Generic Name: oxaliplatin
Product Name: Eloxatin
Indication: What Eloxatin is used for
Eloxatin is used to treat cancer of the oesophagus/stomach, large intestine and rectum (colorectal cancer). Eloxatin is used in combination with other anti-cancer drugs: capecitabine, bevacizumab, epirubicin, fluorouracil (FU), and/or folinic acid.
Your doctors have decided to treat you with Eloxatin because they believe that the benefit of Eloxatin treatment will be greater than the unwanted effects.
Many of the side effects of anticancer drugs are predictable and can be prevented or lessened. Your doctor and other staff will take all of the precautions needed to reduce the unwanted effects of treatment.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
Eloxatin is only available on a prescription from your doctor.
Action: How Eloxatin works
The active ingredient in Eloxatin is called oxaliplatin.
Cancer cells are normal cells which have changed so that they grow in an uncontrolled way. Oxaliplatin works by interfering with cancer cell growth. Because of the similarities between cancer cells and normal cells, anticancer drugs often have unwanted effects on the body.
Oxaliplatin is an antineoplastic drug. Studies on the mechanism of action of oxaliplatin, although not completely elucidated, show that the aqua-derivatives resulting from the biotransformation of oxaliplatin interact with DNA to form both inter- and intra-strand cross-links, resulting in the disruption of DNA synthesis leading to cytotoxic and anti-tumour effects.
Each Eloxatin vial contains the active ingredient, oxaliplatin 50 mg, 100 mg or 200 mg.
The concentrated solution for injection also contains water for injections.
Dose advice: How to use Eloxatin
Before you are given Eloxatin
When you must not receive it
You should not be given Eloxatin if you are allergic to the active ingredient ‘oxaliplatin’. If you have had an allergic reaction to oxaliplatin before, you should not receive it again.
Some of the symptoms of an allergic reaction may include:
- Shortness of breath;
- Wheezing or difficulty breathing;
- Swelling of the face, lips, tongue or other parts of the body;
- Rash, itching or hives on the skin.
You must not receive Eloxatin if you are pregnant or breastfeeding. Oxaliplatin may cause birth defects if you are being treated with it at the time of conception or it is given to women who are already pregnant. Adequate contraception is required during treatment with oxaliplatin. You should discuss this with your doctor. Nursing mothers are advised not to breastfeed while receiving oxaliplatin, as the effect of breast milk from such patients is unknown.
You must not be given Eloxatin if you have a blood disorder with a reduced number of platelets or white blood cells.
You must not be given Eloxatin if you have nerve damage such as numbness or weakness of the arms or legs (neuropathy).
You must not receive Eloxatin if you have severe kidney disease.
Eloxatin is not recommended in children. The safety and effectiveness in children have not been established.
What you should tell your doctor
You must tell your doctor if
- You have had a reaction to any other platinum compound;
- You have severe kidney disease;
- You have nerve damage (neuropathy);
- You have any other medical condition that they are not aware of;
- You are taking any other medicines, including medicines that you have bought without a prescription from a pharmacy, supermarket or health food shop.
Your doctor or pharmacist can tell you what to do if you are taking any of these medicines.
How Eloxatin is given
Eloxatin will be given to you as an infusion into one of your veins (this is called an intravenous infusion). The infusion will be given over 2-6 hours.
The dose of Eloxatin is calculated according to your body surface area, which is calculated from your weight and height. The usual dose is 85 mg/m2 every two weeks, or 130 mg/m2 every three weeks. Your doctor may change the dose in some circumstances.
Each course of treatment is called a cycle; your doctor will tell you how many cycles you will receive.
Eloxatin will be used with one or more of the following drugs: capecitabine, bevacizumab, epirubicin, fluorouracil (FU) and/or folinic acid. Your doctor will select the appropriate combination of drugs for your treatment.
While you are being given Eloxatin
Things you must do
Keep all of your doctor’s appointments so that your progress can be checked.
Tell all the doctors, dentists and pharmacists who are treating you that you are being given Eloxatin.
If you are about to be started on any new medicine, tell your doctor or pharmacist that you are being given Eloxatin.
If you become pregnant while you are being given Eloxatin, tell your doctor immediately.
Avoid cold foods and drinks and cover skin prior to exposure to cold during or within 48 hours following being given oxaliplatin, since neurological effects (such as numbness or weakness of the arms and legs or, difficulty swallowing) may be brought on or worsened by exposure to cold.
Contact your doctor immediately if you develop fever, particularly in association with persistent diarrhoea or evidence of infection since this may indicate low blood count.
Tell your doctor if you notice any bruising or abnormal bleeding, or have an infection. These may be signs of a low blood count.
Contact your doctor if persistent vomiting, diarrhoea, signs of dehydration, cough or breathing difficulties or signs of allergic reaction occur.
Things to be careful of
Be careful driving or operating machinery until you know how Eloxatin affects you.
Visual disturbance is a rare side effect of Eloxatin. Contact your doctor if this happens to you, and do not drive or use machinery until your vision is clear.
