Platinol
Generic Name
Cisplatin PhaRes
Manufacturer
Various Manufacturers
Country
Various
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Description
Overview of the medicine
Cisplatin is a platinum-based chemotherapy drug used to treat various types of cancer. It works by interfering with the DNA of cancer cells, leading to their death.
Uses & Indications
Dosage
Adults
Highly variable depending on cancer type, stage, and combination regimen. Typical doses range from 20 mg/m² daily for 5 days or 100 mg/m² once every 3-4 weeks. Dosing often requires careful calculation based on body surface area (BSA) and renal function.
Elderly
Generally similar to adult dosing, but with careful monitoring of renal function and overall health due to increased risk of toxicity.
Renal_impairment
Dose reduction or delay may be necessary. Not recommended for patients with creatinine clearance less than 50 mL/min; use with extreme caution or alternative treatments considered.
How to Take
Administered intravenously (IV) as an infusion, typically over 6-8 hours, often with extensive pre- and post-hydration to minimize renal toxicity. Must be administered by a healthcare professional experienced in chemotherapy.
Mechanism of Action
Cisplatin forms DNA adducts and interstrand/intrastrand cross-links, inhibiting DNA synthesis and repair. This leads to DNA damage, triggering apoptosis (programmed cell death) in cancer cells. It is cell cycle non-specific.
Pharmacokinetics
Onset
Rapid distribution, cellular uptake begins quickly after infusion.
Excretion
Primarily renal excretion (25-45% within 5 days); some biliary excretion. Impaired renal function significantly reduces clearance.
Half life
Initial plasma half-life of 20-30 minutes for free cisplatin. Terminal half-life of platinum in tissues can be several days to weeks.
Absorption
Complete after intravenous (IV) administration. Rapid distribution to various tissues.
Metabolism
Undergoes non-enzymatic conversion to active and inactive forms. Binds extensively to plasma proteins.
Side Effects
Contraindications
- Severe renal impairment (creatinine clearance < 50 mL/min)
- Severe myelosuppression
- Pre-existing hearing impairment (especially if severe)
- Hypersensitivity to cisplatin or other platinum-containing compounds
- Pregnancy and lactation
Drug Interactions
Phenytoin
Decreased phenytoin levels.
Live vaccines
Risk of severe infection due to immunosuppression.
Myelosuppressive agents
Additive myelosuppression.
Aminoglycoside antibiotics
Increased risk of ototoxicity and nephrotoxicity.
Loop diuretics (e.g., Furosemide)
Increased risk of ototoxicity.
Nephrotoxic agents (e.g., NSAIDs, Amphotericin B)
Increased risk of nephrotoxicity.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not refrigerate as precipitation may occur. Keep out of reach of children.
Overdose
There is no specific antidote for cisplatin overdose. Management is primarily supportive, focusing on treating severe myelosuppression, renal failure, electrolyte imbalances, and severe nausea/vomiting.
Pregnancy & Lactation
Contraindicated during pregnancy due to teratogenic effects; women of childbearing potential should use effective contraception. Breastfeeding is not recommended during treatment due to potential harm to the infant.
Side Effects
Contraindications
- Severe renal impairment (creatinine clearance < 50 mL/min)
- Severe myelosuppression
- Pre-existing hearing impairment (especially if severe)
- Hypersensitivity to cisplatin or other platinum-containing compounds
- Pregnancy and lactation
Drug Interactions
Phenytoin
Decreased phenytoin levels.
Live vaccines
Risk of severe infection due to immunosuppression.
Myelosuppressive agents
Additive myelosuppression.
Aminoglycoside antibiotics
Increased risk of ototoxicity and nephrotoxicity.
Loop diuretics (e.g., Furosemide)
Increased risk of ototoxicity.
Nephrotoxic agents (e.g., NSAIDs, Amphotericin B)
Increased risk of nephrotoxicity.
Storage
Store at controlled room temperature (20°C to 25°C), protect from light. Do not refrigerate as precipitation may occur. Keep out of reach of children.
Overdose
There is no specific antidote for cisplatin overdose. Management is primarily supportive, focusing on treating severe myelosuppression, renal failure, electrolyte imbalances, and severe nausea/vomiting.
Pregnancy & Lactation
Contraindicated during pregnancy due to teratogenic effects; women of childbearing potential should use effective contraception. Breastfeeding is not recommended during treatment due to potential harm to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacture, refer to product label for exact dates.
Availability
Hospitals, Specialized Oncology Centers
Approval Status
Globally Approved, Widely Used
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established cisplatin's efficacy in various solid tumors. Ongoing research explores new combination therapies and strategies to mitigate its toxicity.
Lab Monitoring
- Complete Blood Count (CBC) with differential (before each cycle and regularly)
- Renal function tests (serum creatinine, BUN, creatinine clearance)
- Electrolyte levels (magnesium, potassium, calcium, phosphate)
- Liver function tests
- Audiometry (before treatment and periodically during/after treatment)
Doctor Notes
- Strict adherence to hydration protocols and antiemetic regimens is crucial.
- Careful monitoring of renal function, electrolytes (especially magnesium), and audiometry is mandatory.
- Dose adjustments for renal impairment are critical; avoid in severe impairment.
- Counsel patients on potential long-term toxicities, especially neuropathy and ototoxicity.
Patient Guidelines
- Report any signs of hearing loss, ringing in ears, numbness or tingling in hands/feet immediately.
- Report severe nausea, vomiting, fever, chills, or signs of infection.
- Maintain excellent hydration as instructed by your doctor.
- Avoid exposure to people with infections.
- Do not take any other medications, including over-the-counter drugs and herbal supplements, without consulting your doctor.
Missed Dose Advice
Cisplatin is administered in a controlled clinical setting. If a dose is missed or delayed, the oncology team will adjust the schedule as appropriate.
Driving Precautions
Cisplatin can cause dizziness, fatigue, and visual disturbances. Patients should avoid driving or operating heavy machinery if they experience these side effects.
Lifestyle Advice
- Maintain a high fluid intake to help prevent kidney problems.
- Eat small, frequent meals to help manage nausea.
- Get adequate rest to combat fatigue.
- Discuss any concerns about fertility with your doctor before starting treatment.
- Avoid alcohol and smoking as they can worsen side effects.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.