A platinum chemotherapy
Oxaliplatin
A platinum chemotherapy given by drip, mainly for bowel cancer, usually with fluorouracil.
What is Oxaliplatin?
Oxaliplatin is a platinum-based chemotherapy given as a drip into a vein, used mainly for bowel cancer, usually combined with another chemotherapy called fluorouracil. It works by damaging the DNA inside cancer cells so they cannot divide. Its most distinctive side effect is nerve sensitivity triggered by cold — for a few days after treatment, cold drinks, cold air and touching cold objects can cause unpleasant tingling or even a sense of difficulty swallowing, so it helps to avoid the cold. It also causes longer-lasting numbness and tingling, lowers blood counts and can cause nausea, and a fever must always be reported urgently.
Education and reference only. This is a plain-language guide to Oxaliplatin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Oxaliplatin is a platinum-based cancer chemotherapy given as an infusion (a drip) into a vein in a chemotherapy unit, as part of a planned course of several cycles. It is used mainly for bowel (colorectal) cancer, very often in combination with another chemotherapy medicine, fluorouracil, and sometimes for other cancers of the digestive system. Treatment is always started and supervised by a cancer specialist.
How it works
Oxaliplatin contains platinum, which binds to and damages the DNA inside cells. This damage stops cancer cells from copying themselves and dividing, so the cancer is slowed or shrunk. Because some healthy cells divide quickly too, they can be affected, which causes side effects such as low blood counts and nausea. The platinum also irritates nerves, which is why cold can trigger sharp tingling sensations and why longer-term numbness can build up over the course of treatment.
Company & origin
Originated / developed by: Generic (specialist cancer medicine).
A platinum-based chemotherapy given as a drip in UK cancer units, mainly for bowel cancer, started and supervised by a cancer specialist.
Practical use
How to take Oxaliplatin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by a nurse as a drip into a vein in a chemotherapy unit, often alongside fluorouracil; you do not take it at home.
- For the first few days after each treatment, avoid cold drinks, cold food and cold air, and do not touch cold objects with bare hands.
- Drink warm or room-temperature fluids and wrap up well in cold weather to ease the cold-triggered tingling.
- Keep your chemotherapy helpline number with you and ring it at once if you feel feverish or unwell between treatments.
- Tell your team early if numbness or tingling in your hands or feet lingers or worsens, as the dose can be adjusted.
Weighing it up
Advantages & disadvantages of Oxaliplatin
Advantages
- An effective chemotherapy for bowel cancer, especially combined with fluorouracil.
- Given in planned cycles so treatment and recovery can be balanced.
- Many side effects, such as low blood counts, recover between cycles.
Disadvantages
- Causes distinctive cold-triggered nerve sensations for a few days after each treatment.
- Can cause longer-lasting numbness and tingling that may persist after treatment.
- Lowers blood counts and can cause nausea, raising the risk of infection.
Practical use
Good to know
The hallmark of oxaliplatin is cold sensitivity. For roughly the first few days after each treatment, anything cold — iced drinks, food from the fridge, cold air on your face and hands, or cold metal — can cause unpleasant tingling or pins and needles, and some people feel a strange tightness when swallowing cold things. This is not dangerous but is uncomfortable, so it helps to drink warm or room-temperature fluids, wear gloves and a scarf in cold weather, and avoid the freezer. Over the course, a longer-lasting numbness and tingling in the hands and feet (peripheral neuropathy) can develop and is important to report early, as the dose can be adjusted. As with other chemotherapy, it lowers the white blood cells that fight infection, so a temperature, shivering or feeling very unwell — especially in the days after treatment — can mean neutropenic sepsis, a medical emergency; ring your chemotherapy helpline straight away. Chemotherapy can affect fertility, so discuss this before starting; avoid pregnancy or fathering a child during treatment, and avoid live vaccines.
Who should not take it / use with caution
- People who have had a serious allergic reaction to oxaliplatin or other platinum chemotherapy.
- It is generally not started when blood counts are too low, a serious infection is present, or there is significant existing nerve damage, until reviewed.
- It is avoided in pregnancy and breastfeeding, and used with care in kidney problems.
Monitoring
- Regular blood tests before each cycle to check blood counts, kidney and liver function.
- Checking for nerve symptoms, both the cold-triggered tingling and any longer-lasting numbness, so the dose can be adjusted.
- Watching during infusions for any allergic reaction, which can develop after several cycles.
Side effects
- Cold-triggered tingling in the hands, mouth and throat for a few days after treatment.
- Longer-lasting numbness or tingling in the hands and feet, which can build up over the course.
- Low blood counts (raising the risk of infection, bruising and anaemia) — report fever urgently — plus nausea and diarrhoea.
Key interactions
- Other treatments that lower blood counts add to the risk, so the whole programme is planned together.
- It is usually combined with fluorouracil, and the team plans the medicines to work together safely.
- Live vaccines should be avoided; tell your team about all medicines, including over-the-counter and herbal products.
Available as: An infusion (drip) into a vein, given in a chemotherapy unit, often with fluorouracil.
Answers
Oxaliplatin: frequently asked questions
Why do cold drinks hurt or tingle after treatment?
Oxaliplatin makes the nerves very sensitive to cold for a few days after each treatment; cold drinks, food and air can cause tingling or a tight feeling when swallowing. It is uncomfortable but not dangerous.
How long does the cold sensitivity last?
It is usually worst in the first few days after each treatment and then settles; sticking to warm or room-temperature drinks and wrapping up in the cold helps a lot.
What is the difference between the cold tingling and longer-term numbness?
The cold-triggered tingling comes and goes around each treatment, while a longer-lasting numbness in the hands and feet can build up over the course; report the latter early as the dose can be adjusted.
What should I do if I get a fever?
Treat it as urgent. A temperature can mean a serious infection because your white cells are low, so ring your chemotherapy helpline straight away at any time.
Why is oxaliplatin given with another chemotherapy?
It is commonly combined with fluorouracil for bowel cancer because the two medicines work well together; your specialist plans the combination for your situation.
The wider class
About Chemotherapy (platinum)
Oxaliplatin belongs to the chemotherapy (platinum) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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