Cisplasan Special Precautions

Administer Cisplatin under the supervision of qualified physician experienced in the use of anti-cancer agents.
Cisplatin procedures cumulative renal toxicity which is severe and potentiated by aminoglicoside antibiotics. Therefore, measure the serum creatinine, BUN, creatinine clearance, and Mg, K, and Ca levels prior to initiating therapy, and prior to each subsequent course. At the recommended dosage, do not give this drug more frequently than once every 3-4 weeks.
Since the ototoxicity of Cisplatin is also cumulative, perform audiometric testing prior to initiating therapy and prior to each subsequent dose of drug.
Cisplatin also causes dose-related myelosuppression. Peripheral blood counts should be monitored weekly.
Anaphylactic-like reactions to Cisplatin have occurred in patients with prior exposure to this drug, and have been alleviated by administration of Epinephrine, corticosteroids and antihistamines.
Cisplatin may cause severe neuropathies and these may be irreversible in some patients. Neurologic examination should be performed regularly.
Liver function should also be monitored periodically; elevated SGOT may occur.
Safe use in human pregnancy has not established. In mice, Cisplatin is teratogenic and embryotoxic.