oxaliplatin (Rx)

Brand and Other Names:Eloxatin
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Dosing & Uses

AdultPediatric

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

Next:

Interactions

Interaction Checker

and oxaliplatin

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      Serious - Use Alternative

        Significant - Monitor Closely

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            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.

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            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

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            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

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            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.

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            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

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            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

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            Images

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            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            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.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            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.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.