Posted on April 28th, 2009 by
Generic Name: Oxaliplatin (ocks-AL-ih-PLAT-in)
Trade Name: Eloxatin®
How is this drug used? Oxaliplatin, in combination with the drugs fluoruoracil and leucovorin, is FDA approved for the treatment of advanced colon or rectal cancer. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Oxaliplatin belongs to a class of drugs called alkylating agents. Oxaliplatin produces its anti-cancer effects by causing a chemical reaction that damages the DNA in a cell. The DNA damage caused by oxaliplatin results in cellular death.
How is oxaliplatin given (administered)? Oxaliplatin is administered into a vein (intravenous) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.. Patients may experience a reaction that typically occurs within 1 to 2 hours following administration of oxaliplatin that is characterized by the following symptoms: jaw spasm, abnormal tongue sensation, difficulty swallowing, eye pain and a feeling of chest pressure. This condition is temporary and typically resolves within 14 days. It tends to be triggered or exacerbated by exposure to cold temperatures or cold objects.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with oxaliplatin. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. In addition, patients will be monitored for an allergic-type reaction that may occur with the administration of oxaliplatin. The reaction is characterized by the following symptoms: rash, hives, difficulty in breathing, closing of the throat and low blood pressure, which will cause lightheadedness or dizziness. Patients experiencing any of these symptoms should tell their healthcare provider immediately. In addition, patients will be monitored for a rare but serious side effect affecting the lungs. Patients experiencing difficulty breathing and a cough that does not produce mucous should contact their healthcare provider immediately.
What are the common (occur in 30% or more of patients) side effects of treatment with oxaliplatin?
• Numbness or tingling of the hands or feet – this condition may be exacerbated by exposure to the cold
• Nausea and vomiting
• Low levels of red blood cells – increases risk of anemia
• Low levels of platelets – increases risk of bleeding
• Changes in liver function tests, liver damage
What are the less common (occur in 10% to 29% of patients) side effects of treatment with oxaliplatin?
• Low white blood cell levels- increases risk of infection
• Mouth sores
• Loss of appetite
• Abdominal pain
• Difficulty breathing
• Back pain
• Abnormalities in kidney function levels, as determined by blood tests
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Since numbness or tingling associated with oxaliplatin may be triggered or exacerbated by the cold, patients should observe the following guidelines: avoid cold drinks, avoid the use of ice, cover skin prior to exposure to the cold, try to avoid cold temperatures, try to avoid cold objects or cover skin properly prior to touching cold objects.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.
• If patients have been prescribed an anti-nausea medication, they should be sure to take the prescribed doses.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• If possible, the patient should avoid large crowds or persons who are sick or not feeling well, as this drug may leave the patient susceptible to infection.
• Wash hands often to reduce the risk of infection.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
• Signs of an allergic-type reaction: rash, hives, difficulty in breathing, closing of the throat and low blood pressure, which cause lightheadedness or dizziness
• Signs of a lung reaction: difficulty breathing accompanied by a cough that does not produce mucous
• Signs of an infusion reaction: jaw spasm, abnormal tongue sensation, difficulty swallowing, eye pain and a feeling of chest pressure
• Signs of infection: redness, swelling, pus, tenderness
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Flu or cold-like symptoms: fever, chills, sore throat, cough
• Severe numbness, tingling or cramping of hands or feet
• Sudden swelling of hands, feet, ankles or face
• Severe abdominal pain
• Difficulty breathing or cough
• Sudden weight gain
• Yellowing of skin or eyes
• Mouth sores
• Severe or prolonged nausea or vomiting
• Severe or prolonged diarrhea
• Unusual fatigue
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
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