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Cisplatin

    Brands

    DEA Class; Rx

    Common Brand Names; Platinol, Platinol -AQ

    • Antineoplastics, Alkylating; 
    • Antineoplastics, Platinum Analog

    Non-cell-cycle specific alkylating agent
    Used for the treatment of advanced testicular cancer, advanced ovarian cancer, and advanced bladder cancer, as well as many off-label indications
    Can cause severe nephrotoxicity; ensure adequate hydration and closely monitor renal function and serum electrolytes

    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

    Adults

    100 mg/m2 IV.

    Geriatric

    100 mg/m2 IV.

    Adolescents

    40 mg/m2 IV.

    Children

    40 mg/m2 IV.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Cisplatin 

    injectable solution

    • 1mg/mL