BMA Concise Guide to Medicine & Drugs

Cisplatin

Brand name None

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anticancer drug

Overdose danger rating High

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Cisplatin is one of the most effective drugs available to treat a wide variety of cancers including those of the ovaries, testes, head, neck, bladder, cervix, and lung. It is also used in treating certain children’s cancers and some cancers of the blood. It is usually given along with other anticancer drugs.

The most common and serious adverse effect of cisplatin is impaired kidney function. To reduce the risk of permanent kidney damage, the drug is usually given only once every three weeks, and plenty of fluid must be taken to minimize the effect of the drug on the kidneys. Cisplatin also frequently causes severe nausea and vomiting, which usually start within an hour and last for up to 24 hours, although in some cases they may persist for up to a week. To prevent or control these symptoms, anti-emetic drugs are usually given. Damage to hearing is common, may be more severe in children, and may appear only after treatment has stopped. Cisplatin may also increase the risk of anaemia, blood clotting disorders, and infection during treatment.

INFORMATION FOR USERS

This drug is given only under medical supervision and is not for self-administration.

How taken/used Injection.

Frequency and timing of doses Every 3 weeks for up to 5 days; it may be given alone or in combination with other anticancer drugs.

Adult dosage range Dosage is determined individually according to body height, weight, and response.

Onset of effect Some adverse effects, such as nausea and vomiting, may appear within 1 hour of starting treatment.

Duration of action Some adverse effects may last for up to 1 week after treatment has stopped.

Diet advice Prior to treatment it is important that the body is well hydrated. Therefore, 1–2 litres of fluid are usually given by infusion over 8–12 hours.

Storage Not applicable. The drug is not normally kept in the home.

Missed dose Not applicable. The drug is given only in hospital under medical supervision.

Stopping the drug Not applicable. The drug will be stopped under medical supervision.

Exceeding the dose Overdosage is unlikely since treatment is carefully monitored, and the drug is given intravenously only under close supervision.

POSSIBLE ADVERSE EFFECTS

The most common adverse effects include loss of appetite or taste, nausea, vomiting, and ringing in the ears or hearing loss. More rarely, there may be wheezing or breathing difficulty, abnormal sensations, rash, or facial swelling. Most adverse effects appear within a few hours of injection and are carefully monitored in hospital after each dose. Some effects wear off within about 24 hours, although nausea and vomiting may last for up to about a week. The most common serious adverse effect of cisplatin is impaired kidney function, which may cause reduced urine output. If this occurs, inform medical staff immediately.

INTERACTIONS

General note A number of drugs (e.g. antibacterials such as gentamicin) increase the adverse effects of cisplatin. Because cisplatin is given only under close medical supervision, these interactions are carefully monitored and the dosage is adjusted accordingly.

SPECIAL PRECAUTIONS

Cisplatin is prescribed only under close medical supervision, taking account of your present condition and your medical history. However, be sure to tell your doctor if:

· You have impaired kidney function.

Pregnancy Not usually prescribed. Cisplatin may cause birth defects or premature birth. Discuss with your doctor.

Breast-feeding Not advised. The drug passes into the breast milk and may affect the baby adversely. Discuss with your doctor.

Infants and children The risk of hearing loss is increased. Reduced dose used.

Over 60 Reduced dose may be necessary. Increased likelihood of adverse effects.

Driving and hazardous work No known problems.

Alcohol No known problems.

PROLONGED USE

There is an increased risk of long-term damage to the kidneys, nerves, and bone marrow, and to hearing. The drug may also reduce fertility and increase the risk of further cancers later in life.

Monitoring Hearing tests and blood checks to monitor kidney function and bone marrow activity are carried out regularly.