code

0703- Teva Parenteral Medicines, Inc.
- 0703-3985- Oxaliplatin
  - 0703-3985-01- 1 VIAL, SINGLE-USE in 1 CARTON (0703-3985-01) > 10 mL in 1 VIAL, SINGLE-USE

0703- Teva Parenteral Medicines, Inc.
- 0703-3986- Oxaliplatin
  - 0703-3986-01- 1 VIAL, SINGLE-USE in 1 CARTON (0703-3986-01) > 20 mL in 1 VIAL, SINGLE-USE

0781- Sandoz Inc
- 0781-3315- Oxaliplatin
  - 0781-3315-70- 1 VIAL, SINGLE-USE in 1 CARTON (0781-3315-70) > 10 mL in 1 VIAL, SINGLE-USE

0781- Sandoz Inc
- 0781-3317- Oxaliplatin
  - 0781-3317-80- 1 VIAL, SINGLE-USE in 1 CARTON (0781-3317-80) > 20 mL in 1 VIAL, SINGLE-USE

0781- Sandoz Inc
- 0781-9315- Oxaliplatin
  - 0781-9315-70- 1 VIAL, SINGLE-USE in 1 CARTON (0781-9315-70) > 10 mL in 1 VIAL, SINGLE-USE

0781- Sandoz Inc
- 0781-9317- Oxaliplatin
  - 0781-9317-80- 1 VIAL, SINGLE-USE in 1 CARTON (0781-9317-80) > 20 mL in 1 VIAL, SINGLE-USE

0955- Winthrop U.S.
- 0955-1725- OXALIPLATIN
  - 0955-1725-10- 1 VIAL, GLASS in 1 CARTON (0955-1725-10) > 10 mL in 1 VIAL, GLASS

0955- Winthrop U.S.
- 0955-1727- OXALIPLATIN
  - 0955-1727-20- 1 VIAL, GLASS in 1 CARTON (0955-1727-20) > 20 mL in 1 VIAL, GLASS

0955- Winthrop U.S.
- 0955-1731- OXALIPLATIN
  - 0955-1731-10- 1 VIAL, GLASS in 1 CARTON (0955-1731-10) > 10 mL in 1 VIAL, GLASS

0955- Winthrop U.S.
- 0955-1733- OXALIPLATIN
  - 0955-1733-20- 1 VIAL, GLASS in 1 CARTON (0955-1733-20) > 20 mL in 1 VIAL, GLASS

16714- NorthStar RxLLC
- 16714-727- oxaliplatin
  - 16714-727-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (16714-727-01) > 10 mL in 1 VIAL, SINGLE-DOSE

16714- NorthStar RxLLC
- 16714-728- oxaliplatin
  - 16714-728-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (16714-728-01) > 20 mL in 1 VIAL, SINGLE-DOSE

16729- Accord Healthcare Inc.
- 16729-332- OXALIPLATIN
  - 16729-332-03- 1 VIAL, SINGLE-DOSE in 1 CARTON (16729-332-03) > 10 mL in 1 VIAL, SINGLE-DOSE

16729- Accord Healthcare Inc.
- 16729-332- OXALIPLATIN
  - 16729-332-05- 1 VIAL, SINGLE-DOSE in 1 CARTON (16729-332-05) > 20 mL in 1 VIAL, SINGLE-DOSE

25021- Sagent Pharmaceuticals
- 25021-233- oxaliplatin
  - 25021-233-10- 1 VIAL in 1 CARTON (25021-233-10) > 10 mL in 1 VIAL

25021- Sagent Pharmaceuticals
- 25021-233- oxaliplatin
  - 25021-233-20- 1 VIAL in 1 CARTON (25021-233-20) > 20 mL in 1 VIAL

43066- Baxter Healthcare Corporation
- 43066-014- Oxaliplatin
  - 43066-014-01- 1 VIAL, SINGLE-USE in 1 CARTON (43066-014-01) > 10 mL in 1 VIAL, SINGLE-USE

43066- Baxter Healthcare Corporation
- 43066-018- Oxaliplatin
  - 43066-018-01- 1 VIAL, SINGLE-USE in 1 CARTON (43066-018-01) > 20 mL in 1 VIAL, SINGLE-USE

45963- Actavis Pharma, Inc.
- 45963-611- Oxaliplatin
  - 45963-611-53- 1 VIAL, SINGLE-DOSE in 1 CARTON (45963-611-53) > 10 mL in 1 VIAL, SINGLE-DOSE

45963- Actavis Pharma, Inc.
- 45963-611- Oxaliplatin
  - 45963-611-59- 1 VIAL, SINGLE-DOSE in 1 CARTON (45963-611-59) > 20 mL in 1 VIAL, SINGLE-DOSE

