Common side effects
Many people have one or more of the following side effects when having FOLFOX
- Fatigue – for some people this is the most troublesome side effect of all. Tiredness often carries on after the treatment has ended. Most people find that their energy levels can take at least 6 months to recover sometimes longer.
- Numbness or tingling in the fingers and toes happens to nearly everyone having oxaliplatin and is usually worse if you are cold. You may have trouble doing up buttons, for example. This can come on a few days or a few weeks after treatment and usually goes away within a few months of the treatment finishing
- Feeling or being sick happens to about 7 out of every 10 (70%) people who are treated with oxaliplatin, but is usually well controlled with anti sickness drugs
- Temporary drop in bone marrow function leads to the following side effects
- Increased risk of getting an infection. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. A low white blood count means that you are unable to fight infections and can become very unwell. You may have headaches, aching muscles, cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should urgently contact your doctor if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow and is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice your gums bleed after brushing your teeth.
- Pain in the vein during the infusion of oxaliplatin or folinic acid. Sometimes the drugs may need to be given more slowly
- Soreness and redness of the palms of the hands and soles of the feet (sometimes doctors call this ‘hand and foot syndrome’ or ‘palmar-plantar’ syndrome)
- Diarrhoea happens to 6 out of 10 people (60%) - tell your doctor if it becomes severe, if you cannot drink to replace the lost fluid or if it carries on for more than 3 days. Your doctor may give you anti diarrhoea medicine to take home with you after chemotherapy
- Sore mouth happens to 4 out of 10 people (40%)
- This drug may have a harmful effect on a baby that is developing in your womb. It is not advisable to become pregnant or father a child if you are having this drug. You should talk about contraception with your doctor before having the treatment
- Loss of fertility - we don’t know exactly what effect these drugs may have on your fertility. It is important to talk with your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may be temporary.
Occasional side effects
Some people may have one or more of these side effects
- Sensitivity to sunlight - you should not sit out in the sun if you are having this chemotherapy: cover up or use a sun block
- Brown marking on the skin following the line of the vein where the chemotherapy has been injected
- Hair thinning
- Brittle, chipped and ridged nails
- Gritty eyes, blurred vision or watery eyes from increased production of tears
Rare side effects
A few people have one or more of these side effects
- Difficulty swallowing or breathing - this only happens in 1 or 2 people out of every 100 treated (1 to 2%) because the oxaliplatin affects the nerves to your throat. It is usually triggered by cold weather and can happen in the first 5 days after you have the oxaliplatin infusion. Although this usually clears up on its own, you must tell your doctor if you have this side effect.
- Ringing in the ears (tinnitus) - happens in about 1 in 100 people (1%) treated and usually gets better after your treatment is finished
- Allergic reactions happen to about 1 in every 100 people (1%) treated while the oxaliplatin is going into your blood stream. Tell your nurse if your face goes red,or have an itchy rash, feel faint or feel short of breath. Your nurse will watch for signs of allergic reaction while you are having the treatment.
