Cisplatin

DEA Class; Rx

Common Brand Names; Platinol, Platinol -AQ

• Antineoplastics, Alkylating; 
• Antineoplastics, Platinum Analog

Indicated for

• Metastatic Testicular Tumors
• Advanced Bladder Cancer
• Metastatic Ovarian Carcinoma
• Cancers (Off-label)

Hypersensitivity to cisplatin, other platinum compounds

Severe myelosuppression, renal impairment, hearing impairment

Pregnancy, lactation

• Nausea (76-100%)
• Vomiting (76-100%)
• Nephrotoxicity (28-36%)
• Ototoxicity, especially in children (31%)
• Myelosuppression (25-30%)
• Anaphylaxis (1-20%)
• Alopecia
• Cerebral herniation
• Encephalopathy
• Leukoencephalopathy and reversible posterior leukoencephalopathy syndrome
• Seizure
• Peripheral neuropathy (dose and duration dependent)
• Diarrhea
• Electrolyte changes
• Hyperuricemia
• Hepatotoxicity
• Local tissue irritation

Irritant; injection site reactions may occur during administration; local soft tissue toxicity reported following extravasation of cisplatin for injection; severity of local tissue toxicity appears to be related to concentration of drug; closely monitor infusion site during drug administration

Avoid aluminum needles/equipment

Pediatric patients, hearing impairment, neuropathy, neuromuscular disease, with neurotoxic agents, with ototoxic agents, elderly

Risk of cumulative nephrotoxicity (exacerbated by aminoglycoside antibiotics); renal toxicity becomes more prolonged and severe with repeated courses; renal function must return to normal before administering another dose

Myelosuppression occurs in 25-30%; nadirs in circulating platelets and leukocytes occur between days 18-23 (range 7.5-45) with most patients recovering by day 39; elderly may be more susceptible to myelosuppression

Development of acute leukemia secondary to therapy reported; in these reports, cisplatin for injection was generally given in combination with other leukemogenic agents

Cardiac abnormalities, hiccups, elevated serum amylase, rash, alopecia, malaise, asthenia, and dehydration have been reported

Based on human data from published literature, cisplatin can cause fetal harm when administered to pregnant women; data demonstrates transplacental transfer of cisplatin

Limited data from published literature report the presence of drug in human milk; because of potential for serious adverse reactions in a breastfed child and because of potential for tumorigenicity, advise lactating women not to breastfeed during treatment

Cisplatin 

injectable solution

• 1mg/mL