Oxaliplatin Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Oct 14, 2024.

Applies to oxaliplatin: intravenous powder for solution, intravenous solution.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Receiving this medicine while you are pregnant can harm your unborn baby. If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before starting treatment with this medicine. Female patients should use an effective form of birth control during treatment and for at least 9 months after the last dose. Male patients who have female partners should use effective birth control during treatment and for at least 6 months after the last dose. If you think a pregnancy has occurred while receiving this medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, diarrhea, a fever or chills, hives, hoarseness, itching, lightheadedness or dizziness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive the medicine.

Oxaliplatin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor right away if you start to cough up blood or if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Tell your doctor right away if you have seizures, headache, confusion, vision problems, unusual drowsiness, tiredness, or weakness. These could be symptoms of a serious nervous system problem, called posterior reversible encephalopathy syndrome (PRES).

Check with your doctor right away if you start having cough, fever, or any problems with breathing. These may be signs of a serious lung disease.

Check with your doctor right away if you are having burning, numbness, tingling, or painful sensations in the arms, hands, legs, or feet. These could be symptoms of a condition called peripheral sensory neuropathy.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.

Check with your doctor right away if you have dark urine, fever, muscle cramps or spasms, muscle pain or stiffness, or unusual tiredness or weakness. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.

This medicine may cause dizziness, blurred vision, or other vision problems. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these reactions are especially bothersome, check with your doctor.

Talk with your doctor before using this medicine if you plan to have children. Some men and women who use this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of oxaliplatin

Along with its needed effects, oxaliplatin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking oxaliplatin:

Get emergency help immediately if any of the following symptoms of overdose occur while taking oxaliplatin:

Symptoms of overdose

• agitation
• coma
• cough or hoarseness
• diarrhea
• disorientation
• involuntary, rapid, or rhythmic movement of the eyes
• lack of coordination
• lack of sensation
• lethargy
• paralysis
• respiratory failure
• seizures
• slow or irregular heartbeat
• tremors
• vomiting, profuse

Other side effects of oxaliplatin

Some side effects of oxaliplatin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to oxaliplatin: intravenous powder for injection, intravenous solution.

Nervous system adverse events

• Very common (10% or more): Peripheral sensory neuropathy/paresthesia (92%), pharyngo-laryngeal dysesthesia (38.2%), headache (17%), taste perversion (14%), dizziness (13%), neurosensory reactions (12%), dysgeusia, rigors/tremors
• Common (1% to 10%): Sensory disturbance, neuralgia, neuro NOS (not otherwise specified), vertigo, syncope, ataxia, somnolence, intracerebral bleeding, abnormal tongue sensation
• Rare (less than 0.1%): Dysarthria/aphasia, RPLS/PRES
• Frequency not reported: Vocal cord paralysis, aphonia/dysphonia/hoarseness, trigeminal neuralgia/facial pain, myoclonus, abnormal coordination/abnormal gait, ataxia/balance disorders
• Postmarketing reports: Loss of deep tendon reflexes, Lhermitte's sign, cranial nerve palsies, fasciculations, convulsion^[Ref]

Hematologic

• Very common (10% or more): Anemia (85.2%), leukopenia (85%), neutropenia (82.2%), granulocytopenia (78.9%), thrombocytopenia (77.4%), fever without neutropenia (33%), infection - normal ANC (10%)
• Common (1% to 10%): Leukopenia, infection - low ANC, lymphopenia, febrile neutropenia, immune-allergic thrombocytopenia prolongation of prothrombin time and INR, neutropenic sepsis
• Rare (less than 0.1%): Autoimmune hemolytic anemia
• Postmarketing reports: Hemolytic uremic syndrome^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (74%), diarrhea (67%), vomiting (54.1%), stomatitis/mucositis (44%), abdominal pain (33%), constipation (32%), anorexia (29%), dyspepsia (14%), diarrhea - colostomy (13%)
• Common (1% to 10%): Gastrointestinal NOS (not otherwise specified), flatulence, dry mouth, rectal bleeding, rectal pain, rectal hemorrhage, gastrointestinal reflux, ascites, hemorrhoids, melena, proctitis, intestinal obstruction, gingivitis, tenesmus, enlarged abdomen, vaginal hemorrhage
• Frequency not reported: Gastrointestinal bleeding
• Postmarketing reports: Colitis, Clostridium difficile diarrhea, ileus, pancreatitis^[Ref]

