Cisplatin

Cisplatin is used in the treatment of ovarian, cervical and testicular cancer. It shows its working by stopping or slowing down the growth of cancer cells. Cisplatin is given as an injection into veins by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. Injection site reaction (pain, swelling, redness), nausea and vomiting are some common side effects of this medicine. Hearing problem or ear damage is serious side effect of this medicine, hence your doctor might check you for hearing test before and after the treatment. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and kidney.

Cisplatin is an anti-cancer medication. It works by damaging the genetic material (DNA and RNA) of the cancer cells which stops their growth and multiplication.

• Metastatic Testicular Tumors
• Metastatic Ovarian Tumors
• Advanced Bladder Cancer
• Non-Small Cell Lung Carcinoma
• Cervical Cancer

Cisplatin is a platinum compound of which only the cis-isomer is active. It appears to produce intra-and interstrand cross links which modify DNA structure and inhibit DNA synthesis. In addition and to a lesser extent Cisplatin inhibits protein and RNA synthesis. It does not appear to be phase-specific in the cell cycle.

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.

Metastatic Testicular Tumors: 20 mg/m²/day IV for 5 days/cycle (in combination with other chemotherapeutic agents).

Advanced Bladder Cancer: 50-70 mg/m² IV every 3-4 weeks.

Metastatic Ovarian Carcinoma: 75-100 mg/m² IV every 4 weeks (in combination with cyclophosphamide).

Non-Small Cell Lung Carcinoma: 75 mg/m² (in combination with Paclitaxel) every 3 weeks.

Renal Dose: CrCl 10-50 mL/min: Decrease dose 50%; CrCl <10 mL/min: Contraindicated.

Your doctor or nurse will give you this medicine. Kindly do not self-administer. Administer by slow intravenous infusion. Should not be given by rapid intravenous injection. Do not use needles or IV sets containing aluminum parts (aluminum reacts with Cisplatin causing precipitate formation and loss of potency).

If you miss a dose of Cisplatin, please consult your doctor.

Common Side Effects:

• Injection site reactions (pain, swelling, redness)
• Increased risk of infection
• Ear disorders (hearing loss, tinnitus)
• Vomiting
• Nausea
• Decreased blood cells (red cells, white cells, and platelets)
• Renal impairment (kidney damage)
• Peripheral neuropathy (tingling and numbness of feet and hand)
• Electrolyte disturbances (hypomagnesemia, hypocalcemia, hypokalemia)

Serious Side Effects: Ototoxicity, nephrotoxicity, neurotoxicity, severe bone marrow suppression.

• [UNSAFE] Cisplatin may cause side effects which could affect your ability to drive. Sleepiness and/or vomiting could affect your ability to drive.
• Renal function: Monitor creatinine, BUN, and electrolytes. Hydrate with 1-2 L fluid before treatment and ensure adequate hydration.
• Bone marrow function: Monitor complete blood counts frequently.
• Hearing function: Perform audiometry prior to therapy and repeat when symptoms occur.
• CNS functions: Neurologic examination warranted; discontinue if neurotoxic signs appear.
• Contraindicated during pregnancy and lactation.

• Pre-existing renal impairment
• Hypersensitivity
• Myelosuppressed patients
• Hearing impairment
• Pregnancy and lactation

Nephrotoxicity potentiated with aminoglycosides. Concomitant use of Amphotericin B is not recommended. Increased risk of ototoxicity with aminoglycosides or loop diuretics. Serum concentrations of phenytoin may be decreased (reduced absorption/increased metabolism). Dosage adjustment of antigout agents may be needed (increased uric acid).

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Cisplatin. Please consult your doctor.

[CONSULT YOUR DOCTOR] Cisplatin is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor. Pregnancy Category D.

[UNSAFE] Cisplatin is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby. Cisplatin has been reported to be found in human milk.

Safety and efficacy in pediatric patients have not been fully established.

Limited information is available regarding dose adjustment for elderly patients.

[CAUTION] Cisplatin should be used with caution in patients with kidney disease. Dose adjustment of Cisplatin may be needed. Please consult your doctor. Use of Cisplatin is not recommended in patients with severe kidney disease. CrCl 10-50: Decrease dose 50%; CrCl <10: Contraindicated.

[SAFE IF PRESCRIBED] Cisplatin is probably safe to use in patients with liver disease. Limited data available suggests that dose adjustment may not be needed.

Acute overdosage may result in kidney failure, liver failure, deafness, ocular toxicity (including retinal detachment), significant myelosuppression, intractable nausea and vomiting and/or neuritis. Death can occur following overdosage. No proven antidotes have been established. Hemodialysis has little effect on removing platinum from the body.

Store the vial in original carton at 25°C. Do not refrigerate. Protect from light and keep out of reach of children.

Cisplatin