Glenoxal
Glenoxal Uses, Dosage, Side Effects, Food Interaction and all others data.
Glenoxal, a platinum-containing complex similar to cisplatin, is an alkylating agent. After intracellular hydrolysis, the platinum compound binds to DNA forming cross-links which inhibit DNA replication and transcription, resulting in cell death.
Glenoxal selectively inhibits the synthesis of deoxyribonucleic acid (DNA). The guanine and cytosine content correlates with the degree of Glenoxal-induced cross-linking. At high concentrations of the drug, cellular RNA and protein synthesis are also suppressed.
| Trade Name | Glenoxal |
| Availability | Prescription only |
| Generic | Oxaliplatin |
| Oxaliplatin Other Names | Diaminocyclohexane Oxalatoplatinum, L-OHP, Oxalatoplatin, Oxalatoplatinum, Oxaliplatin, oxaliplatine, oxaliplatino, oxaliplatinum |
| Related Drugs | Tagrisso, Tarceva, Tabrecta, Gilotrif, Paraplatin, Keytruda, capecitabine, pembrolizumab, Avastin, Xeloda |
| Type | Injection |
| Formula | C8H14N2O4Pt |
| Weight | Average: 397.294 Monoisotopic: 397.060149 |
| Protein binding | Plasma protein binding of platinum (active metabolite) is irreversible and is greater than 90%, primarily to albumin and gamma-globulins. It is also irreversibly binds to erythrocytes. |
| Groups | Approved, Investigational |
| Therapeutic Class | Cytotoxic Chemotherapy |
| Manufacturer | Glenmark Pharmaceuticals |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Glenoxal, used in combination with infusional 5-fluorouracil/leucovorin, is used for:
- Adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor.
- Treatment of advanced colorectal cancer.
Glenoxal is also used to associated treatment for these conditions: Advanced Colorectal Cancer, Advanced Ovarian Cancer, Advanced Pancreatic Cancer, Chronic Lymphocytic Leukemia (CLL) - Refractory, Colon Cancer Stage III, Esophageal Cancers, Malignant Neoplasm of Stomach, Advanced biliary adenocarcinoma, Refractory Neuroendocrine Tumour, Refractory Non-Hodgkin's lymphoma, Refractory Testicular cancer
How Glenoxal works
Glenoxal undergoes nonenzymatic conversion to active derivatives via displacement of the labile oxalate ligand. Several transient reactive species are formed, including monoaquo and diaquo DACH platinum, which covalently bind with macromolecules. After activation, oxaliplatin binds preferentially to the guanine and cytosine moieties of DNA, leading to cross-linking of DNA, thus inhibiting DNA synthesis and transcription. Cytotoxicity is cell-cycle nonspecific.
Dosage
Glenoxal dosage
Intravenous (Adult)-
Adjuvant therapy in stage III colon cancer: In combination with fluorouracil/ leucovorin: 85 mg/m2 every 2 wk for 12 cycles. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, every 2 wk; given for 12 cycles. After recovery from toxicity, reduce dose to 75 mg/m2. Administer before fluoropyrimidines.
Advanced colorectal cancer: In combination with fluorouracil/ leucovorin: 85 mg/m2 every 2 wk until disease progression or unacceptable toxicity. Dose to be given by IV infusion over 2-6 hr, dissolved in 250-500 ml of glucose 5%, . After recovery from toxicity, reduce dose to 65 mg/m2. Administer before fluoropyrimidines.
Reconstitute with 10 ml (for 50 mg vial) or 20 ml (for 100 mg vial) water for inj or 5% dextrose inj. Reconstituted solution must be further diluted with 250-500 ml of 5% dextrose inj before admin.
Side Effects
Fatigue, fever, pain, headache, insomnia, nausea, diarrheoa, vomiting, abdominal pain, constipation, anorexia, stomatitis, anemia, thrombocytopenia, leukopenia, aspartate and alanine transaminases increased, total bilirubin increased, peripheral neuropathy, back pain, dyspnoea, cough, oedema, chest pain, peripheral oedema, flushing , thromboembolism, dizziness, rash, alopecia , hand-foot syndrome dehydration, hypokalaemia, dyspepsia, taste perversion, flatulence, mucositis, gastroesophageal reflux, dysphagia, dysuria, neutropenia, inj site reaction, rigors, arthralgia, abnormal lacrimation, serum creatinine increased, rhinitis, epistaxis, pharyngitis, pharyngolaryngeal dysesthesia, allergic reactions, hiccup.