45963- Actavis Pharma, Inc.
- 45963-637- Oxaliplatin
  - 45963-637-49- 1 VIAL, SINGLE-USE in 1 CARTON (45963-637-49) > 10 mL in 1 VIAL, SINGLE-USE

45963- Actavis Pharma, Inc.
- 45963-638- Oxaliplatin
  - 45963-638-58- 1 VIAL, SINGLE-USE in 1 CARTON (45963-638-58) > 20 mL in 1 VIAL, SINGLE-USE

47335- Sun Pharmaceutical Industries, Inc.
- 47335-046- Oxaliplatin
  - 47335-046-40- 1 VIAL, SINGLE-USE in 1 CARTON (47335-046-40) > 10 mL in 1 VIAL, SINGLE-USE

47335- Sun Pharmaceutical Industries, Inc.
- 47335-047- Oxaliplatin
  - 47335-047-40- 1 VIAL, SINGLE-USE in 1 CARTON (47335-047-40) > 20 mL in 1 VIAL, SINGLE-USE

47335- Sun Pharmaceutical Industries, Inc.
- 47335-176- Oxaliplatin
  - 47335-176-40- 1 VIAL, SINGLE-USE in 1 CARTON (47335-176-40) > 10 mL in 1 VIAL, SINGLE-USE

47335- Sun Pharmaceutical Industries, Inc.
- 47335-178- Oxaliplatin
  - 47335-178-40- 1 VIAL, SINGLE-USE in 1 CARTON (47335-178-40) > 20 mL in 1 VIAL, SINGLE-USE

50742- Ingenus Pharmaceuticals, LLC
- 50742-405- Oxaliplatin
  - 50742-405-10- 1 VIAL, SINGLE-USE in 1 CARTON (50742-405-10) > 10 mL in 1 VIAL, SINGLE-USE

50742- Ingenus Pharmaceuticals, LLC
- 50742-406- Oxaliplatin
  - 50742-406-20- 1 VIAL, SINGLE-USE in 1 CARTON (50742-406-20) > 20 mL in 1 VIAL, SINGLE-USE

51991- Breckenridge Pharmaceutical, Inc.
- 51991-218- Oxaliplatin
  - 51991-218-98- 1 VIAL, SINGLE-DOSE in 1 CARTON (51991-218-98) > 10 mL in 1 VIAL, SINGLE-DOSE

51991- Breckenridge Pharmaceutical, Inc.
- 51991-219- Oxaliplatin
  - 51991-219-98- 1 VIAL, SINGLE-DOSE in 1 CARTON (51991-219-98) > 20 mL in 1 VIAL, SINGLE-DOSE

55150- AuroMedics Pharma LLC
- 55150-331- Oxaliplatin
  - 55150-331-01- 1 VIAL in 1 CARTON (55150-331-01) > 10 mL in 1 VIAL

55150- AuroMedics Pharma LLC
- 55150-332- Oxaliplatin
  - 55150-332-01- 1 VIAL in 1 CARTON (55150-332-01) > 20 mL in 1 VIAL

60505- Apotex Corp.
- 60505-6132- oxaliplatin
  - 60505-6132-6- 1 VIAL in 1 CARTON (60505-6132-6) > 10 mL in 1 VIAL

60505- Apotex Corp.
- 60505-6132- oxaliplatin
  - 60505-6132-7- 1 VIAL in 1 CARTON (60505-6132-7) > 20 mL in 1 VIAL

61703- Hospira, Inc.
- 61703-363- Oxaliplatin
  - 61703-363-18- 1 VIAL, SINGLE-USE in 1 CARTON (61703-363-18) > 10 mL in 1 VIAL, SINGLE-USE

61703- Hospira, Inc.
- 61703-363- Oxaliplatin
  - 61703-363-22- 1 VIAL, SINGLE-USE in 1 CARTON (61703-363-22) > 20 mL in 1 VIAL, SINGLE-USE

63323- Fresenius Kabi USA, LLC
- 63323-750- Oxaliplatin
  - 63323-750-10- 1 VIAL in 1 BOX (63323-750-10) > 10 mL in 1 VIAL

63323- Fresenius Kabi USA, LLC
- 63323-750- Oxaliplatin
  - 63323-750-20- 1 VIAL in 1 BOX (63323-750-20) > 20 mL in 1 VIAL

67184- Qilu Pharmaceutical Co., Ltd.
- 67184-0508- Oxaliplatin
  - 67184-0508-1- 1 VIAL, SINGLE-USE in 1 CARTON (67184-0508-1) > 10 mL in 1 VIAL, SINGLE-USE

67184- Qilu Pharmaceutical Co., Ltd.
- 67184-0509- Oxaliplatin
  - 67184-0509-1- 1 VIAL, SINGLE-USE in 1 CARTON (67184-0509-1) > 20 mL in 1 VIAL, SINGLE-USE

