CISplatin, Platinol

 Indications

Metastatic testicular and ovarian carcinoma. Advanced

bladder cancer. Head and neck cancer. Cervical cancer.

Lung cancer. Other tumors.

Action

Inhibits DNA synthesis by producing cross-linking of

parent DNA strands (cell-cycle phase–nonspecific).

Therapeutic Effects: Death of rapidly replicating

cells, particularly malignant ones.

Pharmacokinetics

Absorption: IV administration results in complete

bioavailability.

Distribution: Widely distributed; accumulates for

months; enters breast milk.

Metabolism and Excretion: Excreted mainly by

the kidneys.

Half-life: 30–100 hr.

TIME/ACTION PROFILE (effects on blood

counts)

ROUTE ONSET PEAK DURATION

IV unknown 18–23 days 39 days

Contraindications/Precautions

Contraindicated in: Hypersensitivity; OB, Lactation:

Pregnancy or lactation.

Use Cautiously in: Hearing loss; Renal impairment

(dosageprecommended); HF; Electrolyte abnormalities;

Active infections; Bone marrow depression; Geri: qrisk of nephrotoxicity and peripheral neuropathy;

Rep: Women of reproductive potential.

Adverse Reactions/Side Effects

CNS: REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY

SYNDROME (RPLS), SEIZURES, malaise, weakness.

EENT: ototoxicity, tinnitus. GI: HEPATOTOXICITY, nausea,

vomiting, diarrhea. GU: nephrotoxicity, sterility.

Derm: alopecia. F and E: hypocalcemia, hypokalemia,

hypomagnesemia. Hemat: LEUKOPENIA, THROMBOCYTOPENIA,

anemia. Local: phlebitis at IV site. Metab:

hyperuricemia. Neuro: peripheral neuropathy.

Misc: anaphylactoid reactions.

Interactions

Drug-Drug:qrisk of nephrotoxicity and ototoxicity

with other nephrotoxic and ototoxic drugs (aminoglycosides,

loop diuretics).qrisk of hypokalemia

and hypomagnesemia with loop diuretics and amphotericin

B. Maypphenytoin levels.qbone marrow

depression with other antineoplastics or radiation

therapy. Maypantibody response to live-virus

vaccines andqadverse reactions.

Route/Dosage

Other regimens are used.

IV (Adults): Metastatic testicular tumors—20 mg/

m2 daily for 5 days repeated every 3–4 wk. Metastatic

ovarian cancer—75–100 mg/m2, repeat every 4 wk

in combination with cyclophosphamide or 100 mg/m2

every 3 wk if used as a single agent. Advanced bladder

cancer—50–70 mg/m2 every 3–4 wk as a single

agent.

Availability (generic available)

Injection: 1 mg/mL.