Cisplatin

Cisplatin is a prescription medicine used alone to treat bladder and ovarian cancer. It is also used together with other drugs to help treat testicular cancer, locally advanced squamous cell carcinoma of the head and neck, late stage cervical cancer, malignant mesothelioma, and non-small cell lung cancer.

Cisplatin is in a group of drugs called platinum-containing alkylating agents. It works by slowing or stopping the growth of cancer cells by affecting the DNA within cancer cells.

TMPT is an enzyme involved in the breakdown of cisplatin and other drugs from the body. Some patients inherit a variation in this protein that causes it to be less active.

TMPT testing may be done in order to determine whether a a patient is likely to be at an increased risk of experiencing ear toxicity during treatment with cisplatin. All patients being treated with cisplatin are at an increased risk of experiencing ear toxicities. However, a variation in TMPT has been associated with an even higher risk of ear toxicities in children being treated with cisplatin.

Cisplatin is a prescription medicine used alone to treat bladder and ovarian cancer. Cisplatin is also used together with other drugs to treat:

• testicular cancer
• locally advanced squamous cell carcinoma of the head and neck
• late stage cervical cancer
• malignant mesothelioma
• non-small cell lung cancer that can not be treated with surgery

​This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Cisplatin may be found in some form under the following brand names:

• Platinol

Cisplatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• hair loss
• loss in ability to taste food
• hiccups
• dry mouth, dark urine, decreased sweating, dry skin, and other signs of dehydration

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately:

• swelling, pain, redness, or burning at the injection site
• pain, burning, or tingling in the hands or feet
• muscle cramps
• difficulty walking
• feeling of an electric-like shock when you bend your neck forward
• seizures
• sudden changes in vision, including color vision
• loss of vision
• eye pain
• chest pain or pressure
• fever, sore throat, chills, or other signs of infection
• unusual bleeding or bruising
• black and tarry stools
• red blood in stools
• bloody vomit
• vomited material that looks like coffee grounds

Cisplatin may cause other side effects. Talk to your doctor about the risks of taking cisplatin as well as potential side effects.

Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Especially tell your doctor if you are taking any of the following:

• amphotericin B (Abelcet; AmBisome; Amphotec, Fungizone Intravenous)
• anticonvulsants such as phenytoin (Dilantin)
• bumetanide (Bumex)
• ethacrynic acid (Edecrin)
• furosemide (Lasix)
• pyridoxine (Vitamin B-6).

Many other medications may also interact with cisplatin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

• Tell your doctor and pharmacist if you are allergic to cisplatin, carboplatin (Paraplatin), any other medications, or any of the ingredients in cisplatin injection. Ask your pharmacist for a list of the ingredients.
• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. 
• Tell your doctor if you have kidney disease or hearing problems.
• Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant or breastfeed while you are receiving cisplatin. If you become pregnant while receiving cisplatin, call your doctor. Cisplatin may harm your unborn baby.
• Talk to your doctor if you plan to have any immunizations.
• Cisplatin can increase your chance of getting infections because it can lower the number of white blood cells in your blood.
• Cisplatin can increase your chance of unusual bleeding or bruising because it can lower the number of platelets in your blood.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Cisplatin there are no specific foods that you must exclude from your diet when receiving Cisplatin.

Tell your doctor:

• if you have had an allergic reaction to cisplatin or similar medicines (carboplatin or oxaliplatin)
• about all the medicines you are taking or plan to take including prescription and non-prescription medicines, vitamins and herbal supplements
• if you are pregnant or planning to become pregnant. Cisplatin can harm your unborn baby.
• if you have kidney disease
• if you have liver disease

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. Cisplatin may cause harm to the unborn baby. It is advisable to avoid pregnancy while on cisplatin.

Tell your doctor if you are breastfeeding or plan to breastfeed. Cisplatin may be excreted into human breast milk and may harm the nursing baby.

Cisplatin injection comes as a solution (liquid) to be injected in a vein through an IV over 6 to 8 hours by a doctor or nurse in a hospital or a medical clinic. It is usually given once every 3–4 weeks.

The dose of this medicine will be different for each patient.The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. Cisplatin is injected intravenously (IV) over a 6 to 8 hour period by a doctor or a nurse in a hospital or medical clinic. It is usually given once every 3 to 4 weeks.

If you take too much cisplatin call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If cisplatin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Cisplatin should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Appropriate management of therapy and complications is possible only when adequate diagnostic and treatment facilities are readily available.
• Cumulative renal toxicity associated with cisplatin is severe. Other major dose-related toxicities are myelosuppression, nausea and vomiting.
• Ototoxicity, which may be more pronounced in children, and is manifested by tinnitus, and/or loss of high frequency hearing and occasionally deafness, is significant.
• Anaphylactic-like reactions to cisplatin have been reported. Facial edema, bronchoconstriction, tachycardia, and hypotension may occur within minutes of cisplatin administration. Epinephrine, corticosteroids, and antihistamines have been effectively employed to alleviate symptoms.
• Exercise caution to prevent inadvertent cisplatin overdose. Doses greater than 100 mg/m2/cycle once every 3 to 4 weeks are rarely used. Care must be taken to avoid inadvertent cisplatin overdose due to confusion with carboplatin or prescribing practices that fail to differentiate daily doses from total dose per cycle.