67184- Qilu Pharmaceutical Co., Ltd.
- 67184-0510- Oxaliplatin
  - 67184-0510-1- 1 VIAL, SINGLE-USE in 1 CARTON (67184-0510-1) > 40 mL in 1 VIAL, SINGLE-USE

67457- Mylan Institutional LLC
- 67457-442- Oxaliplatin
  - 67457-442-20- 1 VIAL in 1 CARTON (67457-442-20) > 20 mL in 1 VIAL

67457- Mylan Institutional LLC
- 67457-469- Oxaliplatin
  - 67457-469-10- 1 VIAL in 1 CARTON (67457-469-10) > 10 mL in 1 VIAL

68001- BluePoint Laboratories
- 68001-341- oxaliplatin
  - 68001-341-36- 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-341-36) > 10 mL in 1 VIAL, SINGLE-DOSE (68001-341-28)

68001- BluePoint Laboratories
- 68001-341- oxaliplatin
  - 68001-341-37- 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-341-37) > 20 mL in 1 VIAL, SINGLE-DOSE (68001-341-29)

68083- Gland Pharma Limited
- 68083-170- Oxaliplatin
  - 68083-170-01- 10 mL in 1 VIAL (68083-170-01)

68083- Gland Pharma Limited
- 68083-171- Oxaliplatin
  - 68083-171-01- 20 mL in 1 VIAL (68083-171-01)

68083- Gland Pharma Limited
- 68083-176- Oxaliplatin
  - 68083-176-01- 1 VIAL, SINGLE-USE in 1 CARTON (68083-176-01) > 10 mL in 1 VIAL, SINGLE-USE

68083- Gland Pharma Limited
- 68083-177- Oxaliplatin
  - 68083-177-01- 1 VIAL, SINGLE-USE in 1 CARTON (68083-177-01) > 20 mL in 1 VIAL, SINGLE-USE

68083- Gland Pharma Limited
- 68083-314- Oxaliplatin
  - 68083-314-01- 1 VIAL, SINGLE-USE in 1 CARTON (68083-314-01) > 40 mL in 1 VIAL, SINGLE-USE

69097- Cipla USA Inc.
- 69097-274- oxaliplatin
  - 69097-274-37- 1 VIAL, SINGLE-DOSE in 1 CARTON (69097-274-37) > 10 mL in 1 VIAL, SINGLE-DOSE

69097- Cipla USA Inc.
- 69097-353- oxaliplatin
  - 69097-353-78- 1 VIAL, SINGLE-DOSE in 1 CARTON (69097-353-78) > 20 mL in 1 VIAL, SINGLE-DOSE

70860- Athenex Pharmaceutical Division, LLC.
- 70860-201- Oxaliplatin
  - 70860-201-10- 1 VIAL in 1 CARTON (70860-201-10) > 10 mL in 1 VIAL

70860- Athenex Pharmaceutical Division, LLC.
- 70860-201- Oxaliplatin
  - 70860-201-20- 1 VIAL in 1 CARTON (70860-201-20) > 20 mL in 1 VIAL

71288- Meitheal Pharmaceuticals Inc.
- 71288-101- Oxaliplatin
  - 71288-101-10- 1 VIAL, SINGLE-DOSE in 1 CARTON (71288-101-10) > 10 mL in 1 VIAL, SINGLE-DOSE

71288- Meitheal Pharmaceuticals Inc.
- 71288-101- Oxaliplatin
  - 71288-101-20- 1 VIAL, SINGLE-DOSE in 1 CARTON (71288-101-20) > 20 mL in 1 VIAL, SINGLE-DOSE

72266- Fosun Pharma USA Inc.
- 72266-125- Oxaliplatin
  - 72266-125-10- 10 CARTON in 1 BOX (72266-125-10) > 1 VIAL, SINGLE-USE in 1 CARTON (72266-125-01) > 10 mL in 1 VIAL, SINGLE-USE

72266- Fosun Pharma USA Inc.
- 72266-126- Oxaliplatin
  - 72266-126-10- 10 CARTON in 1 BOX (72266-126-10) > 1 VIAL, SINGLE-USE in 1 CARTON (72266-126-01) > 20 mL in 1 VIAL, SINGLE-USE

72603- NorthStar Rx LLC
- 72603-101- Oxaliplatin
  - 72603-101-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (72603-101-01) > 20 mL in 1 VIAL, SINGLE-DOSE

72603- NorthStar Rx LLC
- 72603-301- Oxaliplatin
  - 72603-301-01- 1 VIAL, SINGLE-DOSE in 1 CARTON (72603-301-01) > 10 mL in 1 VIAL, SINGLE-DOSE

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Code ⬆