Dosing & Uses
Dosage Forms & Strengths
powder for injectable solution
- 50mg/vial
- 100mg/vial
- 200mg/vial
Colorectal Cancer
Indicated in combination with infused 5-fluorouracil/leucovorin for adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor and also for treatment of advanced colorectal cancer
Advanced colorectal cancer
- Day 1: Oxaliplatin 85 mg/m² IV + leucovorin 200 mg/m² IV infused over 2 hr, THEN
- 5-FU 400 mg/m² IV bolus over 2-4 minutes, THEN
- 5-FU 600 mg/m² IV infusion in D5W (500 mL) over 22 hr
- Day 2: Same regimen WITHOUT oxaliplatin
- Repeat every 2 weeks
Adjuvant treatment for stage III colon cancer
- 12 cycles, every 2 weeks, according to the dose schedule above, for a total of 6 months
- Adjuvant use follows tumor resection
Dosage Modification
If persistent Grade 2 neuropathy, decrease dose to 75 mg/m²
If persistent Grade 3 neuropathy, consider discontinuing oxaliplatin
After recovery from grade 3/4 GI or grade 3/4 hematological toxicity: Decrease dose to 75 mg/m² , AND decrease 5-FU by 20% (300 mg/m² bolus, 500 mg/m² infusion)
After recovery from grade 3/4 GI or hematologic toxicities
- Advanced colorectal cancer: Decrease dose to 65 mg/m² , AND decrease 5-FU by 20% (300 mg/m² bolus, 500 mg/m² infusion)
- Adjuvant therapy for stage II colon cancer: Decrease dose to 75 mg/m² , AND decrease 5-FU by 20% (300 mg/m² bolus, 500 mg/m² infusion)
Renal impairment
- Exposure of unbound platinum tends to increase in renally impaired patients
- Mild-to-moderate (CrCl 30-80 mL/min): No dosage adjustment required
- Severe (CrCl <30 mL/min): Reduce starting dose to 65 mg/m²
Ovarian Cancer (Orphan)
Orphan designation for treatment of ovarian cancer
Sponsor
- Debio Pharm S.A.; Rue des Terreaux 17 CH-1000; Switzerland
Cholangiocarcinoma (Orphan)
Orphan designation for liposomal oxaliplatin for treatment of cholangiocarcinoma
Sponsor
- KC Specialty Therapeutics, LLC; 2002 West 39th Avenue; Kansas City, Arkansas 66103
Pancreatic Adenocarcinoma (Orphan)
Orphan designation for liposomal oxaliplatin for treatment of pancreatic adenocarcinoma
Sponsor
- 2 KC Specialty Therapeutics, LLC; 2002 West 39th Avenue; Kansas City, Arkansas 66103
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (15)
- adenovirus types 4 and 7 live, oral
oxaliplatin decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- BCG vaccine live
oxaliplatin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- influenza virus vaccine quadrivalent, intranasal
oxaliplatin decreases effects of influenza virus vaccine quadrivalent, intranasal by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- measles (rubeola) vaccine
oxaliplatin decreases effects of measles (rubeola) vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- measles mumps and rubella vaccine, live
oxaliplatin decreases effects of measles mumps and rubella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- measles, mumps, rubella and varicella vaccine, live
oxaliplatin decreases effects of measles, mumps, rubella and varicella vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- pimozide
oxaliplatin will increase the level or effect of pimozide by Other (see comment). Contraindicated. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- rotavirus oral vaccine, live
oxaliplatin decreases effects of rotavirus oral vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- rubella vaccine
oxaliplatin decreases effects of rubella vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- smallpox (vaccinia) vaccine, live
oxaliplatin decreases effects of smallpox (vaccinia) vaccine, live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- typhoid polysaccharide vaccine
oxaliplatin decreases effects of typhoid polysaccharide vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- typhoid vaccine live
oxaliplatin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- varicella virus vaccine live
oxaliplatin decreases effects of varicella virus vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- yellow fever vaccine
oxaliplatin decreases effects of yellow fever vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
- zoster vaccine live
oxaliplatin decreases effects of zoster vaccine live by pharmacodynamic antagonism. Contraindicated. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3 mo. after cessation of immunosuppressive therapy.
Serious - Use Alternative (34)
- alfuzosin
alfuzosin and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- amphotericin B deoxycholate
amphotericin B deoxycholate and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.
