Eloxatin (Oxaliplatin)

Eloxatin is an anti-cancer (“antineoplastic” or “cytotoxic”) platinum-based chemotherapy drug. Eloxatin is classified as an “alkylating agent.”

It interferes with the growth and spread of cancer cells in the body.

Eloxatin infusion is used together with fluorouracil and leucovorin, to treat colon and rectal cancer.

It is not known if Eloxatin infusion is effective in children.

HOW ELOXATIN IS GIVEN

Eloxatin is given as an infusion into a vein. A healthcare provider will give you this injection.

Eloxatin must be given slowly, and the infusion can take at least 2 hours to complete.

Eloxatin is usually given once every 2 weeks. Your doctor will determine how long to treat you with this medicine.

You may be given medication to prevent nausea or vomiting.

Receiving Eloxatin can make you more sensitive to cold, which can cause numbness, tingling, and muscle spasms. This includes exposure to cold temperatures and coming into contact with cold objects. To prevent discomfort, follow these steps:

• do not inhale deeply when you are exposed to cold air;
• cover your skin, head, and face when you are outside in cold temperatures;
• wear gloves when handling cold objects or refrigerated foods;
• do not run an air conditioner at a very cool temperatures in your home or car (even during hot weather);
• do not drink cold drinks or use ice cubes in drinks;
• do not put ice packs on your body.

Chemotherapy often causes nausea or mouth sores. Do not eat ice chips to ease these discomforts because you will be more sensitive to cold. Talk to your doctor about other ways to treat nausea or mouth sores. You may be given other medications to prevent nausea or vomiting while you are receiving Eloxatin.

Eloxatin can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

Your heart function may need to be checked using an electrocardiogram or ECG (sometimes called an EKG).

SIDE EFFECTS

Oxaliplatin can cause a severe or life-threatening allergic reaction. Some people receiving an Eloxatin injection have had a reaction to the infusion within minutes after the medicine is injected into the vein. Tell your caregiver right away if you feel dizzy, short of breath, confused, sweaty, itchy, or have diarrhea, chest pain, warmth or redness in your face, or feel like you might pass out.

Get emergency medical help if you have signs of an allergic reaction to Eloxatin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• increased sensitivity to cold temperatures and cold objects;
• numbness, tingling, or burning pain that interferes with daily activities;
• severe or ongoing diarrhea or vomiting;
• confusion, change in mental status, vision problems, seizure (convulsions);
• pain or burning when you urinate;
• sudden chest pain or discomfort, wheezing, dry cough, feeling short of breath;
• pain, redness, swelling, or skin changes where the injection was given;
• dehydration symptoms – feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• heart problems – headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
• liver problems – nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• muscle problems – unexplained muscle pain, tenderness, or weakness especially if you also have a fever, unusual tiredness, and dark-colored urine;
• nerve problems – jaw or chest tightness, eye pain, strange feeling in your tongue, problems with speech or swallowing; or
• low blood cell counts – fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.

Common Eloxatin side effects may include:

• nausea, vomiting, diarrhea;
• numbness, tingling, burning pain;
• low blood cell counts;
• abnormal liver function tests;
• mouth sores; or
• Feeling tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

DOSAGE

Usual Adult Dose for Colorectal Cancer:-

85 mg/m2 via IV infusion over 120 minutes every 2 weeks; administered in combination with infusional 5-fluorouracil and leucovorin.

Duration of Therapy:-

• Adjuvant Treatment of Stage III Colon Cancer: Total of 6 months (12 cycles)
• Treatment of Advanced Colorectal Cancer: Until disease progression or unacceptable toxicity

Comments:-

• Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.
• Consult the manufacturer product information for 5-fluorouracil and leucovorin dosing recommendations.

Uses:- 

In combination with infusional 5-fluorouracil and leucovorin:

• Adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor.
• Treatment of advanced colorectal cancer.

PRECAUTIONS

• Before starting Eloxatin treatment, make sure you tell your doctor about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your doctor permits this.
• Do not receive any kind of immunization or vaccination without your doctor’s approval while taking Eloxatin.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Eloxatin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking Eloxatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breastfeed while taking this medication.

SELF-CARE TIPS

• While receiving treatment with Eloxatin: avoid cold temperatures and cold objects.
• Cover your skin, mouth, and nose if you must go outside in cold temperatures.
• Do not drink cold drinks or use ice cubes in drinks.
• Do not put ice or ice packs on your body.
• Other ways to reduce the side effects caused by cold:
• Cover yourself with a blanket while you receive your Eloxatin infusion.
• Do not breathe deeply when exposed to cold air.
• Wear warm clothing in cold weather at all times. Cover your mouth and nose with a scarf, mask, or a pull-down cap (ski cap) to warm the air that goes to your lungs.
• Do not take things from the freezer or refrigerator without wearing gloves.
• Drink fluids warm or at room temperature.
• Always drink through a straw.
• Do not use ice chips if you have nausea or a sore mouth. Call your health care professional.
• Be aware that metals are cold to touch especially in the winter. Wear gloves to touch cold objects including your house door, car door, or mailbox.
• Do not run the air conditioner on high either in the house or car in hot weather.
• If your body gets cold, warm up the affected part with warm water.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your healthcare provider. 
• Wash your hands often.
• Use an electric razor and soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. You should discuss this with your healthcare provider.
• Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine. 
• Acetaminophen or ibuprofen may help relieve discomfort from fever, headache, and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be avoided. You should discuss this with your doctor.
• Get plenty of rest. 
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.