Cisplatin
Welcome to Dwaey, specifically on Cisplatin page.
This medicine contains important and useful components, as it consists of
Cisplatin is available in the market in concentration.
Generic Name of Cisplatin - Learn More
Cisplatin
Cisplatin Precaution - What You Need to Know
Cisplatin, an antineoplastic chemotherapy drug, requires caution in certain populations and situations. It is contraindicated in pregnant and breastfeeding women unless the potential benefit justifies the risk to the fetus or infant. Cisplatin can cause fetal harm, including developmental defects, and should only be used in pregnancy when no alternative therapy is available. It is not recommended during breastfeeding due to its potential to pass into breast milk and harm the infant. Patients with pre-existing kidney disease, liver dysfunction, or a history of hearing impairment must be closely monitored, as cisplatin can exacerbate these conditions. Additionally, the drug can cause bone marrow suppression, requiring regular blood counts to detect early signs of toxicity. For efficacy, cisplatin levels and kidney function should be monitored regularly throughout treatment, with a focus on renal parameters like serum creatinine and electrolytes. Cisplatin also poses a risk for misuse in patients attempting to use it off-label for unapproved conditions, highlighting the need for strict medical supervision.
Cisplatin Indication - Uses and Benefits
Cisplatin is primarily indicated for the treatment of various cancers, including testicular cancer, ovarian cancer, bladder cancer, and advanced non-small cell lung cancer. It is a cornerstone of chemotherapy regimens for solid tumors and is used both in curative and palliative settings. Cisplatin works by interfering with DNA replication, preventing cancer cells from dividing and growing. Clinical guidelines support its use in combination therapies with other agents to enhance efficacy and reduce resistance. The drug is also used off-label in some cases, such as for the treatment of head and neck cancers, although the evidence base for these uses is less robust. Additionally, cisplatin can sometimes be used in combination with other chemotherapeutic agents in cancers that are not responsive to single-agent therapy. In such cases, its nephrotoxicity and other adverse effects must be carefully managed to avoid complications.
Cisplatin Contraindications - Important Warnings
Cisplatin is contraindicated in patients with severe renal impairment, such as those with a creatinine clearance below 30 mL/min, due to its nephrotoxic effects. It should not be used in patients who are hypersensitive to cisplatin or any of its components. Other absolute contraindications include pre-existing hearing loss, as cisplatin can exacerbate ototoxicity, and bone marrow suppression, which may lead to life-threatening blood cell deficiencies. It is also contraindicated in patients with active infections, as cisplatin can further impair immune function. Age restrictions apply as well, particularly in the very young and elderly populations, who may have a higher risk of severe side effects such as nephrotoxicity and ototoxicity. Cisplatin should not be administered concurrently with other nephrotoxic drugs, such as certain antibiotics, unless strictly necessary and under close monitoring.
Cisplatin Side Effects - What to Expect
Cisplatin's side effects can vary from mild to severe and include both immediate and long-term complications. Common immediate side effects include nausea, vomiting, and fatigue, which are typically managed with supportive care. Nephrotoxicity is one of the most significant adverse effects, and monitoring renal function is essential throughout treatment. Other acute side effects include myelosuppression, leading to anemia, leukopenia, and thrombocytopenia, which require blood count monitoring. Ototoxicity, manifesting as hearing loss or tinnitus, may also occur, particularly with high doses or prolonged therapy. Long-term side effects include peripheral neuropathy, which can cause pain, tingling, and loss of sensation, as well as potential reproductive toxicity. Cisplatin can also increase the risk of secondary cancers, such as leukemia, particularly when used over extended periods. Patients experiencing severe side effects, such as persistent nausea, significant changes in hearing, or signs of renal failure, should seek immediate medical attention.