- apomorphine
apomorphine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- aripiprazole
aripiprazole and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
artemether/lumefantrine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- atomoxetine
atomoxetine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- bacitracin
oxaliplatin and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs
- bedaquiline
bedaquiline and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- chloroquine
chloroquine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- cidofovir
cidofovir and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Concomitant use of cidofovir and agents with nephrotoxic potential is contraindicated. Such agents must be discontinued at least 7 days prior to starting therapy with cidofovir.
- citalopram
citalopram and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- clozapine
clozapine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- crizotinib
crizotinib and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- dasatinib
dasatinib and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- deferiprone
deferiprone, oxaliplatin. Either increases toxicity of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.
- degarelix
degarelix and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
oxaliplatin will increase the level or effect of dofetilide by Other (see comment). Avoid or Use Alternate Drug. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- dronedarone
oxaliplatin will increase the level or effect of dronedarone by Other (see comment). Avoid or Use Alternate Drug. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- fexinidazole
fexinidazole and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fingolimod
oxaliplatin increases effects of fingolimod by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid use of fingolimod and other immunosuppressants when possible. If combined, closely monitor for additive immunosuppressant effects (eg, infections). When switching to fingolimod after discontinuation of another immunosuppressant, consider duration of action of the discontinued drug to avoid additive immunosuppressive effects.
- lefamulin
lefamulin and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- nilotinib
oxaliplatin will increase the level or effect of nilotinib by Other (see comment). Avoid or Use Alternate Drug. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ocrelizumab
oxaliplatin and ocrelizumab both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects.
- palifermin
palifermin increases toxicity of oxaliplatin by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.
- paliperidone
oxaliplatin will increase the level or effect of paliperidone by Other (see comment). Avoid or Use Alternate Drug. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- pimecrolimus
oxaliplatin and pimecrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Consider not using a leflunomide loading dose in patients receiving other immunosuppressants. Monitor for bone marrow suppression at least monthly in patients concomitantly using leflunomide and another immunosuppressant.
- selinexor
oxaliplatin, selinexor. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- tacrolimus
oxaliplatin and tacrolimus both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects.
- tofacitinib
oxaliplatin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- trifluridine/tipiracil
oxaliplatin and trifluridine/tipiracil both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- trilaciclib
trilaciclib will decrease the level or effect of oxaliplatin by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.
Monitor Closely (204)
- acalabrutinib
acalabrutinib, oxaliplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.
- acyclovir
acyclovir and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- adefovir
adefovir and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- albuterol
oxaliplatin will increase the level or effect of albuterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
albuterol and oxaliplatin both increase QTc interval. Use Caution/Monitor. - alfuzosin
oxaliplatin will increase the level or effect of alfuzosin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- amikacin
amikacin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- amiodarone
oxaliplatin will increase the level or effect of amiodarone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- amitriptyline
oxaliplatin will increase the level or effect of amitriptyline by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- amoxapine
oxaliplatin will increase the level or effect of amoxapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- amphotericin B cholesteryl sulfate
oxaliplatin increases toxicity of amphotericin B cholesteryl sulfate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with oxaliplatin.
- amphotericin B deoxycholate
oxaliplatin increases toxicity of amphotericin B deoxycholate by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with oxaliplatin.
- amphotericin B liposomal
oxaliplatin increases toxicity of amphotericin B liposomal by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with oxaliplatin.
- amphotericin B phospholipid complex
oxaliplatin increases toxicity of amphotericin B phospholipid complex by unknown mechanism. Use Caution/Monitor. Monitor for possible increases in renal toxicity, bronchospasm, and hypotension if amphotericin is given concomitantly with oxaliplatin.
- anagrelide
oxaliplatin will increase the level or effect of anagrelide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- anthrax vaccine adsorbed
oxaliplatin decreases effects of anthrax vaccine adsorbed by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- arformoterol
oxaliplatin will increase the level or effect of arformoterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
arformoterol and oxaliplatin both increase QTc interval. Use Caution/Monitor. - arsenic trioxide
oxaliplatin will increase the level or effect of arsenic trioxide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- artemether
oxaliplatin will increase the level or effect of artemether by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- artemether/lumefantrine
oxaliplatin will increase the level or effect of artemether/lumefantrine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- asenapine
oxaliplatin will increase the level or effect of asenapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- azathioprine
oxaliplatin and azathioprine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- azithromycin
oxaliplatin will increase the level or effect of azithromycin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- basiliximab
oxaliplatin and basiliximab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- bedaquiline
oxaliplatin will increase the level or effect of bedaquiline by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- belimumab
oxaliplatin and belimumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- bleomycin
oxaliplatin and bleomycin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- bosutinib
oxaliplatin and bosutinib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- budesonide
oxaliplatin and budesonide both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- cabazitaxel
oxaliplatin, cabazitaxel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression. Administer taxanes derivative before oxaliplatin when given as sequential infusions to limit toxicity.
