Example orders for mFOLFOX 6 in colon cancer
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Example regimen #1
- Fluorouracil (5-FU) 400 mg/m2 IV bolus over 10-15 minutes on day 1 after oxaliplatin and leucovorin
- Fluorouracil (5-FU) 1200 mg/m2/day (total dose 2400 mg/m2) IV continuous infusion over 46 hours on days 1-2, given after 5-FU bolus
- Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours on day 1, given first, concurrently with oxaliplatin
- Mixed in 250 mL D5W.
- Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours on day 1, given first, concurrently with leucovorin
- Mixed in 500 mL D5W, and only infuse through D5W line.
14-day cycles x 12 cycles, to start within 10 weeks of surgery (if adjuvant); in metastatic settings, given until progression of disease or unacceptable toxicity
- Ondansetron (Zofran) 8 mg IV 30 minutes prior to oxaliplatin
- Dexamethasone (Decadron) 10 mg IV 30 minutes prior to oxaliplatin
- Lorazepam (Ativan) 0.5-1 mg PO prn nausea/anxiety, given 30 minutes prior to chemotherapy
- Calcium gluconate 1 g & magnesium sulfate 1 g (admixed together) IV, given over 30 minutes, to start prior to oxaliplatin to decrease likelihood of neuropathy
- Calcium gluconate 1 g & magnesium sulfate 1 g (admixed together) IV, given over 30 minutes, to start after oxaliplatin infusion is complete to decrease likelihood of neuropathy
- 500 ml D5W at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml D5W.
- Hold if ANC <1500 or platelets <75 and notify physician.