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Pharmacologic class: Alkylator

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Anaphylaxis may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines have been used to relieve symptoms.


Unclear. Thought to form reactive platinum complexes that inhibit DNA synthesis through formation of interstrand and intrastrand cross-linking of DNA molecules. Cell-cycle-phase nonspecific.


Powder for reconstitution for injection, lyophilized: 5 mg/ml in 50-mg and 100-mg single-use vials

Solution for injection: 5 mg/ml in 10-ml, 20-ml, and 40-ml single-use vials

Indications and dosages

Metastatic cancer of colon or rectum, given with 5-fluorouracil (5-FU) and leucovorin

Adults: On day 1, 85 mg/m2 oxaliplatin I.V. infusion and 200 mg/m2 leucovorin; give both drugs simultaneously over 2 hours, followed by 400 mg/m2 I.V. bolus of 5-FU over 2 to 4 minutes, then 600 mg/m2 5-FU I.V. as 22-hour continuous infusion. On day two, 200 mg/m2 leucovorin I.V. infusion over 2 hours, followed by 400 mg/m2 5-FU I.V. bolus over 2 to 4 minutes, then 600 mg/m2 5-FU I.V. as 22-hour continuous infusion.


• Hypersensitivity to drug or platinum products


Use cautiously in:
• thrombocytopenia
• radiation therapy
• recent pneumococcal or smallpox vaccination
• elderly patients
• pregnant or breastfeeding patients
• children.


Follow facility policy for preparing, handling, and administering mutagenic, teratogenic, and carcinogenic drugs.
• Premedicate patient with antiemet-ics, as prescribed.
• Reconstitute with sterile water or dextrose 5% in water (D5W)-never with normal saline solution or other solutions containing chloride.
• Further dilute reconstituted drug in 250 to 500 ml of D5W.
• Infuse over 2 hours simultaneously with leucovorin, but in a separate I.V. bag.
• Don't use administration sets or needles that contain aluminum.

Be aware of importance of using leucovorin rescue with this drug.

Avoid extravasation, which may cause necrosis and other severe reactions.
• Know that treatment cycles are usually repeated every 2 weeks.

Adverse reactions

CNS: headache, dizziness, fatigue, insomnia, peripheral neuropathy

CV: cardiac abnormalities

EENT: decreased visual acuity, hearing loss, tinnitus, rhinitis, pharyngitis

GI: severe nausea, vomiting, diarrhea, constipation, dyspepsia, gastroesoph-ageal reflux, mucositis, flatulence, stomatitis, anorexia

GU: hematuria, dysuria

Hematologic: anemia, thrombocytopenia, leukopenia, pancytopenia, neutropenia, hemolytic uremic syndrome

Metabolic: hypokalemia

Respiratory: dyspnea, cough, upper respiratory infection, pulmonary fibrosis

Skin: alopecia, rash, flushing, extravasation, redness, swelling, angioedema

Other: weight loss, increased cold sensitivity, pain at injection site, anaphylaxis


Drug-drug.Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Aspirin, nonsteroidal anti-inflammatory drugs: increased risk of bleeding

Live-virus vaccines: decreased antibody response to vaccine

Myelosuppressants: increased bone marrow depression

Drug-diagnostic tests.Alanine aminotransferase, aspartate aminotransferase, bilirubin, creatinine: increased levels

Hemoglobin, neutrophils, platelets, white blood cells: decreased levels

Drug-behaviors.Alcohol use: increased risk of bleeding

Patient monitoring

Monitor I.V. site frequently to avoid extravasation.
• Monitor CBC, blood chemistry, and kidney and liver function tests before each treatment cycle.

Watch closely for blood dyscrasias, hemolytic uremic syndrome, serious pulmonary problems, and anaphylaxis.
• Conduct complete neurologic exam before and after each dose.
• Monitor vital signs and ECG. Evaluate cardiovascular and respiratory status closely.
• Assess patient's comfort level. Keep him warm during infusion to minimize neurologic effects.
• Watch for signs and symptoms of toxicity (paresthesia, nausea, vomiting).

Patient teaching

• Inform patient that chemotherapy drugs can cause many adverse effects.
• Tell patient he'll receive drug from trained health care professionals in hospital setting.

Instruct patient to inform nurse immediately if drug contacts his skin, eyes, or mouth.
• Advise patient to notify nurse if pain or redness occurs at I.V. site.
• Instruct patient to stay warm and avoid iced drinks to minimize neurologic symptoms.

Tell patient to report itching, hives, swelling of hands or face, chest tightness, difficulty breathing, unsteadiness, severe diarrhea or vomiting, or tingling sensation in hands, arms, legs, or feet.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.


A platinum-containing chemotherapeutic drug used in the treatment of colorectal cancer.


an antineoplastic agent used to treat metastatic carcinoma of the colon or rectum in combination with 5-FU/leucovorin.


Eloxatin® Oncology A parenteral platinum used with 5-FU and leukovorin for advanced colorectal CA. See Cisplatin, 5-FU, Leukovorin.
References in periodicals archive ?
Amerisource cited strong sales of generic medicines, for which large wholesalers can leverage low prices, including the sale of a generic version of Sanofi-Aventis SA's (Paris FRA) Eloxatin cancer drug.
Sanofi-Aventis markets four out of the 25 cytotoxic therapy cancer brands, Eloxatin (oxaliplatin), Taxotere (docetaxel), Gliadel (carmustine) and TS-1 (tegafur + gimeracil + oteracil), which it co-develops with Taiho, making it the current market leader.
Two chemotherapy treatments - one a combination of drugs including Eloxatin and the other an oral tablet known as Xeloda - are thought to offer a potential cure for patients caught soon enough.
International trials have shown that adding Eloxatin to the standard chemotherapy combination helps reduce the risk of relapse after surgery by 25 per cent.
It is believed Eloxatin, used with other drugs, offers a potential cure for patients with early stage bowel cancer.
The years of 2003 and 2004 brought considerable change to the treatment of metatstatic colorectal cancer via the approval of Sanofi-Aventis's Eloxatin and Genentech's Avastin for front-line use, and ImClone Systems's Erbitux in the refractory setting.
The Food and Drug Administration (FDA) today announced the approval of Eloxatin (oxaliplatin) injection for use in combination with infusional 5-fluorouracil (5-FU) and leucovorin for the treatment of patients with colorectal cancer whose disease has recurred or become worse following initial therapy with a combination of irinotecan with bolus 5-FU and leucovorin.
Debiopharm (Lausanne, Switzerland) announced that it has extended its patent and know-how agreement on Eloxatin (oxaliplatin), currently indicated for advanced colorectal cancer, with multinational Sanofi-Synthelabo (Paris, France).
Purvis brings more than 25 years of oncology drug development experience to Accelovance, having provided significant contribution in the development, approval, and postmarketing development of multiple cytotoxic, biological, targeted, and hormonal products; including: IV Alkeran, IV Zyloprim, Navelbine, Eloxatin, Nolvadex, Faslodex, Arimidex, Casodex, Iressa, and Torisel.
In April, French drugmaker Sanofi-Aventis settled a patent lawsuit over Eloxatin with a number of drugmakers, including Fresenius Kabi, stopping them from selling their generic versions in the United States from June 30 until August 2012.
Draft guidance by the National Institute for Health and Clinical Excellence (Nice) has recommended a combination treatment, which includes the drug Eloxatin, should be available for NHS patients.