Oxaliplatin is usually given as one of the drugs in FOLFIRINOX to treat locally advanced or advanced pancreatic cancer. It is also combined with leucovorin (folinic acid) and 5-FU in FOLFOX, a second-line treatment for people who have previously had gemcitabine with nab-paclitaxel. Occasionally, it may be given in combination with gemcitabine for advanced pancreatic cancer.
How is oxaliplatin given?
You will have your chemotherapy as an outpatient in the chemotherapy unit at the hospital, which means you will go in for treatment, but won’t need to stay overnight.
Oxaliplatin is usually given as a drip (infusion) through a central line, such as a PICC line, Hickmann line or a portacath.These are tubes that deliver drugs directly into a large vein in your chest, and stay in place for as long as your course of treatment lasts. The infusion lasts two hours.
How is FOLFIRINOX given?
FOLFIRINOX is given in a two-week cycle, and the exact number of cycles you have will depend on your treatment plan. On your first day of treatment, your nurse will give you oxaliplatin as a drip (infusion) over two hours. Read more about how FOLFIRINOX is given.
How is FOLFOX given?
For FOLFOX the usual cycle last two weeks, with the drugs given over the first two days.
- Oxaliplatin is given first and lasts about 90 minutes.
- You will then have an injection of 5-FU, called a bolus.
- This is followed by an infusion of 5-FU, which lasts 46 hours. This is given through a small portable pump attached to a belt, so that you can go home. When it’s finished, the pump is usually disconnected at the hospital, or at home by a trained nurse.
- You will then have a break from chemotherapy for the next 12 days.
How is oxaliplatin given with gemcitabine?
For oxaliplatin with gemcitabine the usual cycle lasts two weeks, with both drugs usually given in the first couple of days. This is followed by a break of 12 days. The number of cycles you have will depend on your treatment plan and how well you respond to the treatment. Talk to your nurse or doctor about your treatment plan.
What are the side effects of oxaliplatin?
Common side effects
- Increased risk of infection. Oxaliplatin can increase your risk of getting an infection, because it can cause a drop in the number of your white blood cells. This means your body is less able to fight infection. Signs of an infection include a high temperature, headaches, aching muscles, a cough, sore throat or feeling shivery and cold.
- Bruising and bleeding. Oxaliplatin can lower the number of platelets in your blood. Platelets are cells that help the blood to clot. You may bruise more easily than normal, have nosebleeds, bleeding gums or tiny red spots on your skin. You may have blood in your urine but this is less common. Speak to your doctor or nurse straight away about any of these side effects, as your dose may need to be reduced.
- Anaemia (low level of red blood cells). Oxaliplatin can lower the number of red blood cells in your blood (anaemia). This can make you feel tired, faint and short of breath. If you are very anaemic, you may need to be given extra red blood cells in a drip (blood transfusion).
- Tingling and numbness in your fingertips and toes (peripheral neuropathy). This is caused by the effect of oxaliplatin on your nerves. It usually improves after treatment finishes, but for some people it may never go away. Talk to your nurse or doctor if you have these symptoms, as the dose of the chemotherapy drug may be stopped or reduced.
- Feeling sick and being sick (nausea and vomiting). This is a common side effect of oxaliplatinbut can be controlled with anti-sickness medication. You will usually be given medication before your chemotherapy starts to help control or prevent sickness. If it doesn’t work, tell your doctor or nurse – you should be able to change the medication. Read more about coping with feeling and being sick.
- Problems swallowing and breathing (laryngeal spasm). Oxaliplatin can affect your throat, which can cause swallowing and breathing problems. This can happen in the first few hours of having oxaliplatin. Cold temperatures can make this worse so try to avoid ice-cold drinks or foods, and wrap up warm if you go out in the cold.
- Loose watery poo (diarrhoea). If you have diarrhoea, make sure you drink plenty of fluids. If you have diarrhoea more than four times a day, tell your doctor or nurse. They may give you medication to control it, or reduce the dose of the chemotherapy drug in future cycles.
- Risk of a blood clot. Oxaliplatin can increase the risk of a blood clot forming in a vein (thrombosis). If you have pain or swelling in one of your legs or arms, or are very short of breath, immediately phone an ambulance or the emergency contact number that you will have been given immediately. A blood clot needs to be treated straight away.
- Allergic reactions. Oxaliplatin may cause an allergic reaction while it’s being given. Signs of this can include a rash, feeling dizzy, or swelling of the face and hands. If this happens tell your nurse or doctor immediately as any allergic reaction will need to be treated straight away.
Less common side effects
- Problems emptying your bowels (constipation). If this happens drink plenty of fluids and try to eat high fibre foods, such as vegetables and fruit. Gentle exercise such as walking can also help. There are medications to help manage constipation.
We haven’t listed every possible side effect of oxaliplatin. Speak to your doctor or nurse for more information if you experience anything unusual. If you are unable to contact your doctor or nurse contact the emergency number that you should have been given by your medical team.
If you have any questions about oxaliplatin or side effects you can also call our specialist nurses free on our Support Line.
More chemotherapy information
- Read more about how chemotherapy is given.
- Read more about managing the main side effects of chemotherapy.
Published May 2017
Review date May 2019