Cisplatin

Intravenous
Metastatic ovarian cancer

Intravenous
Metastatic testicular tumours

Intravenous
Advanced bladder cancer

Dose adjustment may be needed.

Incompatible w/ sodium bicarbonate. Y-site incompatibility: Amphotericin B cholesteryl sulfate complex, gallium nitrate, amifostine, cefepime, thiotepa, piperacillin/tazobactam.

Patients with severe renal or auditory disorder, known hypersensitivity, severe bone marrow suppression, peripheral neuropathy, pregnancy, lactation.

Patients with renal or hepatic disorder, myelosuppression. Monitor renal, neurological and auditory function. Perform blood counts regularly. Maintain adequate hydration before and 24 hr after admin to minimise nephrotoxicity.

Severe nausea and vomiting. Serious toxic effects on the kidneys, bone marrows and ears. Hypomagnesaemia, hypocalcaemia, hyperuricaemia. Peripheral neuropathies, papilloedema, optic neuritis, seizures. Ototoxicity (children) manifested as tinnitus, loss of hearing, deafness or vestibular toxicity.
Potentially Fatal: Rarely, renal damage due to inadequate hydration during therapy. Very rarely life-threatening myelosuppression. Anaphylactoid reactions (rare) and cardiac abnormalities.

IV/Parenteral: D

Acute overdosage may result in kidney failure, liver failure, deafness, ocular toxicity, significant myelosuppression, intractable nausea and vomiting and/or neuritis. Death may also occur following overdosage. Treatment should include general supportive measures.

Synergistic with 5-fluorouracil and etoposide. Efficacy increased and toxicity reduced when combined with radioprotecting agent WR 2721. At doses ≤100 mg, cisplatin is an ideal drug to combine with other cytotoxic drugs; unlike other antineoplastic drugs, it causes little myelosuppression.
Potentially Fatal: Potentiates nephrotoxicity with aminoglycosides. Increased toxicity when combined with other cytotoxic drugs.

Description:
Mechanism of Action: Cisplatin modifies cell cycle by interfering with DNA structure and function. Effects are most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs e.g. fluorouracil. It has a narrow therapeutic margin and is highly toxic.
Pharmacokinetics:
Absorption: Well absorbed (intraperitoneal).
Distribution: Concentrated in the liver, kidneys, large and small intestines; poor penetration into the CNS.
Excretion: Urine. Elimination half-life: 25-49 min (initial), 58-73 hr (terminal).

Store at 15-25°C.

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