Toxicity
There have been five cases of oxaliplatin overdose reported. One patient received two 130 mg/m2 doses of oxaliplatin (cumulative dose of 260 mg/m2) within a 24-hour period. The patient experienced Grade 4 thrombocytopenia (3) without any bleeding, which resolved. Two other patients were mistakenly administered oxaliplatin instead of carboplatin. One patient received a total oxaliplatin dose of 500 mg and the other received 650 mg. The first patient experienced dyspnea, wheezing, paresthesia, profuse vomiting and chest pain on the day of administration. She developed respiratory failure and severe bradycardia, and subsequently did not respond to resuscitation efforts. The other patient also experienced dyspnea, wheezing, paresthesia, and vomiting. Most common adverse reactions (incidence ≥ 40%) were peripheral sensory neuropathy, neutropenia, thrombocytopenia, anemia, nausea, increase in transaminases and alkaline phosphatase, diarrhea, emesis, fatigue and stomatitis.
Precaution
Should be administered under the supervision of an experienced cancer chemotherapy physician. Use appropriate precautions for handling and disposal. Monitor neurological status and dose should be reduced if symptoms are prolonged or severe. Monitor blood counts during treatment and courses should not be repeated until blood counts have recovered. Caution in elderly, moderate degrees of renal impairment. Avoid using aluminum-containing needles or IV admin sets that may come into contact with oxaliplatin as aluminum has been reported to cause degradation of platinum compounds.
Interaction
May decrease plasma levels of digoxin. May increase risk of toxicity with nephrotoxic drugs. When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before oxaliplatin to limit myelosuppression and enhance efficacy.
Food Interaction
No interactions found.Glenoxal Drug Interaction
Moderate: palonosetron, prochlorperazine, loperamide, polyethylene glycol 3350, pegfilgrastim, capecitabine, ondansetronUnknown: lorazepam, bevacizumab, diphenhydramine, docusate, dexamethasone, apixaban, fentanyl, omega-3 polyunsaturated fatty acids, acetaminophen, acetaminophen, cyanocobalamin, ascorbic acid, cholecalciferol
Glenoxal Disease Interaction
Major: arrhythmias, pulmonary toxicityModerate: neurologic toxicity, neutropenia, renal impairment, rhabdomyolysis, thrombocytopenia
Volume of Distribution
- 440 L [single 2-hour IV infusion at dose of 85 mg/m^2] At the end of a 2-hour infusion of oxaliplatin, approximately 15% of the administered platinum is present in the systemic circulation. The remaining 85% is rapidly distributed into tissues or eliminated in the urine.
Elimination Route
Bioavailability is complete following intravenous administration. When a single 2-hour intravenous infusion of oxaliplatin at a dose of 85 mg/m^2 is given, the peak serum concentration was 0.814 mcg/mL.
Half Life
The decline of ultrafilterable platinum levels following oxaliplatin administartion is triphasic, with two distribution phases: t1/2α; 0.43 hours and t1/2β; 16.8 hours. This is followed by a long terminal elimination phase that lasts 391 hours (t1/2γ).
Clearance
- 10 - 17 L/h [renal clearance]
Elimination Route
The major route of platinum elimination is renal excretion. At five days after a single 2-hour infusion of oxaliplatin, urinary elimination accounted for about 54% of the platinum eliminated, with fecal excretion accounting for only about 2%.
Pregnancy & Breastfeeding use
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Contraindication
Pregnancy. Peripheral neuropathy with functional impairment. Severe renal impairment.
Special Warning
Renal Impairment: Dose adjustment may be needed
Acute Overdose
Extensions of known adverse reaction (e.g. thrombocytopenia, myelosuppression, nausea, vomiting, neurotoxicity, respiratory symptoms). Treatment is supportive.
Storage Condition
Store intact vials at 15-30°C; do not freeze. Reconstituted solution: May store at 2-8°C for up to 24 hr. Diluted solutions: Stable up to 6 hr at 20-25°C or up to 24 hr under refrigeration at 2-8°C.
