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Drug information (i. Anti-infectives, ii. cytostatics, iii. others)
Calcium gluconate and magnesium sulphate in the prevention of sensory neurotoxicity associated with the use of oxaliplatin
  1. M.P. Quesada Sanz,
  2. B. Marmesat Rodas,
  3. E. Márquez Fernández,
  4. J.J. Ramos Báez,
  5. M. Gallego Galisteo
  1. 1Hospital Punta Europa, Pharmacy, Algeciras, Spain


Background The use of calcium and magnesium reduces both the incidence and time of development of peripheral sensory neurotoxicity, oxaliplatin-limiting toxicity.

Purpose To determine the effectiveness of calcium gluconate and magnesium sulphate in preventing sensory neurotoxicity associated with the use of oxaliplatin.

Materials and methods Retrospective observational study of patients diagnosed with colorectal cancer treated with oxaliplatin + 5-fluorouracil (5-FU) and calcium folinate or capecitabine plus oxaliplatin for the years 2009-2010, with oxaliplatin treatments of 85 mg/m2 every 14 days or 130 mg/m2 every 21 days, respectively. All received 1 gram of calcium gluconate and 1.5 grams of magnesium sulphate of 15% diluted in 250 ml glucose 5% before and after oxaliplatin administration. In all cases, the oxaliplatin infusion time was 2 h. Symptoms of chronic or cumulative sensory neurotoxicity (SNT), graduated according to the scale of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE v3). The primary end point was the percentage of patients with grade 2 or higher SNT at any time during or after oxaliplatin-based therapy.

Results The authors included 48 patients. The mean age was 63.62 years (50% men and 50% women). The primary tumour was colon in 70.8% of cases (33.3% adjuvant and 37.5% metastatic) and rectum in 29.1% (16.7% adjuvant and 12.5% metastatic). A total of 33 patients received oxaliplatin regimens of 85 mg/m2 every 14 days, while 15 patients received oxaliplatin regimens of 130 mg/m2 every 21 days. 12.5% patients (6/26) presented SNT=2 (none grade > 2), with a mean cumulative dose (±SD) of 878.33±205.88 (mg/m2) and an average of 10.33±2.42 cycles received. In 83.3% (5/6) of cases was necessary to reduce the dose of oxaliplatin administered.

Conclusions The low incidence of SNT=2 or higher (6 patients and none, respectively) of our study support the neuroprotective activity of the Ca/Mg.

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