According to the World Health Organization (WHO), adverse reactions are classified according to their frequency of development as follows: very often (≥ 1/10), often (≥1/100, <1/10), infrequently (≥1/1000, <1/100), rarely (≥1/10000, <1/1000) and very rarely (<1/10000); frequency is unknown - according to available data, it was not possible to establish the frequency of occurrence.
On the part of the blood and lymphatic system
very often: anemia, leukopenia, neutropenia, thrombocytopenia, lymphopenia;
often: febrile neutropenia (including grade 3-4), sepsis against neutropenia;
rarely: granulocytopenia, hemolytic anemia, immune thrombocytopenia.
From the nervous system
very often: peripheral sensory neuropathy, sensitivity disorders, headache, asthenia, taste disorders;
often: dizziness, meningism, depression, insomnia;
infrequently: increased nervousness;
rarely: dysarthria, reverse reversible leukoencephalopathy syndrome.
Neurotoxicity is a dose-limiting factor. Often the symptoms of sensory neuropathy are provoked by cold. The duration of these symptoms, which are usually docked in the interval between courses, increases depending on the total dose of oxaliplatin. Functional disorders in the form of difficulty in performing precise movements are possible consequences of sensory damage. The risk of functional disorders for a total dose of about 850 mg / m2 (10 cycles) is about 10%, reaching 20% in the case of a total dose of 1020 mg / m2 (12 cycles). In most cases, the severity of the neurological symptoms weakens or they completely stop.However, 3% of patients within 3 years after treatment were observed localized paresthesia or sustained moderate (2.3%) or paresthesia affecting the functional activity (0.5%). On the background of treatment with oxaliplatin, acute neurosensory manifestations were noted, which usually occurred within a few hours after the administration of the drug and were most often provoked by exposure to cold. They are characterized by transient paresthesia, dysesthesia or hypoesthesia, rare (1-2%), acute syndrome of laryngopharyngeal dysesthesia. Last manifested subjective feeling of dysphagia and dyspnea without objective signs of respiratory distress syndrome (cyanosis or hypoxia) or laryngeal spasm or bronchospasm (no stridor or wheezing). Also observed were such phenomena as spasm of the jaw, dysesthesia of the tongue, dysarthria and a feeling of pressure in the chest. Usually, these symptoms were quickly stopped both without the use of drug therapy, and with the administration of antihistamines and bronchodilators. Increasing the infusion time during subsequent cycles of oxaliplatin therapy can reduce the incidence of this syndrome.
From the side of the organ of vision
often: conjunctivitis, visual impairment;
rarely: transient reduction in severity vision, loss of visual fields, neuritis of the optic nerve.
From the side of the hearing organ and labyrinthine disorders
infrequently: ototoxicity;
Rcaustic: hearing loss, auditory neuritis nerve, deafness.
From the respiratory system of the chest and mediastinum
very often: cough, shortness of breath;
often: rhinitis, infection of the upper respiratory tract, pain in the area chest;
rarely: pulmonary fibrosis, interstitial lung disease, sometimes with development lethal outcome.
From the gastrointestinal tract
very often: nausea, vomiting, diarrhea, stomatitis, mucositis, pain in the abdomen, constipation, loss of appetite;
often: dyspepsia, hiccough, gastroesophageal reflux, bleeding from of the gastrointestinal tract (including rectum);
infrequently: intestinal obstruction, incl. paralytic;
rarely: colitis, including cases pseudomembranous colitis, pancreatitis.
From the liver and biliary tract
very often: increased activity alkaline phosphatase, lactate dehydrogenase "hepatic" enzymes and concentration bilirubin;
very rarely: obliterating endophlebitis hepatic veins, including hepatic purpura. nodular regenerative hyperplasia of the liver, perisinusoidal fibrosis, which can clinically manifest itself in the form of signs of portal hypertension and / or increased activity "hepatic" transaminases.
From the side of the kidneys and urinary tract
often: hematuria, dysuria, change frequency of urination, increase the concentration of creatinine in the blood plasma;
very rarely: hemolytic-uremic syndrome, acute tubular (tubular) necrosis, acute interstitial nephritis, acute renal insufficiency.
From the skin and subcutaneous tissues
very often: alopecia, dermal rashes;
often: peeling of the skin of the palms and feet, erythematous rashes, increased sweating, changes from the nails.
From the musculoskeletal and connective tissue
very often: back pain;
hasto: arthralgia, pain in the bones.
From the side of metabolism and nutrition
very often: anorexia, hyperglycemia, hypokalemia, hypernatremia;
often: dehydration;
infrequently: metabolic acidosis.
From the heart
often: chest pain.
From the side of the vessels
often: deep vein thrombophlebitis, pulmonary embolism, bleeding, increased blood pressure pressure, "tides" of blood to the face.
From the immune system
rarely (with monotherapy) or often (in combination with fluorouracil +/- calcium folinate) can be observed bronchospasm, angioedema, hypotension and anaphylactic shock;
often cases of such allergic manifestations as a skin rash (in especially hives), conjunctivitis or rhinitis.
General disorders and disorders at the site of administration
very often: increased body temperature, increased fatigue, weight gain, asthenia.
When extravasation of the drug - pain and inflammatory reactions at the injection site.