Innovators Monograph
You find simplified version here Glenoxal
Glenoxal contains Oxaliplatin see full prescribing information from innovator Glenoxal Monograph, Glenoxal MSDS, Glenoxal FDA label
FAQ
What is Glenoxal used for?
Glenoxal is a cancer medication used to treat colorectal cancer. Often it is used together with fluorouracil and folinic acid (leucovorin) in advanced cancer.
How safe is Glenoxal?
While Glenoxal has only mild hematologic and gastrointestinal side effects, its dose-limiting toxicity is a cumulative sensory neurotoxicity that resembles that of cisplatin with the important difference of a more rapid and complete reversibility.
How does Glenoxal work?
Glenoxal interferes with the development of DNA in a cell. This stops it from dividing into 2 new cells and kills it.
What are the common side effects of Glenoxal?
Common side effects of Glenoxal are include: Diarrhea, changes in taste, mouth sores, nosebleeds, tiredness, headache, dizziness, or trouble sleeping. Nausea and vomiting may be severe in some patients. Your doctor may prescribe medication to prevent or relieve nausea and vomiting.
Is Glenoxal safe during pregnancy?
During pregnancy is contraindicated. Use of this drug is not recommended during pregnancy, especially during the first trimester, based on the results of animal studies and the pharmacological action of this drug.
Is Glenoxal safe during breastfeeding?
The manufacturer recommends that women should not breastfeed during treatment with Glenoxal injection and for 3 months after the final dose.
Can I drink alcohol Glenoxal?
The drinking of alcohol (in small amounts) does not appear to affect the safety or usefulness of Glenoxal. It is best to use birth control while being treated with Glenoxal.
Can I drive after taking Glenoxal?
This Glenoxal can cause dizziness, vision problems or vision loss. You should not drive or operate machinery until you know how the medication affects you.
When should be taken of Glenoxal?
You should take them within 30 minutes of finishing a meal.
How often can I take Glenoxal?
You usually take the tablets twice a day, about 12 hours apart.
How effective is Glenoxal?
The introduction of Glenoxal was associated with no significant improvement in the slopes (per half-year) of the three-year disease-free survival rate (0.2%, 95% CI: −1.7∼2.2%) and five-year overall survival rate (0.6%, 95% CI: −1.8∼3%).
How long does Glenoxal stay in my system?
The first elimination half-life (t1/2) for cisplatin was 5.02 months and the second 37.0 months. For Glenoxal, these half-lifes were 1.37 and 535 months.
How long can I take Glenoxal?
Each cycle lasts 3 weeks (21 days). Depending on your needs, you may have between 4 and 8 cycles.
Will I lose my hair with Glenoxal?
You could lose all your hair.
Can Glenoxal cause liver damage?
There are an increasing number of reports indicating that Glenoxal-based chemotherapy can cause liver damage (1–5). Glenoxal-induced liver damage is characterized histologically by sinusoidal dilatation, hepatocyte atrophy and/or fibrosis and venular obstruction.
Can Glenoxal cause cancer?
In cancer survivors, neuropathy induced by Glenoxal has a deleterious impact on their quality of life.
Who should not take Glenoxal?
A patient who is producing milk and breastfeeding. muscle pain or tenderness with increase creatine kinase. a type of brain disorder called posterior reversible encephalopathy syndrome. chronic kidney disease stage 4.
What happens if I miss a dose?
Contact your doctor if you miss an appointment for your oxaliplatin injection.
Can Glenoxal cause heart damage?
Glenoxal is able to induce coronary vasoconstriction leading to acute but reversible heart failure.
What happens if I overdose?
Seek emergency medical attention.
Can Glenoxal affect my kidneys?
Glenoxal is an experimental anti-cancer drug that can shrink tumors such as colon cancer. However, because this drug can damage the kidneys, it is necessary to determine what doses of the drug can safely be given to patients with poor kidney function.
Can Glenoxal affects my heart ?
Glenoxal is able to induce coronary vasoconstriction leading to acute but reversible heart failure.
Will Glenoxal affect my fertility?
The risk for infertility and hypogonadism in males and females after adjuvant oxaliplatin-based chemotherapy seems to be low to moderate, but the general recommendation of appropriate fertility conserving measures shall should not be changed.
