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Oxaliplatin side effects: what 73,749 FDA adverse event reports show

Oxaliplatin · 1,227 reaction terms · 230,553 drug–reaction co-reports · data 2026-09-14
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Drug class

Platinum-based Drug

FDA label (Established Pharmacologic Class) · compare the class

Who reports

73,749 reports · 97% serious · 10,724 with death outcome · 41% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Oxaliplatin injection USP, in combination with infusional fluorouracil and leucovorin, is indicated for: adjuvant treatment of stage III colon cancer in patients who have undergone complete resection of the primary tumor. treatment of advanced colorectal cancer.

FDA label, Indications and Usage

What it is

Oxaliplatin is a platinum-based drug with the molecular formula C 8 H 14 N 2 O 4 Pt and the chemical name of cis -[(1 R ,2 R )-1,2-cyclohexanediamine- N , N ′] [oxalato(2-)- O , O ′] platinum..

FDA label, Description section

Boxed warning

HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS Serious and fatal hypersensitivity adverse reactions, including anaphylaxis, can occur with oxaliplatin injection within minutes of administration and during any cycle.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled — boxed warning 1Labeled adverse reaction 4Labeled (related wording) 3Likely indication confounding 1Reporting / coding artifact 1Lab value / disease marker 2Not in label — unassessed 28
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,187 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Monocyte chemotactic protein-1 increased334,612.8
1,106.9–19,223.4ROR 4,614.9 · calibrated p 8e-14 ✓
229.5 EB05 171.0 · IC025 +5.2
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Lab value / disease markerserious n=33 · ♀ 0% (drug 41%)no trial arm names this drug
Stomal varices50698.9
416.1–1,173.8ROR 699.4 · calibrated p 6e-14 ✓
186.2 EB05 146.8 · IC025 +5.6
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=50 · ♀ 0% (drug 41%) · 100% clinicianno trial arm names this drug
Dysaesthesia pharynx115554.3
404.3–760.0ROR 555.2 · calibrated p 7e-14 ✓
180.9 EB05 154.8 · IC025 +6.4
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=115 · ♀ 69% (drug 41%) · 100% clinicianno trial arm names this drug
Type ii hypersensitivity56260.9
181.3–375.5ROR 261.1 · calibrated p 1e-10 ✓
129.6 EB05 103.5 · IC025 +5.5
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=56 · 100% clinicianno trial arm names this drug
Ductal adenocarcinoma of pancreas110189.8
149.0–241.8ROR 190.1 · calibrated p 1e-9 ✓
111.3 EB05 94.9 · IC025 +5.9
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=110 · 92% clinicianno trial arm names this drug
Non-cirrhotic portal hypertension144187.2
151.6–231.2ROR 187.6 · calibrated p 1e-9 ✓
110.9 EB05 96.5 · IC025 +6.1
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=144 · ♀ 65% (drug 41%) · 100% clinicianno trial arm names this drug
Alpha tumour necrosis factor increased33153.8
100.6–235.1ROR 153.8 · calibrated p 2e-8 ✓
94.3 EB05 70.2 · IC025 +4.8
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Lab value / disease markerserious n=33 · ♀ 0% (drug 41%)no trial arm names this drug
Tumour perforation91117.8
92.2–150.5ROR 117.9 · calibrated p 5e-8 ✓
81.8 EB05 68.6 · IC025 +5.5