- canakinumab
oxaliplatin and canakinumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- capreomycin
capreomycin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- carboplatin
carboplatin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- cephaloridine
oxaliplatin and cephaloridine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- ceritinib
oxaliplatin will increase the level or effect of ceritinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- certolizumab pegol
oxaliplatin and certolizumab pegol both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- chlorambucil
oxaliplatin, chlorambucil. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- chloroquine
oxaliplatin will increase the level or effect of chloroquine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- chlorpromazine
oxaliplatin will increase the level or effect of chlorpromazine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ciprofloxacin
oxaliplatin will increase the level or effect of ciprofloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- cisplatin
cisplatin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- citalopram
oxaliplatin will increase the level or effect of citalopram by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- clarithromycin
oxaliplatin will increase the level or effect of clarithromycin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- clofazimine
oxaliplatin will increase the level or effect of clofazimine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- clozapine
oxaliplatin and clozapine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
oxaliplatin will increase the level or effect of clozapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval. - contrast media (iodinated)
oxaliplatin and contrast media (iodinated) both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- crizotinib
oxaliplatin will increase the level or effect of crizotinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- cyclosporine
cyclosporine and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
oxaliplatin and cyclosporine both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections. - deflazacort
oxaliplatin and deflazacort both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- degarelix
oxaliplatin will increase the level or effect of degarelix by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- dengue vaccine
oxaliplatin decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.
- denosumab
oxaliplatin, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.
- deutetrabenazine
oxaliplatin will increase the level or effect of deutetrabenazine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- dinutuximab
oxaliplatin and dinutuximab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- diphtheria & tetanus toxoids
oxaliplatin decreases effects of diphtheria & tetanus toxoids by passive renal tubular reabsorption due to increased pH. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- diphtheria & tetanus toxoids/ acellular pertussis vaccine
oxaliplatin decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by passive renal tubular reabsorption due to increased pH. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine
oxaliplatin decreases effects of diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine by passive renal tubular reabsorption due to increased pH. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- disopyramide
oxaliplatin will increase the level or effect of disopyramide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- docetaxel
oxaliplatin, docetaxel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression. Administer taxanes derivative before oxaliplatin when given as sequential infusions to limit toxicity. .
- dolasetron
oxaliplatin will increase the level or effect of dolasetron by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- droperidol
oxaliplatin will increase the level or effect of droperidol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- echinacea
echinacea decreases effects of oxaliplatin by Other (see comment). Use Caution/Monitor. Comment: Echinacea is reported possess immunostimulatory activity demonstrated by activation of macrophages (releasing interleukin-1), and proliferation of B-lymphocytes; theoretically, may oppose the therapeutic effects of immunosuppressants.
- efavirenz
oxaliplatin will increase the level or effect of efavirenz by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- eliglustat
oxaliplatin will increase the level or effect of eliglustat by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
oxaliplatin and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- erdafitinib
erdafitinib increases levels of oxaliplatin by decreasing renal clearance. Modify Therapy/Monitor Closely. Consider alternatives that are not OCT2 substrates or consider reducing the dose of OCT2 substrates based on tolerability.
- eribulin
oxaliplatin will increase the level or effect of eribulin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- erythromycin base
oxaliplatin will increase the level or effect of erythromycin base by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- erythromycin ethylsuccinate
oxaliplatin will increase the level or effect of erythromycin ethylsuccinate by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- erythromycin lactobionate
oxaliplatin will increase the level or effect of erythromycin lactobionate by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- erythromycin stearate
oxaliplatin will increase the level or effect of erythromycin stearate by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- escitalopram
oxaliplatin will increase the level or effect of escitalopram by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- etanercept
oxaliplatin and etanercept both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- flecainide
oxaliplatin will increase the level or effect of flecainide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- fluconazole
oxaliplatin will increase the level or effect of fluconazole by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- fluorouracil
oxaliplatin will increase the level or effect of fluorouracil by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- formoterol
oxaliplatin will increase the level or effect of formoterol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- foscarnet
foscarnet and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- fosphenytoin
oxaliplatin decreases levels of fosphenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxaliplatin decreases levels of fosphenytoin by increasing metabolism. Use Caution/Monitor.