Cisplatin Pregnancy Category ID - Safety Information
4
Cisplatin Mode of Action - How It Works
Cisplatin is a platinum-based chemotherapy drug that exerts its effects by binding to DNA, leading to the formation of DNA crosslinks. This binding interferes with the DNA's ability to replicate, causing cell cycle arrest and initiating apoptosis (programmed cell death). Its primary mechanism of action involves the inhibition of DNA repair, making it especially effective against rapidly dividing cancer cells, which have less efficient DNA repair mechanisms. Cisplatin's ability to target both dividing and non-dividing cells is why it remains effective across a range of solid tumors. Pharmacokinetically, cisplatin is administered intravenously and is widely distributed in body tissues. It is primarily eliminated via the kidneys, where its nephrotoxic effects are most evident. Its clinical efficacy is enhanced when used in combination with other agents that inhibit DNA repair mechanisms or enhance its cellular uptake.
Cisplatin Drug Interactions - What to Avoid
Cisplatin has several significant drug interactions, particularly with other nephrotoxic agents like aminoglycosides (e.g., gentamicin) and nonsteroidal anti-inflammatory drugs (NSAIDs), which can exacerbate renal toxicity. Concomitant use of cisplatin with myelosuppressive agents, including certain chemotherapy drugs, can lead to increased bone marrow suppression. Cisplatin may also interact with anticonvulsants, such as phenytoin, altering their therapeutic effects. Alcohol should be avoided, as it can worsen cisplatin's liver toxicity, while food does not significantly affect its absorption. However, it’s important to ensure adequate hydration before and after cisplatin administration to minimize kidney damage. Clinical recommendations include pre-treatment with antiemetics, as cisplatin can cause severe nausea and vomiting, and adjusting doses when used with other drugs that affect kidney function or bone marrow.
Cisplatin Adult Dose - Recommended Dosage
For adult patients, cisplatin is typically administered intravenously, with the dose depending on the type of cancer being treated and the regimen being followed. The standard dose for testicular cancer is usually 20 mg/m² per day for 5 days, repeated every 3 weeks. For ovarian cancer, a typical dose is 75–100 mg/m² every 3–4 weeks. In combination with other chemotherapy agents, dosages may vary. Cisplatin should be administered over 1 to 2 hours to reduce the risk of severe side effects. In patients with compromised renal function, dose adjustments are often necessary. Hydration before and after administration is crucial to prevent nephrotoxicity. The maximum allowable dose of cisplatin is generally limited to 100 mg/m² per cycle, although some regimens may adjust this based on patient-specific factors, including renal function and previous toxicities.
Cisplatin Child Dose - Dosage for Children
The use of cisplatin in pediatric patients is carefully dosed based on body surface area (BSA), typically 20–25 mg/m² per day for 5 days, repeated every 3–4 weeks. This dosing may vary depending on the type of cancer, the child's age, and their ability to tolerate therapy. Pediatric patients require close monitoring of renal function, as children may be more susceptible to cisplatin-induced nephrotoxicity. Auditory function should also be monitored, as cisplatin can cause hearing loss, particularly in young children. Pediatric dosing must also take into account the child’s overall health, hydration status, and concurrent medications. Special care must be taken with infants and very young children, as they may have more pronounced side effects. Any signs of renal impairment, hearing loss, or neuropathy should be addressed promptly, and therapy should be adjusted accordingly.
Cisplatin Renal Dose - Dosage for Kidney Conditions
In patients with renal impairment, cisplatin should be used with extreme caution, and dosage adjustments are required. In those with mild renal dysfunction (creatinine clearance 60–90 mL/min), standard doses may be used, but close monitoring of renal function is essential. For patients with moderate renal impairment (creatinine clearance 30–59 mL/min), cisplatin doses are often reduced by 50%. In severe renal impairment (creatinine clearance <30 mL/min), cisplatin is typically contraindicated, as it can exacerbate nephrotoxicity and lead to irreversible renal damage. Patients with pre-existing kidney disease or those at risk of renal failure should receive aggressive hydration before and after cisplatin administration, and renal function should be monitored frequently, including serum creatinine, electrolytes, and urine output. If signs of acute renal failure appear, cisplatin should be discontinued immediately.