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=91 · 97% clinicianno trial arm names this drug
Colorectal cancer metastatic52584.7
76.8–93.4ROR 85.3 · calibrated p 4e-7 ✓
65.1 EB05 60.5 · IC025 +5.8
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Likely indication confounding
shares a disease stem with the indications wording
serious n=523 · 94% clinicianno trial arm names this drug
Gastrointestinal anastomotic leak8274.9
58.7–95.6ROR 75.0 · calibrated p 1e-6 ✓
58.5 EB05 48.6 · IC025 +5.1
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=81 · 100% clinicianno trial arm names this drug
Dihydropyrimidine dehydrogenase deficiency4371.1
50.9–99.4ROR 71.2 · calibrated p 2e-6 ✓
55.6 EB05 43.0 · IC025 +4.6
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=43 · 90% clinicianno trial arm names this drug
Anastomotic leak12361.0
50.2–74.1ROR 61.1 · calibrated p 5e-6 ✓
49.9 EB05 42.9 · IC025 +5.1
3/3 methods agree
vs other Platinum-based Drugs: PRR 2.9 (2.2–3.8)
Not in label — unassessedserious n=123 · 98% clinicianno trial arm names this drug
Rectal cancer metastatic6059.5
45.0–78.6ROR 59.5 · calibrated p 7e-6 ✓
48.5 EB05 39.1 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=60 · 100% clinicianno trial arm names this drug
Mucosal toxicity4556.2
40.8–77.4ROR 56.2 · calibrated p 1e-5 ✓
46.1 EB05 35.8 · IC025 +4.5
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=45 · 100% clinicianno trial arm names this drug
Hepatectomy5055.7
41.1–75.4ROR 55.7 · calibrated p 1e-5 ✓
45.8 EB05 36.1 · IC025 +4.5
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=50no trial arm names this drug
Nodular regenerative hyperplasia11454.2
44.4–66.2ROR 54.3 · calibrated p 1e-5 ✓
45.2 EB05 38.7 · IC025 +4.9
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Labeled adverse reaction
exact term
serious n=112 · ♀ 64% (drug 41%) · 100% clinicianno trial arm names this drug
Evans syndrome7552.4
41.0–67.1ROR 52.5 · calibrated p 1e-5 ✓
43.8 EB05 36.1 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=75 · 100% clinicianno trial arm names this drug
Focal nodular hyperplasia8151.6
40.7–65.4ROR 51.6 · calibrated p 1e-5 ✓
43.3 EB05 35.9 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Labeled adverse reaction
exact term
serious n=81 · 100% clinicianno trial arm names this drug
Arteriospasm coronary59150.0
45.8–54.6ROR 50.4 · calibrated p 1e-5 ✓
42.5 EB05 39.7 · IC025 +5.2
3/3 methods agree
vs other Platinum-based Drugs: PRR 12.8 (10.3–16.0)
Not in label — unassessedserious n=591 · 99% clinicianno trial arm names this drug
Laryngospasm39248.3
43.4–53.8ROR 48.6 · calibrated p 2e-5 ✓
41.3 EB05 38.0 · IC025 +5.1
3/3 methods agree
vs other Platinum-based Drugs: PRR 13.8 (10.4–18.2)
Labeled adverse reaction
exact term
serious n=390 · ♀ 75% (drug 41%) · 98% clinicianno trial arm names this drug
Xeroderma3238.1
26.3–55.1ROR 38.1 · calibrated p 1e-4 ✓
33.0 EB05 24.5 · IC025 +3.9
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=32 · 100% clinicianno trial arm names this drug
Anastomotic complication4137.6
27.1–52.1ROR 37.6 · calibrated p 1e-4 ✓
32.8 EB05 25.2 · IC025 +4.1
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Reporting / coding artifactserious n=41 · ♀ 0% (drug 41%) · 100% clinicianno trial arm names this drug
Rectal perforation6236.8
28.2–48.0ROR 36.8 · calibrated p 1e-4 ✓
32.3 EB05 26.1 · IC025 +4.3
