Eloxatin

Drugs

Generic Name: Oxaliplatin
Product Name: Eloxatin

Indication of Eloxatin
Action of Eloxatin
Dose advice of Eloxatin
Schedule of Eloxatin
Common side effects of Eloxatin
Uncommon side effects of Eloxatin
Reference

Indication of Eloxatin:

Eloxatin is used in the treatment of advanced colorectal cancer, in combination with 5-fluorouracil and folinic acid. It is also used postoperatively in colon cancer.

Colon cancers may be of the adenocarcinoma type and usually arise from the epithelium (layer of cells) lining the inside of the large bowel. Surgery is usually carried out to remove the colon cancer for all types except Duke D (Stage IV) disease.

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Action of Eloxatin:

Oxaliplatin is a new platinum based antineoplastic. Because of its slightly different structure, oxaliplatin is useful in the treatment of cancers that have become resistant to cisplatin, the original platinum-based antineoplastic.

Once inside the body, oxaliplatin is broken down to form metabolites, which are thought to interact with DNA. They form links within and between strands on DNA, which results in disruption of DNA production and eventual cell death.

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Dose advice of Eloxatin:

Eloxatin is for use with 5-fluorouracil and folinic acid.

Either:

85mg/m² intravenously every two weeks; or
130mg/m² intravenously every three weeks.

Eloxatin should be administered before 5-fluorouracil. The dose should be dissolved in 250-500ml glucose 5% (not sodium chloride) and administered over at least 2 hours. Injection materials containing aluminium should be avoided.

Dosage adjustments

Patients should be evaluated for signs of toxicity prior to each subsequent dose. Dosage adjustments should be made according to symptoms experienced previously.

Neurological toxicity:

Altered throat sensation: increase infusion time from 2 hours to 6 hours
Sensory loss >7 days: reduce dose by 25%
If neuropathy interferes with daily function discontinue Eloxatin

Haematological toxicity:

Neutrophils < 1.5x10⁹/L or platelets < 75x10⁹/L: delay next dose until measurements are above these levels, and reduce dose to 65mg/m² (from 85mg) or 100mg/m² (from 130mg)
5-fluorouracil dose should be reduced by 20% in this case

Gastrointestinal toxicity:

Grade 3 or 4 reaction: delay next dose until toxicity resolves, and reduce dose to 65mg/m² (from 85mg) or 100mg/m² (from 130mg)
5-fluorouracil dose should be reduced by 20% in this case

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Schedule of Eloxatin:

Schedule 4

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Common side effects of Eloxatin:

Peripheral neuropathy, which consists of damage to the nerves of the extremities, is very common and symptoms include:

Loss of tendon reflexes
Changes in sensation
Loss of sensation
Cramps
Difficulty with fine movements

This usually disappears as treatment continues, but Eloxatin should be stopped if pain or functional impairment develops.

Other neurological effects that are commonly seen include:

Altered sensation in the throat (feeling of being unable to swallow or breath)
Jaw spasm
Altered tongue sensation
Feeling of chest pressure

Oxaliplatin also causes bone marrow toxicity, which results in decreased red blood cells (anaemia), white blood cells (increased infection risk) and platelets (increased bleeding risk). These effects are very common. Other effects that are seen very commonly include:

Diarrhoea
Nausea and vomiting
Mouth ulcers
Appetite loss
Abdominal pain
Dehydration
Intestinal obstruction
Constipation
Changes in liver enzymes
Infections
Fever

Common effects include:

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Uncommon side effects of Eloxatin:

Inability to speak due to dysfunction of mouth muscles
Difficulty breathing
Allergic reaction
Hearing impairment
Visual disturbances
Interstitial lung disease - pulmonary fibrosis
Clostridium difficile diarrhoea

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Reference:

MIMS Australia. MIMSOnline Prescribing Information: Eloxatin [online]. 2005 [cited: 3/2/2005]. Available from URL: http://proxy8.use.hcn.com.au/ifmx-nsapi/mims-data/?MIval=2MIMS_abbr_pi&product_code=5813&product_name=Eloxatin#AdverseReactions.
Sanofi-Synthelabo Australia Pty Limited. Eloxatin Product Information. North Ryde, New South Wales: Sanofi-Synthelabo Australia Pty Limited; 2003.
Sanofi-Synthelabo Australia Pty Limited. Eloxatin Consumer Medicine Information. North Ryde, New South Wales: Sanofi-Synthelabo Australia Pty Limited; 2002.

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