Side Effect Navigator

⏱ 1–6 hours after infusion; delayed nausea 24–120 hours later

Cisplatin causes the most severe chemotherapy-induced nausea of any drug — rated 90%+ emetogenic without prophylaxis. Carboplatin is moderately emetogenic. Both trigger acute and delayed nausea via serotonin and substance P pathways.

⏱ During or immediately after infusion (oxaliplatin acute); cumulative over months (cisplatin/oxaliplatin chronic)

Oxaliplatin causes a unique acute neuropathy triggered by cold — touching cold objects or drinking cold liquid causes intense tingling/pain. This is temporary. The more serious chronic cumulative neuropathy (numbness, tingling, pain in hands and feet) develops over repeated cycles and can become permanent with cisplatin at high cumulative doses.

⏱ Days 7–14 after cisplatin infusion; cumulative over cycles

Cisplatin is directly toxic to kidney tubules — it accumulates there and damages cells. Carboplatin has much less nephrotoxicity. Oxaliplatin has minimal kidney toxicity. Cisplatin requires aggressive IV hydration before, during, and after infusion to protect the kidneys.

⏱ Nadir (lowest point) Days 10–14; recovery Days 21–28

All platinums reduce bone marrow function, lowering blood cell counts. The nadir (lowest count) occurs around Day 10–14. Low white cells (neutropenia) increases infection risk; low platelets (thrombocytopenia) causes bleeding risk; low red cells (anaemia) causes fatigue.