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=62 · 93% clinicianno trial arm names this drug
Diffuse large b-cell lymphoma recurrent23835.4
30.9–40.4ROR 35.5 · calibrated p 1e-4 ✓
31.4 EB05 28.2 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.7 (0.6–0.9)
Not in label — unassessedserious n=238 · 95% clinicianno trial arm names this drug
Venoocclusive liver disease54035.0
32.0–38.3ROR 35.2 · calibrated p 1e-4 ✓
31.2 EB05 29.0 · IC025 +4.8
3/3 methods agree
vs other Platinum-based Drugs: PRR 2.6 (2.3–3.0)
Not in label — unassessedserious n=539 · 99% clinicianno trial arm names this drug
Peripheral sensory neuropathy59232.0
29.4–34.8ROR 32.2 · calibrated p 2e-4 ✓
28.8 EB05 26.9 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: PRR 1.9 (1.7–2.1)
Labeled — boxed warning
exact term
serious n=563 · 96% clinicianno trial arm names this drug
Metastases to ovary3231.8
22.1–45.9ROR 31.8 · calibrated p 3e-4 ✓
28.3 EB05 21.0 · IC025 +3.7
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=32 · ♀ 100% (drug 41%) · 90% clinicianno trial arm names this drug
Dermatitis acneiform60331.4
28.9–34.1ROR 31.6 · calibrated p 2e-4 ✓
28.3 EB05 26.5 · IC025 +4.7
3/3 methods agree
vs other Platinum-based Drugs: PRR 3.3 (2.9–3.8)
Not in label — unassessedserious n=580 · 94% clinicianno trial arm names this drug
Portal hypertension30631.2
27.7–35.1ROR 31.3 · calibrated p 2e-4 ✓
28.1 EB05 25.6 · IC025 +4.6
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Labeled adverse reaction
exact term
serious n=304 · 98% clinicianno trial arm names this drug
Diffuse large b-cell lymphoma refractory8829.6
23.8–36.9ROR 29.7 · calibrated p 3e-4 ✓
26.8 EB05 22.4 · IC025 +4.2
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.6 (0.4–0.7)
Not in label — unassessedserious n=88no trial arm names this drug
Metastases to peritoneum23529.4
25.7–33.6ROR 29.5 · calibrated p 3e-4 ✓
26.6 EB05 23.9 · IC025 +4.4
3/3 methods agree
vs other Platinum-based Drugs: PRR 1.5 (1.3–1.8)
Not in label — unassessedserious n=235 · 90% clinicianno trial arm names this drug
Hyperammonaemic encephalopathy15929.0
24.6–34.2ROR 29.1 · calibrated p 3e-4 ✓
26.3 EB05 23.1 · IC025 +4.3
3/3 methods agree
vs other Platinum-based Drugs: PRR 6.6 (4.8–9.1)
Not in label — unassessedserious n=159 · 100% clinicianno trial arm names this drug
Colon cancer metastatic14528.2
23.7–33.4ROR 28.2 · calibrated p 4e-4 ✓
25.6 EB05 22.3 · IC025 +4.3
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=144 · 91% clinicianno trial arm names this drug
Intravascular haemolysis5028.0
20.9–37.4ROR 28.0 · calibrated p 5e-4 ✓
25.3 EB05 19.9 · IC025 +3.9
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=50 · 100% clinicianno trial arm names this drug
Pseudocirrhosis2927.5
18.8–40.2ROR 27.5 · calibrated p 6e-4 ✓
24.8 EB05 18.1 · IC025 +3.5
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=29 · 100% clinicianno trial arm names this drug
Rectal adenocarcinoma5227.0
20.3–35.9ROR 27.0 · calibrated p 6e-4 ✓
24.5 EB05 19.4 · IC025 +3.9
3/3 methods agree
vs other Platinum-based Drugs: only this drug
Not in label — unassessedserious n=52no trial arm names this drug
Paronychia36826.4
23.7–29.3ROR 26.5 · calibrated p 5e-4 ✓
24.1 EB05 22.1 · IC025 +4.4
3/3 methods agree
vs other Platinum-based Drugs: PRR 3.5 (2.9–4.1)
Not in label — unassessedserious n=360 · 95% clinicianno trial arm names this drug