Other

• Very common (10% or more): Fatigue (70.3%), infection (31.6%), fever (29%), asthenia (23.4%), edema (15%), pain (15%), peripheral edema (10%)
• Common (1% to 10%): Death, catheter infection, chest pain, unknown infection, feeling of chest pressure
• Uncommon (0.1% to 1%): Ototoxicity
• Postmarketing reports: Deafness, septic shock^[Ref]

Dermatologic

• Very common (10% or more): Alopecia (67%), skin disorder (35.5%), sweating (12%), hand-foot syndrome (11%), rash (11%)
• Common (1% to 10%): Pruritus, dry skin, nail changes, pigmentation changes, urticaria, erythematous rash, purpura^[Ref]

Hepatic

• Very common (10% or more): Increased transaminases (57%), abnormal alkaline phosphatase (56.5%), abnormal AST (54%), abnormal ALT (36%), bilirubinemia (20%)
• Postmarketing reports: Liver veno-occlusive disease/sinusoidal obstruction syndrome, perisinusoidal fibrosis^[Ref]

Respiratory

• Very common (10% or more): Cough (35%), dyspnea (20%), epistaxis (16%), rhinitis (15%), allergic rhinitis (10%), upper respiratory tract infection (10%)
• Common (1% to 10%): Hiccups, pneumonitis, other pulmonary reaction, hypoxia, pharyngitis, hemoptysis, pneumonia, bronchospasm
• Rare (less than 0.1%): Acute interstitial lung disease, pulmonary fibrosis
• Frequency not reported: Throat tightness/pressure/discomfort/pain
• Postmarketing reports: Laryngospasm, other interstitial lung diseases^[Ref]

Metabolic

• Very common (10% or more): Anorexia (35%), hyperglycemia (14%), hypokalemia (11%), decreased weight (11%), increased weight (10%)
• Common (1% to 10%): Dehydration, hypoalbuminemia, hyponatremia, hypocalcemia, elevated creatinine, other metabolic reactions
• Postmarketing reports: Metabolic acidosis^[Ref]

Musculoskeletal

• Very common (10% or more): Back pain (19%), myalgia (14%), arthralgia (10%)
• Common (1% to 10%): Bone pain, muscle weakness, involuntary muscle contractions, jaw spasm/muscle spasm/muscle contractions
• Frequency not reported: Muscle twitching
• Postmarketing reports: Rhabdomyolysis^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (13%)
• Common (1% to 10%): Depression, anxiety, nervousness^[Ref]

Hypersensitivity

• Very common (10% or more): Hypersensitivity reaction (12%), allergic reaction (10.3%)
• Postmarketing reports: Angioedema, anaphylactic shock^[Ref]

Local

• Very common (10% or more): Injection site reaction (11.1%)
• Frequency not reported: Extravasation^[Ref]

Cardiovascular

• Very common (10% or more): Flushing (10%)
• Common (1% to 10%): Thrombosis/phlebitis, thromboembolism, hypotension, hypertension, tachycardia, hot flashes
• Postmarketing reports: QT prolongation, ventricular arrhythmias, Torsade de Pointes^[Ref]

Genitourinary

• Common (1% to 10%): Abnormal micturition frequency, dysuria, hematuria, urinary incontinence^[Ref]

Ocular

• Common (1% to 10%): Conjunctivitis, abnormal lacrimation, abnormal vision, tearing
• Rare (less than 0.1%): Optic neuritis
• Frequency not reported: Ptosis, diplopia, eye pain
• Postmarketing reports: Decreased visual acuity, visual field disturbance/disorders, transient/reversible vision loss^[Ref]

Oncologic

• Common (1% to 10%): Secondary malignancies^[Ref]

Renal

• Common (1% to 10%): Altered renal function
• Very rare (less than 0.01%): Renal tubular necrosis
• Postmarketing reports: Acute interstitial nephritis, acute renal failure^[Ref]

See also:

Frequently asked questions

• What is FOLFIRINOX regimen​ and how is it used?
• What is the FOLFOX chemo regimen and is it effective?
• What is the CAPOX chemotherapy regimen?
• What is the FLOT chemotherapy regimen and how does it work?
• How long does oxaliplatin stay in your system?
• How many cycles of oxaliplatin can you have?

Further information

Oxaliplatin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer