oxaliplatin

CLINICAL USE

Treatment of metastatic colorectal cancer in combination with fluorouracil and folinic acid

DOSE IN NORMAL RENAL FUNCTION

85 mg/m2; can be repeated at intervals of 2 weeks if toxicity permits

PHARMACOKINETICS

Molecular weight :397.3

%Protein binding :331

%Excreted unchanged in urine : 54

Volume of distribution (L/kg) :330 +/– 40.9 litres

half-life – normal/ESRD (hrs) :273/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : No information on use, therefore use with great caution and monitor closely

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAminoglycosides: increased risk of nephrotoxicity and possibly ototoxicity with aminoglycosides, capreomycin, polymyxins or vancomycin

Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)

ADMINISTRATION

Reconstition

Glucose 5% or water for injection to give a concentration of 5 mg/mL

Route

IV infusion

Rate of Administration

2–6 hours

Comments

Dilute with 250–500 mL glucose 5% to a concentration 0.2–0.7 mg/mL

OTHER INFORMATION

No in vitro evidence of cytochrome P450 metabolism. Extensive nonenzymatic biotransformation occurs. Platinum removal is mainly by renal excretion and tissue distribution; platinum metabolites mainly by renal excretion. By day 5, approximately 54% of the total dose was recovered in the urine and <3% in the faeces. Binds irreversibly to red blood cells, which can prolong the half-life of the drugReduced renal clearance and volume of distribution in renal impairment
There is a 38–44% reduction of platinum clearance in mild-moderate renal impairment (GFR=20–39 mL/min) but no increased incidence of side effects has been reported.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

Home