Cisplatin

Indications
 Intravenous
Metastatic ovarian cancer
Adult: As monotherapy: 100 mg/m2 per cycle, given as a single dose infused in 0.9% sodium chloride or glucose once every 4 wk. For combination therapy with cyclophosphamide: 75-100 mg/m2 on day 1 of every 4-wk cycle.
Child:
Renal impairment: Dose adjustment may be needed.
Intravenous
Metastatic testicular tumours
Adult: 20 mg/m2 BSA daily for 5 days per cycle.
Renal impairment: Dose adjustment may be needed.
Intravenous
Advanced bladder cancer
Adult: 50-70 mg/m2 per cycle once every 3-4 wk, depending on the extent of prior exposure to radiation and/or chemotherapy treatment. An initial dose of 50 mg/m2 every 4 wk may be used in heavily pre-treated patients.
Renal impairment: Dose adjustment may be needed.

Incompatibility: Y-site incompatibility: Thiotepa, cefepime, amphotericin B, amifostine, piperacillin/tazobactam, cholesteryl sulfate complex. Admixture incompatibility: Mesna, thiotepa, fluorouracil.
Contraindications
 Patients with severe renal or auditory disorder, known hypersensitivity, severe bone marrow suppression, peripheral neuropathy, pregnancy, lactation.
Warnings / Precautions
 Patients with renal or hepatic disorder, myelosuppression. Monitor renal, neurological and auditory function. Perform blood counts regularly. Maintain adequate hydration before and 24 hr after admin to minimise nephrotoxicity.
Adverse Reactions
 Severe nausea and vomiting. Serious toxic effects on the kidneys, bone marrows and ears. Hypomagnesaemia, hypocalcaemia, hyperuricaemia. Peripheral neuropathies, papilloedema, optic neuritis, seizures. Ototoxicity (children) manifested as tinnitus, loss of hearing, deafness or vestibular toxicity.
Potentially Fatal: Rarely, renal damage due to inadequate hydration during therapy. Very rarely life-threatening myelosuppression. Anaphylactoid reactions (rare) and cardiac abnormalities.
Overdose Reactions
 Acute overdosage may result in kidney failure, liver failure, deafness, ocular toxicity, significant myelosuppression, intractable nausea and vomiting and/or neuritis. Death may also occur following overdosage. Treatment should include general supportive measures.
Drug Interactions
 Synergistic with 5-fluorouracil and etoposide. Efficacy increased and toxicity reduced when combined with radioprotecting agent WR 2721. At doses ≤100 mg, cisplatin is an ideal drug to combine with other cytotoxic drugs; unlike other antineoplastic drugs, it causes little myelosuppression.
Potentially Fatal: Potentiates nephrotoxicity with aminoglycosides. Increased toxicity when combined with other cytotoxic drugs.
See Below for More cisplatin Drug Interactions
Mechanism of Actions
 Cisplatin modifies cell cycle by interfering with DNA structure and function. Effects are most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs e.g. fluorouracil. It has a narrow therapeutic margin and is highly toxic.
Absorption: Well absorbed (intraperitoneal).
Distribution: Concentrated in the liver, kidneys, large and small intestines; poor penetration into the CNS.
Excretion: Urine. Elimination half-life: 25-49 min (initial), 58-73 hr (terminal).
Storage Conditions
 Intravenous: Store at 15-25°C.
ATC Classification
 L01XA01 - cisplatin ; Belongs to the class of platinum-containing antineoplastic agents. Used in the treatment of cancer.
Storage
 Intravenous: Store at 15-25°C.
Available As
  • Cisplatin 0.5 mg
  • Cisplatin 1 mg

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    Cisplatin is used in following diseases

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