FOLFOX: what to expect

Cliff notes

Drugs in it: Oxaliplatin, 5-FU (fluorouracil), plus leucovorin (a vitamin that helps 5-FU work better).

Typical schedule: Usually every 2 weeks. You get oxaliplatin and leucovorin by IV in the clinic, a quick 5-FU 'push', then a 46-hour 5-FU pump you wear home. Many people get about 12 cycles (around 6 months) after surgery, but your plan may differ.

What to expect: The most talked-about side effect is cold-triggered tingling from oxaliplatin. Diarrhea, nausea, tiredness and mouth sores are also common. 5-FU's FDA label now recommends a DPYD gene test before starting.

Your exact schedule and number of cycles are set by your oncologist and may differ from what's described here.

Side effects to know

📅 Sample 14-day cycle

= 💉 clinic day 1, home pump to day 3. Repeats every 2 weeks. This is an example; follow the schedule your team gives you.

Call your care team now if you have:

Fever of 100.4°F (38°C) or higher, or chills (possible infection when blood counts are low)
Vomiting or diarrhea that won't stop, or you can't keep fluids down
Unusual bleeding or bruising
Shortness of breath or chest pain
Signs of an allergic reaction during or after an infusion: trouble breathing, swelling of the face or throat, hives

Call 911 for trouble breathing, chest pain or signs of stroke.

💬 What experts are saying

OncLive reported on a large trial in people getting FOLFOX for colon cancer. IV calcium and magnesium given around the infusion did not prevent oxaliplatin nerve problems. Telling your team about tingling early, so they can adjust the dose, is still the main tool.

Source: IV Calcium/Magnesium Has No Effect on Oxaliplatin-Induced Neuropathy (OncLive, July 6, 2013)

▶ Watch

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🗣 Patient voices

Watch: What is FOLFOX Chemotherapy? (Survivor Jelena)

Real people sharing their own experiences on YouTube. Everyone's treatment is different; talk with your care team about yours.

❓ Questions to ask your doctor

What is the goal of this treatment for me?
How will we know if it's working?
Which side effects should I call about right away, and what number do I call after hours?
Which medicines, vitamins or supplements should I avoid?
Will this affect my ability to work, drive or care for my family?
What will this cost me, and who can help me with coverage?
How many cycles will I get, and what happens after?

Help paying

See each drug page for programs, or the independent foundations. Infused chemo is usually covered by Medicare Part B; see Medicare and your cancer drugs.

PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
Good Days: Copay help and some travel costs.
NeedyMeds: Free database of assistance programs, open to anyone.

Common questions

FOLFOX vs FOLFIRI: what's the difference?

Both use 5-FU and leucovorin. FOLFOX adds oxaliplatin (known for neuropathy); FOLFIRI adds irinotecan (known for diarrhea). Doctors choose based on your situation and earlier treatments.

What is FOLFOX6?

mFOLFOX6 is a common version of FOLFOX, given every 2 weeks.

How long does FOLFOX take?

The clinic part takes a few hours; the pump runs for about 46 hours.

Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write

Not medical advice. This page is general information to help you talk with your care team. It can't replace advice from your doctor or nurse. If you have a fever of 100.4°F (38°C) or higher during treatment, or any symptom that worries you, call your care team now. In an emergency, call 911.