oxaliplatin will decrease the level or effect of fosphenytoin by unknown mechanism. Use Caution/Monitor. Monitor phenytoin concentrations/effects during treatment with oxaliplatin. Adjust phenytoin/fosphenytoin dose as necessary to maintain concentrations in the desired range. - fostemsavir
oxaliplatin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gemifloxacin
oxaliplatin will increase the level or effect of gemifloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- gemtuzumab
oxaliplatin will increase the level or effect of gemtuzumab by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- gentamicin
gentamicin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- goserelin
oxaliplatin will increase the level or effect of goserelin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- granisetron
oxaliplatin will increase the level or effect of granisetron by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- guselkumab
oxaliplatin and guselkumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- haemophilus influenzae type b vaccine
oxaliplatin decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .
- haloperidol
oxaliplatin will increase the level or effect of haloperidol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- hepatitis A vaccine inactivated
oxaliplatin decreases effects of hepatitis A vaccine inactivated by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- hepatitis a/b vaccine
oxaliplatin decreases effects of hepatitis a/b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- hepatitis b vaccine
oxaliplatin decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- histrelin
oxaliplatin will increase the level or effect of histrelin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- HIV vaccine
oxaliplatin decreases effects of HIV vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- human papillomavirus vaccine, nonavalent
oxaliplatin decreases effects of human papillomavirus vaccine, nonavalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- human papillomavirus vaccine, quadrivalent
oxaliplatin decreases effects of human papillomavirus vaccine, quadrivalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- hydroxyurea
oxaliplatin, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.
- ibutilide
oxaliplatin will increase the level or effect of ibutilide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ifosfamide
oxaliplatin, ifosfamide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- iloperidone
oxaliplatin will increase the level or effect of iloperidone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- indacaterol, inhaled
oxaliplatin will increase the level or effect of indacaterol, inhaled by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- influenza A (H5N1) vaccine
oxaliplatin decreases effects of influenza A (H5N1) vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine (H5N1), adjuvanted
oxaliplatin decreases effects of influenza virus vaccine (H5N1), adjuvanted by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine quadrivalent
oxaliplatin decreases effects of influenza virus vaccine quadrivalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine quadrivalent, adjuvanted
oxaliplatin decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine quadrivalent, cell-cultured
oxaliplatin decreases effects of influenza virus vaccine quadrivalent, cell-cultured by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine quadrivalent, recombinant
oxaliplatin decreases effects of influenza virus vaccine quadrivalent, recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine trivalent
oxaliplatin decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine trivalent, adjuvanted
oxaliplatin decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- influenza virus vaccine trivalent, recombinant
oxaliplatin decreases effects of influenza virus vaccine trivalent, recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- inotuzumab
oxaliplatin will increase the level or effect of inotuzumab by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ioversol
ioversol and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- Japanese encephalitis virus vaccine
oxaliplatin decreases effects of Japanese encephalitis virus vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- lapatinib
oxaliplatin will increase the level or effect of lapatinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- leflunomide
oxaliplatin increases toxicity of leflunomide by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider not using a leflunomide loading dose in patients receiving other immunosuppressants. Monitor for bone marrow suppression at least monthly in patients concomitantly using leflunomide and another immunosuppressant.
- lenvatinib
oxaliplatin will increase the level or effect of lenvatinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- leuprolide
oxaliplatin will increase the level or effect of leuprolide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- levofloxacin
oxaliplatin will increase the level or effect of levofloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- lofexidine
oxaliplatin will increase the level or effect of lofexidine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- lomustine
oxaliplatin, lomustine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- lopinavir
oxaliplatin will increase the level or effect of lopinavir by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- mechlorethamine
oxaliplatin, mechlorethamine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.
- melphalan
oxaliplatin, melphalan. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of myelosuppression.
- meningococcal A C Y and W-135 diphtheria conjugate vaccine
oxaliplatin decreases effects of meningococcal A C Y and W-135 diphtheria conjugate vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- meningococcal A C Y and W-135 polysaccharide vaccine combined
oxaliplatin decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- meningococcal group B vaccine
oxaliplatin decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- mercaptopurine
oxaliplatin, mercaptopurine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of myelosuppression.
