Oxaliplatin (Eloxatin)

• What oxaliplatin is
• How you have treatment
• Common side effects
• Rare side effects
• Important points to remember
• Immunisations and chemotherapy

Oxaliplatin is a chemotherapy drug based on platinum and is similar to cisplatin and carboplatin. It is mainly used to treat bowel cancer (colorectal cancer). It is also used in research trials for a number of other cancers.

Oxaliplatin is a clear liquid that you have through a drip into a vein (intravenous infusion). The infusion usually takes about 2 hours but may take up to 6 hours if you have side effects. You may have it every 2 weeks or every 3 weeks, as a course of treatment.

Chemotherapy is usually given as a course of several cycles of treatment. The treatment plan for oxaliplatin depends on which type of cancer you are being treated for. There is more about how doctors plan chemotherapy in CancerHelp UK.

The side effects associated with oxaliplatin are listed below. You can use the links to find out more about each side effect or click on search at the top of the page.

With this drug, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells - it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) - you may need a blood transfusion
• Bruising more easily due to a drop in platelets - you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

These effects on your bone marrow can begin about 7 days after each treatment and usually go back to normal after about 21 to 28 days. Some of these side effects can be life threatening, particularly infections.  You should contact your doctor if you have any of these side effects.  Your doctor will check your blood counts regularly to see how well your bone marrow is working

Other common side effects include

• Fatigue may be the most disruptive side effect of all - it often carries on after treatment has ended, but most people find their energy levels are back to normal from 6 months to a year after their treatment finishes
• Numbness or tingling in the fingers and toes can start a few days or a few weeks after treatment and nearly everyone has this to some extent but it usually goes away a few months after your treatment is over. It may be worse if you are cold and may cause trouble with fiddly tasks, such as doing up buttons. Tell your specialist if this occurs
• Feeling or being sick happens to about 7 out of every 10 people (70%) treated with oxaliplatin, but is usually well controlled with anti sickness medicines
• Diarrhoea happens in about 4 out of 10 people (40%) treated with oxaliplatin alone, but in 6 out of 10 people (60%) who have oxaliplatin with other chemotherapy drugs - tell your doctor if it gets severe, if you cannot drink to replace lost fluid or if it carries on for more than 3 days
• A sore mouth can happen in as many as 4 out of 10 people (40%) treated with oxaliplatin in combination with fluorouracil - but with oxaliplatin alone, only about 4 out of every 100 people (4%) get a sore mouth
• This drug may harm a baby developing in the womb, so it is not advisable to become pregnant or father a child if you are having this drug - talk about contraception to your doctor before having the treatment if there is any chance you or your partner could become pregnant
• You should not breastfeed while having this drug as it may come through in the breast milk

A few people have the following side effects

• Kidney damage is usually mild and only happens in about 3 out of every 100 people (3%). Your doctor will monitor your kidneys with blood tests but let them know immediately if you stop passing urine
• Hair loss happens to about 2 out of every 100 people (2%) and all body hair may be affected
• Difficulty swallowing or breathing happens in 1 or 2 people out of every 100 (1 to 2%) - it is usually triggered by cold in the first 5 days after you have the drug but usually clears up on its own. Tell your doctor if you have this side effect.
• Ringing in the ears (tinnitus) happens in about 1 in 100 people (1%) and usually gets better after your treatment ends
• Allergic reactions can happen in about 1 in every 200 people (0.5%) while this drug is going into your bloodstream - tell your nurse if you go red in the face, have an itchy rash, or feel faint or breathless
• Loss of fertility may happen with this drug, so it is important to talk with your doctor before starting treatment if you are concerned
• Women may stop having periods (amenorrhoea), but this may only be temporary

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Some side effects are inconvenient or upsetting but not damaging to your health.

Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - some drugs can react together. Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them.

Your chemotherapy nurse, clinic or ward nurse will have given you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.