Oxaliplatin Side Effects

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

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

Important warnings This medicine can cause some serious health issues

Intravenous route (solution; powder for solution)

Hypersensitivity Reactions, including Anaphylaxis. Serious and fatal hypersensitivity adverse reactions, including anaphylaxis, can occur with oxaliplatin within minutes of administration and during any cycle.

Oxaliplatin is contraindicated in patients with hypersensitivity reactions to oxaliplatin and other platinum-based drugs.

Immediately and permanently discontinue oxaliplatin for hypersensitivity reactions and administer appropriate treatment.

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:

More common side effects

• abnormal tongue sensation
• black, tarry stools
• bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• bleeding gums
• blistering, peeling, redness, or swelling of the palms of the hands or bottoms of the feet
• blood in the urine or stools
• burning, prickling, itching, or tingling of the skin
• chest pain
• chills
• cough
• decreased urination
• difficulty performing daily activities such as writing, buttoning, swallowing, or walking
• difficulty with articulating words
• difficulty with breathing
• difficulty with moving
• difficulty with swallowing
• dizziness
• dry mouth
• eye pain
• fainting
• fever
• increase in heart rate
• jaw spasm
• lightheadedness
• lower back or side pain
• muscle pain or stiffness
• numbness or painful sensations
• pain in the chest, groin, or legs, especially the calves
• pain in the joints
• painful or difficult urination
• pale skin
• pinpoint red spots on the skin
• rapid breathing
• sensation of pins and needles
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• stabbing pain
• sunken eyes
• swelling
• swelling or inflammation of the mouth
• swollen glands
• thirst
• trouble breathing with exertion
• unsteadiness or awkwardness
• unusual bleeding or bruising
• unusual tiredness or weakness
• vision changes
• wrinkled skin

Less common side effects

• chest tightness
• fast heartbeat
• hives, itching, or skin rash
• increased thirst
• irregular heartbeat
• loss of appetite
• mood changes
• nausea or vomiting
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

Incidence not known

• back, leg, or stomach pains
• blindness
• bloated stomach
• blue-yellow color blindness
• blurred vision
• changes in patterns and rhythms of speech
• dark urine
• deafness
• decreased vision
• deep breathing
• drowsiness
• electric shock-like sensation that moves down the back and into the legs following a bending movement of the neck
• general body swelling
• increased urination
• irregular heartbeat, recurrent
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• loss of deep tendon reflexes
• muscle cramps or spasms
• muscle tremors
• pain and fullness in the right upper abdomen or stomach
• restlessness
• severe constipation
• severe diarrhea
• severe nosebleeds
• severe stomach cramps or tenderness
• severe vomiting
• trouble with speaking
• twitches of the muscle visible under the skin
• weakness of the muscles in your face
• weight gain
• yellow eyes or skin

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:

More common side effects

• acid or sour stomach
• belching
• body aches or pain
• ear congestion
• feeling unusually cold, shivering
• headache
• heartburn
• indigestion
• loss of voice
• nasal congestion
• runny nose
• sneezing
• stomach discomfort, upset, or pain
• trouble sleeping
• weight loss

Less common side effects

• bad, unusual, or unpleasant (after) taste
• bloated or full feeling
• bloody nose
• burning while urinating
• change in taste
• congestion
• cracked lips
• dryness or soreness of the throat
• excess air or gas in stomach or intestines
• feeling of warmth
• hair loss
• passing gas
• rapid weight gain
• redness of the face, neck, arms, and occasionally upper chest
• tender, swollen glands in the neck
• thinning of the hair
• unusual tearing of the eyes
• voice changes

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]

Frequently asked questions

• 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