- methadone
oxaliplatin will increase the level or effect of methadone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- methotrexate
methotrexate and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
oxaliplatin, methotrexate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of myelosuppression. - mifepristone
oxaliplatin will increase the level or effect of mifepristone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- mitoxantrone
oxaliplatin and mitoxantrone both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- moxifloxacin
oxaliplatin will increase the level or effect of moxifloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- neomycin PO
neomycin PO and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- niraparib
oxaliplatin and niraparib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- nivolumab
oxaliplatin and nivolumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.
- ofloxacin
oxaliplatin will increase the level or effect of ofloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- olanzapine
oxaliplatin will increase the level or effect of olanzapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- olaparib
oxaliplatin and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.
- ondansetron
oxaliplatin will increase the level or effect of ondansetron by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- osilodrostat
osilodrostat and oxaliplatin both increase QTc interval. Use Caution/Monitor.
- osimertinib
oxaliplatin and osimertinib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
oxaliplatin will increase the level or effect of osimertinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval. - paclitaxel
oxaliplatin, paclitaxel. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression. Administer taxanes derivative before oxaliplatin when given as sequential infusions to limit toxicity. .
- paclitaxel protein bound
oxaliplatin, paclitaxel protein bound. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression. Administer taxanes derivative before oxaliplatin when given as sequential infusions to limit toxicity. .
- palbociclib
oxaliplatin, palbociclib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression.
- panobinostat
oxaliplatin and panobinostat both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.
oxaliplatin will increase the level or effect of panobinostat by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval. - paromomycin
oxaliplatin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- pasireotide
oxaliplatin will increase the level or effect of pasireotide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- pazopanib
oxaliplatin, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression.
oxaliplatin will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval. - pentamidine
oxaliplatin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
oxaliplatin will increase the level or effect of pentamidine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval. - peramivir
oxaliplatin increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.
- phenytoin
oxaliplatin decreases levels of phenytoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxaliplatin decreases levels of phenytoin by increasing metabolism. Use Caution/Monitor.
oxaliplatin will decrease the level or effect of phenytoin by unknown mechanism. Use Caution/Monitor. Monitor phenytoin concentrations/effects during treatment with oxaliplatin. Adjust phenytoin/fosphenytoin dose as necessary to maintain concentrations in the desired range. - pneumococcal vaccine 13-valent
oxaliplatin decreases effects of pneumococcal vaccine 13-valent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- pneumococcal vaccine heptavalent
oxaliplatin decreases effects of pneumococcal vaccine heptavalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- pneumococcal vaccine polyvalent
oxaliplatin decreases effects of pneumococcal vaccine polyvalent by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- poliovirus vaccine inactivated
oxaliplatin decreases effects of poliovirus vaccine inactivated by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .
- polymyxin B
oxaliplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- ponesimod
ponesimod and oxaliplatin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- primaquine
oxaliplatin will increase the level or effect of primaquine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- procainamide
oxaliplatin will increase the level or effect of procainamide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- propafenone
oxaliplatin will increase the level or effect of propafenone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- quetiapine
oxaliplatin will increase the level or effect of quetiapine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- quinidine
oxaliplatin will increase the level or effect of quinidine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- quinine
oxaliplatin will increase the level or effect of quinine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- rabies vaccine
oxaliplatin decreases effects of rabies vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- rabies vaccine chick embryo cell derived
oxaliplatin decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- ranolazine
oxaliplatin will increase the level or effect of ranolazine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ribociclib
oxaliplatin will increase the level or effect of ribociclib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- risperidone
oxaliplatin will increase the level or effect of risperidone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- roflumilast
roflumilast and oxaliplatin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- romidepsin
oxaliplatin will increase the level or effect of romidepsin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- saquinavir
oxaliplatin will increase the level or effect of saquinavir by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- siponimod
siponimod and oxaliplatin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.
- sipuleucel-T
oxaliplatin and sipuleucel-T both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Consider avoiding such combinations when clinically appropriate. If such a combination is used, monitor the patient closely for clinical response.
- sorafenib
oxaliplatin will increase the level or effect of sorafenib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- sotalol
oxaliplatin will increase the level or effect of sotalol by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- streptomycin
oxaliplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- streptozocin
oxaliplatin and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
oxaliplatin, streptozocin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression. - sunitinib
oxaliplatin will increase the level or effect of sunitinib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- tacrolimus
oxaliplatin and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- teicoplanin
oxaliplatin and teicoplanin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- telavancin
oxaliplatin will increase the level or effect of telavancin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- tenofovir DF
oxaliplatin and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Combination may also increase tenofovir levels.
- tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine
oxaliplatin decreases effects of tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine by passive renal tubular reabsorption due to increased pH. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- tetanus toxoid adsorbed or fluid
oxaliplatin decreases effects of tetanus toxoid adsorbed or fluid by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
- tetrabenazine
oxaliplatin will increase the level or effect of tetrabenazine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- thioridazine
oxaliplatin will increase the level or effect of thioridazine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- tobramycin
oxaliplatin and tobramycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- tobramycin inhaled
tobramycin inhaled and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity.
- tocilizumab
oxaliplatin and tocilizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- topotecan
oxaliplatin, topotecan. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Closely monitor for hematologic toxicity (eg, neutropenia, thrombocytopenia). Interaction may be sequence dependent and primarily associated with regimens in which oxaliplatin is administered prior to topotecan. Lower doses are recommended when using this combination (in the sequence of platinum derivative prior to topotecan). Alternatively, consider using a sequence in which the platinum derivative is given after topotecan when possible.
- toremifene
oxaliplatin will increase the level or effect of toremifene by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- trastuzumab
trastuzumab, oxaliplatin. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
- trastuzumab deruxtecan
trastuzumab deruxtecan, oxaliplatin. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .
oxaliplatin and trastuzumab deruxtecan both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections. - trazodone
oxaliplatin will increase the level or effect of trazodone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- triamcinolone acetonide extended-release injectable suspension
oxaliplatin and triamcinolone acetonide extended-release injectable suspension both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- triamcinolone acetonide injectable suspension
oxaliplatin and triamcinolone acetonide injectable suspension both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- triptorelin
oxaliplatin will increase the level or effect of triptorelin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ustekinumab
oxaliplatin and ustekinumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- vancomycin
oxaliplatin and vancomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.
- vandetanib
oxaliplatin will increase the level or effect of vandetanib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- vedolizumab
oxaliplatin and vedolizumab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Use of oxaliplatin with concomitant immunosuppressants or with impaired immune systems may increased risk for serious infections.
- vemurafenib
oxaliplatin will increase the level or effect of vemurafenib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- voriconazole
oxaliplatin will increase the level or effect of voriconazole by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- zidovudine
oxaliplatin, zidovudine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of myelosuppression.
- ziprasidone
oxaliplatin will increase the level or effect of ziprasidone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- zoster vaccine recombinant
oxaliplatin decreases effects of zoster vaccine recombinant by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the vaccine may occur. If possible, complete all age-appropriate vaccinations at least 2 weeks prior to initiation of immunosuppressant therapy. Patients vaccinated <14 days before initiation or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued. .
Minor (7)
- colistin
colistin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- entecavir
oxaliplatin, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.
- maitake
maitake increases effects of oxaliplatin by pharmacodynamic synergism. Minor/Significance Unknown. Maitake mushroom has anti-tumor effects (animal/in vitro research).
- methoxyflurane
oxaliplatin and methoxyflurane both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.
- taurine
oxaliplatin decreases levels of taurine by unspecified interaction mechanism. Minor/Significance Unknown.
- vitamin A
vitamin A, oxaliplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
- vitamin E
vitamin E, oxaliplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.
Adverse Effects
>10%
Peripheral neuropathy (76%)
Anemia (64%)
Nausea (64%)
Fatigue (61%)
Diarrhea (46%)
Vomiting (37%)
Abdominal pain (31%)
Constipation (31%)
Thrombocytopenia (30%)
Fever (25%)
Anorexia (20%)
Leukopenia (13%)
Dyspnea (13%)
Cough (11%)
1-10%
Edema (10%)
Neutropenia (7%)
Pharyngolaryngeal dysesthesia (1-2%)
<1%
Pulmonary fibrosis
Posterior leukoencephalopathy syndrome
Frequency Not Defined
Anaphylactic-like reaction (uncommon)
Pulmonary fibrosis (uncommon)
Postmarketing Reports
Body as a whole: Angioedema, anaphylactic shock
Central and peripheral nervous system disorders: Loss of deep tendon reflexes, dysarthria, Lhermitte’s sign, cranial nerve palsies, fasciculations, convulsion, RPLS
Hearing and vestibular system disorders: Deafness
Infusion reactions/hypersensitivity: Laryngospasm
Liver and gastrointestinal system disorders: Severe diarrhea/vomiting resulting in hypokalemia, colitis (including Clostridium difficile diarrhea), metabolic acidosis; ileus; intestinal obstruction, pancreatitis; veno-occlusive disease of liver (ie, sinusoidal obstruction syndrome), perisinusoidal fibrosis which rarely may progress