Trial evidence (ClinicalTrials.gov)

ClinicalTrials.gov returned results-bearing trials mentioning Oxaliplatin only as a background or rescue medication (NCT00112918, NCT00079274); no trial listing it as the tested intervention was cached, so no trial cross-check is shown.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Diarrhoea (diarrhea)6,8703.1
3.0–3.1ROR 3.3 · calibrated p 0.545
3.0 EB05 3.0 · IC025 +1.6
3/3 methods agree
vs other Platinum-based Drugs: PRR 1.4 (1.3–1.4)
Labeled adverse reaction
exact term
serious PRR 3.1 · 93% clinicianno trial arm names this drug
Nausea5,4802.0
1.9–2.0ROR 2.1 · calibrated p 0.977
2.0 EB05 1.9 · IC025 +0.9
vs other Platinum-based Drugs: PRR 0.9 (0.9–0.9)
Labeled adverse reaction
exact term
serious PRR 2.2 · 93% clinicianno trial arm names this drug
Off label use (used outside approved label)4,6681.5
1.5–1.6ROR 1.6 · calibrated p 0.686
1.5 EB05 1.5 · IC025 +0.6
vs other Platinum-based Drugs: PRR 0.6 (0.6–0.7)
Reporting / coding artifactserious PRR 1.6no trial arm names this drug
Vomiting4,4152.7
2.6–2.8ROR 2.8 · calibrated p 0.694
2.7 EB05 2.6 · IC025 +1.4
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.9 (0.9–0.9)
Labeled adverse reaction
exact term
serious PRR 2.3 · 94% clinicianno trial arm names this drug
Neuropathy peripheral (nerve damage in hands/feet)4,31713.6
13.2–14.0ROR 14.3 · calibrated p 0.008 ✓
13.0 EB05 12.7 · IC025 +3.6
3/3 methods agree
vs other Platinum-based Drugs: PRR 2.2 (2.1–2.3)
Labeled — boxed warning
synonym match
serious PRR 8.9 · 92% clinicianno trial arm names this drug
Disease progression4,31410.8
10.4–11.1ROR 11.4 · calibrated p 0.020 ✓
10.4 EB05 10.1 · IC025 +3.3
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.8 (0.8–0.8)
Reporting / coding artifactserious PRR 7.0 · 95% clinicianno trial arm names this drug
Neutropenia (low neutrophils (infection-fighting cells))4,2069.1
8.8–9.4ROR 9.6 · calibrated p 0.037 ✓
8.8 EB05 8.6 · IC025 +3.1
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.7 (0.7–0.7)
Labeled — boxed warning
exact term
serious PRR 5.4 · 95% clinicianno trial arm names this drug
Thrombocytopenia (low platelets)3,5259.3
9.0–9.6ROR 9.7 · calibrated p 0.036 ✓
9.0 EB05 8.7 · IC025 +3.1
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.7 (0.7–0.8)
Labeled — boxed warning
exact term
serious PRR 5.5 · 96% clinicianno trial arm names this drug
Dyspnoea (shortness of breath)3,0841.6
1.5–1.6ROR 1.6 · calibrated p 0.692
1.6 EB05 1.5 · IC025 +0.6
vs other Platinum-based Drugs: PRR 0.8 (0.8–0.9)
Labeled adverse reaction
exact term
serious PRR 1.2 · 94% clinicianno trial arm names this drug
Fatigue (tiredness)2,8221.0
1.0–1.1ROR 1.0 · calibrated p 0.329
1.0 EB05 1.0 · IC025 -0.0
PRR-only: not supported by EBGM or IC
vs other Platinum-based Drugs: PRR 0.8 (0.7–0.8)
Labeled adverse reaction
exact term
serious PRR 1.1no trial arm names this drug
Anaemia (low red blood cells)2,4253.6
3.5–3.8ROR 3.7 · calibrated p 0.430
3.6 EB05 3.5 · IC025 +1.8
3/3 methods agree
vs other Platinum-based Drugs: PRR 0.4 (0.4–0.4)
Labeled adverse reaction
exact term
serious PRR 2.3 · 95% clinicianno trial arm names this drug
Asthenia (weakness)2,3601.8
1.7–1.9ROR 1.8 · calibrated p 0.839
1.8 EB05 1.7 · IC025 +0.8
vs other Platinum-based Drugs: PRR 0.8 (0.8–0.8)
Not in label — unassessedserious PRR 1.5 · 92% clinicianno trial arm names this drug
Death2,3140.8
0.7–0.8ROR 0.8 · calibrated p 0.159
0.8 EB05 0.7 · IC025 -0.5
PRR-only: not supported by EBGM or IC
vs other Platinum-based Drugs: PRR 0.7 (0.6–0.7)
Outcome field, not a reaction
boxed warning mentions mortality
serious PRR 0.5 · 90% clinicianno trial arm names this drug
Drug ineffective (drug did not work)2,1470.5
0.4–0.5ROR 0.4 · calibrated p 0.033 ✓
0.5 EB05 0.4 · IC025 -1.2
PRR-only: not supported by EBGM or IC
vs other Platinum-based Drugs: PRR 0.6 (0.5–0.6)
Reporting / coding artifactserious PRR 0.8 · 96% clinicianno trial arm names this drug

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Oxaliplatin ↔ Peripheral neuropathy.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Oxaliplatin?

In FDA FAERS, the most frequently co-reported reaction terms for Oxaliplatin are diarrhoea, nausea, vomiting, neuropathy peripheral, neutropenia, thrombocytopenia. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Oxaliplatin have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS Serious and fatal hypersensitivity adverse reactions, including anaphylaxis, can occur with oxaliplatin injection within minutes of administration and during any cycle.

Do FAERS signals prove that Oxaliplatin causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.