Oxaliplatin

Generic Name : Oxaliplatin

TradeName : DACPLAT, Eloxatin

Overview :
• Oxaliplatin is a platinum-based drug used in the treatment of cancer.
• Its exact method of functioning remains unclear.
• The active form of this cytotoxic drug inhibits DNA replication, leading to cell death and impaired tumor growth.
• It is available as 50 mg or 100 mg of sterile, preservative-free lyophilized powder for reconstitution.
• When dissolved it appears as a colorless fluid

Why it is prescribed (Indications) :
• It is used in combination with infusional 5- Fluorouracil/ Leucovorin to treat patients who have undergone surgery for colo-rectal cancer.
• It is used for treatment of advanced carcinoma of the colon or rectum.
• Oxaliplatin is also used to treat late-stage ovarian cancer

When it is not to be taken (Contraindications) :
• Oxalitoxin is not given to patients who have a known history of hypersensitivity to Oxaliplatin.
• Not recommended for breast- feeding mothers.
• Not suitable for patients who have myelosuppression, evidenced by a baseline neutrophile value of less than 2x109/l and platelet count of less than 100x109/l.
• Not given to patients who have peripheral sensitive neuropathy (a disease of the nervous system that affects legs and feet), with associated functional impairment.
• Not recommended for patients with severely impaired renal function.

How it should be taken :
• On day 1
- Oxaliplatin is given as 85mg/m2 infusion in 250-500ml 5% Dextrose in Water solution
- This is given along with Leucovorin 200mg/m2 infusion in 5% Dextrose in Water for over 120 minutes simultaneously.
- This is followed by 400mg/m2 of 5- Fluorouracil given over 2-4 minutes.
- Later, 600mg/m2 of 5- Fluorouracil in 500ml 5% Dextrose in Water (recommended) is given as a 22 hour infusion.
• On day 2,
- Leucovorin is given as a 200mg/m2 infusion in 5% Dextrose in Water for over 120 minutes.
- This is followed by 400mg/m2 of 5- Fluorouracil, given over 2-4 minutes.
- Following this, 600mg/m2 of 5- Fluorouracil in 500ml 5% Dextrose in Water (recommended)is given as a 22 hour infusion.
• This 2 day cycle is repeated for every 2 weeks for a total of 6 months i.e. 12 cycles.

Special Instruction :
• Patients taking drugs like cyclosporine or non- Steroidal Anti-Inflammatory Drugs (NSAID) e.g. ibuprofen, along with Oxaliplatin are at a higher risk of developing kidney problems.
• Amino glycosides, like Vancomycin, or NSAIDs taken with Oxaliplatin causes side –effects, like hearing loss.

Side Effects :
• Thrombosis
• Bruising/Bleeding
• Anemia
• Constipation
• Dizziness
• Hair loss
• Headache
• Neuropathy
• Heartburn
• Hearing Loss
• Nausea or Vomiting
• Redness or swelling at the injection site
• Lower resistance to infection

Other Precautions :
• Patients should be monitored for symptoms associated with neuropathy such as loss of sensation, tingling feeling, etc, as Oxaliplatin is said to cause peripheral neuropathy. These symptoms are exacerbated when patients are exposed to extreme hot or cold temperatures. Therefore patients are advised to protect themselves from extreme temperatures.
• Caution should be exercised when Oxaliplatin is advised for nursing mothers.

Storage Conditions :
• After the initial reconstitution of the lyophilized Oxaliplatin powder with water, the solution may be stored for 24 hours at 2-8°C.
• After the final dilution with 250-500 ml of 5% Dextrose, the shelf life is 6 hours at room temperature or 24 hours at 2-8°C.
• Oxaliplatin is not light- sensitive.