If you receive too much (overdose)
Your doctor will decide what dose of Eloxatin you need, and this will be given under close supervision, usually in a hospital setting. The risk of an overdosage in these circumstances is low. In the event of an overdose occurring, your doctor will decide on the treatment necessary.
If you need to store Eloxatin before you take it with you to the hospital, make sure it is stored in a cool dry place where the temperature does not exceed 30°C. Do not freeze.
Do not use it after the expiry date (EXP) printed on the vial.
If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.
Schedule of Eloxatin
Eloxatin is a prescription only medicine (Schedule 4).
Side effects of Eloxatin
Tell your doctor or nurse as soon as possible if you do not feel well while Eloxatin is being given to you. You should also tell your doctor if you do not feel well between courses of Eloxatin.
All medicines can have side effects. It is important to understand the side effects that Eloxatin may cause, even though you may not experience them. As well as the predictable side effects of Eloxatin, there are other effects that occur much more rarely.
If you have any side effects or notice anything unusual it is important to inform your doctor before your next treatment. Your doctor will decide whether such effects are because of your treatment, and what action needs to be taken.
This section explains the side effects of Eloxatin, and some of the checks made before each treatment to prevent excessive side effects.
- Physical condition:
- Before each treatment with Eloxatin, you will be examined for any condition that may be affected by chemotherapy (for example, infection, or loss of feeling). This will include those conditions caused by previous treatment, those caused by your disease, and those caused by other things;
- Loss of feeling:
- Eloxatin can affect nerves in the hands and feet. This is common soon after treatment and can appear as tingling or numbness in the fingers or toes, and may be made worse by cold temperatures or by contact with cold water or other cold objects. These symptoms often go away between treatments but may last longer and get worse with repeated treatment. In some patients, the limbs may become weak or painful. However, in most patients these symptoms improve after treatment is stopped;
- Tell your doctor if any of these things happen. Your doctor will examine you before treatment to see if you are affected;
- Nausea and vomiting:
- Severe nausea and vomiting are uncommon with Eloxatin. Mild nausea and vomiting is more common. Medication to prevent the sickness caused by Eloxatin will be given before treatment, and may sometimes be continued after treatment;
- Severe diarrhoea may occur during treatment with Eloxatin;
- If you suffer from persistent or severe diarrhoea or vomiting, contact your doctor urgently for treatment advice;
- Low blood counts:
- Eloxatin can affect the body’s ability to make blood cells. There are three types of blood cells checked before each treatment: platelets, which help control bleeding; white blood cells, which help fight infection; and red blood cells which move oxygen around the body. If your blood count is too low, your treatment may be postponed, or the dose reduced;
- Difficulty swallowing:
- Some patients may experience a sudden, temporary feeling of difficulty with swallowing or breathing. This sensation, if it occurs, usually happens during the infusion or within hours after the infusion. It may be triggered by swallowing a cold drink. Although unpleasant, this feeling does not last long, and goes away by itself;
- Tell your doctor if this happens to you.
Tell your doctor, nurse or pharmacist if you notice any of the following and they worry you:
- Abdominal pain;
- Mild hair loss (alopecia);
- Inflammation around the injection site;
- Tiredness or unusual weakness;
- Runny or blocked nose;
- Altered taste;
- Nose bleeds;
- Voice disturbance (rare);
- Loss of hearing (rare);
- Lightheadedness or dizziness;
- Jaw spasm;
- High blood pressure;
- Back pain;
- Joint pain.
Tell your doctor, nurse or pharmacist as soon as possible if you notice any of the following:
- Sore lips or mouth;
- Mouth ulcers;
- Skin rash or hives;
- Abnormal tongue sensation;
- Lung disorders (rare);
- Visual disturbance (rare);
- Infection in the body (symptoms include lightheadness, tiredness, fever, feeling unwell);
- Abnormal clotting followed by abnormal bleeding;
- Duodenal stomach ulcer, which may cause abdominal pain;
- Headaches or confusion, particularly if associated with visual disturbances.
Tell your doctor, nurse or pharmacist immediately, and go to your nearest Accident and Emergency centre if you notice any of the following:
- Allergic reactions;
- Swelling of the face, lips, mouth, touch or throat;
- Chest pain or feeling of chest pressure;
- Abnormal changes to your heart rate;
- Difficulty breathing;
- Breakdown of muscle tissue causing muscle fibres to be released into the blood. Symptoms include dark, red urine, decreased urine output, muscle stiffness or aching;
- Shortness of breath and looking pale;
- Serious lung infections. Symptoms include fever, chills, shortness of breath, and a cough which produces yellow-green phlegm and occasionally blood;
- Convulsions, fits or seizures;
- Vomiting blood or material that looks like coffee grounds;
- Bleeding from the back passage, black sticky bowel motions (stools) or bloody diarrhoea.
These are very serious side effects. You may need urgent medical attention or hospitalisation.
Some of these side effects (for example, changes in liver or kidney function, changes in blood pressure, changes in blood glucose or calcium levels) can only be found when your doctor does tests from time to time to check your progress.
Other side effects not listed above may also occur in some patients. Tell your doctor if you notice anything else that is making you feel unwell.
For further information talk to your doctor.