Platelet, bleeding, and clotting disorders: immuno-allergic thrombocytopenia prolongation of prothrombin time and of INR in patients receiving anticoagulants
Red blood cell disorders: Hemolytic uremic syndrome, immuno-allergic hemolytic anemia
Renal disorders: Acute tubular necrosis, acute interstitial nephritis, acute renal failure
Respiratory system disorders: Pulmonary fibrosis, and other interstitial lung diseases (sometimes fatal)
Cardiovascular toxicity
Rhabdomyolysis
Septic shock
Warnings
Black Box Warnings
The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications
Anaphylactic-like reactions have been reported and may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines have been used to treat these symptoms
Contraindications
Hypersensitivity to oxaliplatin, other platinum compounds
Pregnancy
Cautions
Caution in renal impairment, elderly, neuropathy, neurotoxic agents
For 3-4 days, avoid contact with ice/cold food/objects, avoid breathing cold air
Avoid contact with aluminum needles or equipment
Avoid pregnancy
Pulmonary fibrosis may occur
Concomitant use with fluorouracil may increase gastrointestinal effects
Grade 3 or 4 neutropenia reported in patients with colorectal cancer treated in combination with 5-flurouracil (5-FU) and leucovorin; delay oxaliplatin therapy until neutrophils are at 1.5 x 10^9/L; withhold oxaliplatin for sepsis or septic shock; reduce dose after recovery from Grade 4 neutropenia or febrile neutropenia
Cardiovascular toxicity reported; ECG monitoring recommended if therapy initiated in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities; correct hypokalemia or hypomagnesemia prior to initiating oxaliplatin and monitor these electrolytes periodically during therapy; avoid oxaliplatin in patients with congenital long QT syndrome
Reversible posterior leukoencephalopathy syndrome (RPLS, also known as PRES, Posterior Reversible Encephalopathy Syndrome) reported in clinical trials and postmarketing experience
Rhabdomyolysis, including fatal cases reported; discontinue oxaliplatin if any signs or symptoms of rhabdomyolysis occur
Pregnancy & Lactation
Pregnancy
Based on direct interaction with DNA, therapy can cause fetal harm when administered to a pregnant woman; available human data do not establish presence or absence of major birth defects or miscarriage related to use of drug; advise a pregnant woman of potential hazard to fetus
Verify pregnancy status in females of reproductive potential prior to initiating therapy
Therapy can cause embryo-fetal harm when administered to a pregnant woman
Advise females of reproductive potential to use effective contraception while receiving therapy and for 9 months after final dose
Based on mechanism action as a genotoxic drug, advise males with female partners of reproductive potential to use effective contraception while receiving drug and for 6 months after final dose
Based on animal studies, therapy may impair fertility in males and females
Animal data
- Reproductive toxicity studies demonstrated adverse effects on embryo-fetal development in rats at maternal doses that were below the recommended human dose based on body surface area
Lactation
There are no data on presence of drug or its metabolites in human or animal milk, effects on breastfed infant or on milk production; because of potential for serious adverse reactions in breastfed infants, advise women not to breastfeed during treatment and for 3 months after final dose
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Platinum coordination compound that inhibits DNA synthesis; cross-links and denatures strands of DNA; disrupts DNA function by covalently binding to DNA bases
Pharmacokinetics
Peak plasma time: 2 hr
Concentration: 1.21 mcg/mL
Protein bound: >90%; platinum accumulates in RBCs
Vd: 440 L
Half-life: 391 hr
Clearance: 10.1 L/hr
Excretion: Urine (54%); feces (2%)
Dialyzable: no
Administration
IV Incompatibilities
Alkaline medications or media (eg, basic solutions of 5-FU)
IV Preparation
Reconstitute by adding 10 mL (for 50 mg vial) or 20 mL (for 100 mg vial) of SWI or D5W. Dilute required amount of reconstituted solution in an infusion solution of 250-500 mL of D5W. Do NOT use NS or chloride-containing solutions
Reconstituted solution may be refrigerated up to 24 hr at 2-8°C (36-46°F). After final dilution with 250-500 mL D5W, the shelf life is 6 hr at room temp [20-25°C (68-77°F)] or up to 24 hr under refrigeration at 2-8°C (36-46°F)
Eloxatin is not light sensitive
Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can react causing precipitate formation and loss of potency)
IV Administration
Flush infusion line with D5W prior to administration of oxaliplatin or any concomitant drug
Inspect visually for particulate matter and discoloration prior to administration and discard if present
Use separate bags for oxaliplatin and leucovorin (administered through Y-site)
See adult dosing for infusion and bolus rate
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 100 mg vial |  | |
| oxaliplatin intravenous - | 50 mg vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg vial |  | |
| oxaliplatin intravenous - | 50 mg vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 100 mg/20 mL vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  | |
| oxaliplatin intravenous - | 50 mg/10 mL (5 mg/mL) vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
oxaliplatin intravenous
OXALIPLATIN - INJECTION
(ox-AL-ih-plah-tin)
COMMON BRAND NAME(S): Eloxatin
WARNING: Oxaliplatin may rarely cause a severe (possibly fatal) allergic reaction within minutes after a dose. Get medical help right away if you develop any signs of an allergic reaction (such as rash, itching, swelling, trouble breathing, swelling of throat, dizziness).
