Handout 5: Reversible Nerve-related Side Effects: Acute Neuropathy

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During or after your ELOXATIN (oxaliplatin injection) infusion, you may experience feelings of tingling, numbness, or pain in the fingers, toes, or around the mouth. This side effect is called acute neuropathy.1,2 Jaw spasm, abnormal tongue sensation, dysarthria, eye pain, and a feeling of chest pressure have also been observed.

Acute neuropathy may occur within hours of infusion or within a couple of days of treatment with ELOXATIN (oxaliplatin injection). It will resolve within 14 days, but will frequently occur again during or after a later treatment.2

Protect Yourself From Cold

Acute neuropathy may occur or be made worse by exposure to cold or cold objects. Avoid cold drinks and the use of ice, and cover your exposed skin before you are exposed to cold temperatures or cold objects.

The cold can cause or worsen these symptoms, so the less you are in contact with the cold, the better.

Here are some ways you can help reduce the side effects caused by cold temperatures2

  • Cover yourself with a blanket while you are getting your ELOXATIN infusion
  • Do not breathe deeply when exposed to cold air
  • Wear warm clothing in cold weather at all times. Cover your mouth and nose with a scarf or a pull-down cap (ski cap) to warm the air that goes to your lungs
  • Wear gloves when taking things from the freezer or refrigerator
  • Drink fluids warm or at room temperature
  • Always drink through a straw
  • Do not use ice chips if you have nausea or mouth sores. Ask your nurse about what you can use
  • Be aware that most metals are cold to touch, especially in the winter. These include your car door and mailbox. Wear gloves to touch cold objects
  • Do not run the air-conditioning at high levels in the house or in the car in hot weather
  • If your body gets cold, warm-up the affected part. If your hands get cold, wash them with warm water
  • Always let your nurse and doctor know before your next treatment how well you did since your last visit

This list is not complete and your healthcare provider may have other useful tips for helping you with these side effects.

A Less Common Side Effect1,2,3

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With another form of acute neuropathy, you may feel like you have trouble breathing or swallowing. This may be temporary and can happen during or within hours of treatment, or up to 14 days after. Other symptoms can include trouble talking, tightness in the jaw, chest pressure, or odd feelings in the tongue.Warming up the mouth and throat may help resolve these sensations—you can hold your hands over your mouth to warm the air.

Always tell a nurse or other health-care provider if you feel like you are having trouble breathing or swallowing. They can make sure your airway is clear, and can offer you something that may soothe your symptoms, like a scarf or a hot drink to reduce the cold.

Because of side effects, your doctor may change your treatment in any of these ways:

  • Give ELOXATIN (oxaliplatin injection) for a longer treatment time
  • Give a lower dose of ELOXATIN (oxaliplatin injection)
  • Discontinue ELOXATIN (oxaliplatin injection)

Important Safety Information

Anaphylactic-like reactions to ELOXATIN have been reported and may occur within minutes of ELOXATIN administration. Epinephrine, corticosteroids, and antihistamines have been employed to alleviate symptoms.

  • Do not take ELOXATIN if you are allergic to any of the ingredients in ELOXATIN or other medicines that contain platinum. Tell your doctor right away if you feel like your throat is closing up, have shortness of breath, a flushed face, a rash, itching/hives, swelling of lips or tongue, sudden cough, dizziness, sweating or chest pain.
  • ELOXATIN can cause nerve problems. Tell your doctor right away if you become sensitive to cold temperatures and cold objects; have trouble breathing, swallowing or saying words; experience jaw tightness, odd feelings in your tongue, or chest pressure; pain; tingling or burning in your hands, feet or around your mouth or throat.
  • Tell your doctor if you develop a dry cough or have trouble breathing; these may be signs of serious lung disease.
  • ELOXATIN can cause liver problems (hepatotoxicity); your doctor will do blood tests to watch for this.
  • Because of the potential risk of fetal harm, pregnant women should not receive ELOXATIN. Women of childbearing potential should avoid becoming pregnant while receiving ELOXATIN.
  • ELOXATIN can cause a decrease in white blood cells, which can lead to infections. Tell your doctor right away if develop any of the following signs of infection: fever, chills, or shivering; cough that brings up mucus, burning or pain on urination, pain on swallowing; sore throat; or redness or swelling at injection site.
  • Other common side effects of ELOXATIN include a decrease in white blood cells, red blood cells, and platelets, nausea, vomiting, diarrhea, and tiredness.
  • Tell your doctor about all the medications you take, including prescription and non-prescription medications, vitamins and herbal supplements.

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of ELOXATIN. For more information, ask your doctor or pharmacist.

Please click here for full prescribing information including boxed WARNING ».

References:

  1. Pazdur R, Royce M. Myths & Facts About Colorectal Cancer. Oncology Group. 1998.
  2. ELOXATIN® (oxaliplatin injection) prescribing information, Sanofi US.
  3. Wilkes, GM. Colorectal Cancer Drugs and Treatment. Sudbury, Massachusetts: Jones and Bartlett Publishers; 2005.

WARNING: ANAPHYLACTIC REACTIONS

Anaphylactic-like reactions to ELOXATIN have been reported and may occur within minutes of ELOXATIN administration. Epinephrine, corticosteroids, and antihistamines have been employed to alleviate symptoms.
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INDICATIONS

ELOXATIN® (oxaliplatin injection), used in combination with infusional 5-FU/LV, is indicated for

  • Adjuvant treatment of stage III colon cancer patients who have undergone complete resection of the primary tumor.
  • Treatment of advanced carcinoma of the colon or rectum.
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