USES: This medication is used to treat advanced cancer of the colon and rectum. Oxaliplatin is a chemotherapy drug that contains platinum. It is used to slow or stop cancer cell growth.
HOW TO USE: Read the Patient Information Leaflet if available from your health care professional before you receive oxaliplatin.This medication is usually given by infusion into a vein over at least 2 hours by a health care professional. It is usually given every 2 weeks along with other medications (e.g., 5-fluorouracil and leucovorin). The dosage is based on your medical condition, body size, and response to therapy.
SIDE EFFECTS: Diarrhea, changes in taste, mouth sores, nosebleeds, tiredness, headache, dizziness, or trouble sleeping may occur. Nausea and vomiting may be severe in some patients. Your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Temporary hair loss may rarely occur. Normal hair growth should return after treatment has ended.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: pain/redness/swelling at the injection site, easy or unusual bruising/bleeding, mental/mood changes (e.g., depression), signs of dehydration (e.g., decreased urination, increased thirst, dry mouth), muscle pain/tenderness/weakness/cramps, signs of kidney problems (such as change in the amount of urine), pain/redness/swelling of the arms/legs, groin/calf pain.Oxaliplatin can sometimes affect how your nerves work (peripheral neuropathy). Tell your doctor right away if you develop: sensitivity to cold, trouble breathing/swallowing/speaking, jaw tightness, strange feeling in your tongue, eye pain, chest pressure, numbness/tingling/"pins and needles" sensation of the hands/feet/mouth/throat.You may lessen these types of nerve problems by avoiding cold drinks and ice and by dressing warmly. Tell your doctor right away if your nerve problems begin to interfere with your normal daily activities (e.g., walking, writing, eating).Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, fast/irregular heartbeat, dry cough, shortness of breath, chest pain, black stools, vomit that looks like coffee grounds, vision changes (such as blurred vision, temporary vision loss), seizures, sudden confusion.This medication can lower your body's ability to fight an infection. Tell your doctor right away if you develop any signs of an infection such as fever, chills, or persistent sore throat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using oxaliplatin, tell your doctor or pharmacist if you are allergic to it; or to other platinum-containing products (e.g., cisplatin, carboplatin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, blood disorders, bone marrow problems, nerve disorders.Oxaliplatin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using oxaliplatin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using oxaliplatin safely.This drug may make you dizzy or cause vision changes. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.Older adults may be more sensitive to the side effects of this drug, especially diarrhea, dehydration and electrolytes imbalance, low white blood cell count, tiredness, fainting, and QT prolongation (see above).This medication can affect fertility in both males and females. Ask your doctor for more details.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using oxaliplatin. Oxaliplatin may harm an unborn baby. Your doctor should do a pregnancy test before you start taking this medication. Women of childbearing age should ask about reliable forms of birth control while using this medication and for 9 months after the last dose. Men with female partners who are pregnant or of childbearing age should ask about reliable forms of birth control while using this medication and for 6 months after the last dose. If you or your partner becomes pregnant or may be pregnant, tell your doctor right away.It is unknown if oxaliplatin passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug and for 3 months after the last dose is not recommended. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aminoglycosides (e.g., gentamicin, amikacin), amphotericin B, nalidixic acid, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), tacrolimus.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe vomiting, chest pain, shortness of breath, wheezing, very slow heartbeat, numbness/tingling of the arms/legs.
NOTES: Laboratory and/or medical tests (e.g., complete blood counts, liver and kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.
STORAGE: Not applicable. This medication is given in a clinic and will not be stored at home.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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