Cisplatin Pharmacology

Cisplatin

About Cisplatin
Alkylating Agent, Platinum- Analog , Antineoplastic.
Mechanism of Action of Cisplatin
Cisplatin exerts its cytotoxic effect by different ways. It binds to the DNA and this result the inhibition of DNA synthesis and DNA repair (which activate apoptosis). It also has an alkylating agent function i.e. chlorine molecules in the drug undergo displacement reaction with water molecules forming a positively charged molecule which form inter and intrastrand cross links with DNA. This leads to the cell death. Its cytotoxic effects are more prominent at S phase but it kills the cells at all stages.
Pharmacokinets of Cisplatin
Absorption- Rapidly absorbed after intravenous administration.
Distribution- Widely distributed in the body. Platinum metal in the drug after degradation from it extensively and irreversibly bound to the plasma proteins.
Excretion- Excreted through urine as metabolites (small portion) and as unchanged form (large portion).
Onset of Action for Cisplatin
N/A
Duration of Action for Cisplatin
N/A
Half Life of Cisplatin
N/A
Side Effects of Cisplatin
1. Nausea
2. Vomiting
3. Lowered resistance to infection
4. Bruising or unusual bleeding
5. Anemia
6. Weakness
7. Sore in mouth
8. Taste changes
9. Diarrhea
10. Loss of appetite
11. Visual changes
12. Black, tarry stools
13. Blood in urine or in stool
14. Cough or hoarseness
15. Fever
16. Chills
17. Lower back or side pain
18. Painful or difficult urination
19. Pinpoint red spot on skin
20. Slurred speech
21. Swelling on leg or lower leg
22. Shortness of breath
23. Pulmonary fibrosis
24. Hepatotoxicity
25. Nephrotoxicity
26. Stomatitis
27. Disorientation
28. Lethargy
29. Ataxia
30. Thrombocytopenia
31. Leucopenia
32. Bone marrow suppression
33. Raynaud`s syndrome
34. Hyperkalemia
35. Hypomagnesaemia
36. Hemolysis
37. Sterility
38. Teratogenesis
39. Ototoxicity
40. Peripheral neuropathy
41. Papilloedema
42. Hypocalcaemia
43. Hyperurecemia
44. Seizures
45. Optic neuritis
Contra-indications of Cisplatin
1. Hypersensitivity to the drug or other platinum compounds
2. Severe renal disease
3. Hearing impairment
4. Myelosuppression
5. Peripheral neuropathy
Special Precautions while taking Cisplatin
Monitor renal, neurological and auditory functions of patient regularly.
Used with caution in patients with :
1. Renal disorder
2. Kidney disease
3. Hypocalcaemia
4. Hypomagnesaemia
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Cisplatin
1. Testicular carcinoma
2. Ovarian carcinoma
3. Bladder cancer
4. Squamous cell carcinoma
5. Head and neck carcinoma
6. Lung cancer
7. Cancer of esophagus
9. Waldenstrom`s macroglobulinaemia
10. Brain tumor
11. Osteogenic sarcoma
12. Neuroblastoma
13. Cervical cancer
14. Kaposi`s sarcoma
15. Retinoblastoma
16. Gestational trophoblastic tumor
17. Thymoma
18. Hepatoblastoma
19. Lymphoma
20. Wilm`s tumor
21. Cancer of unknown primary site
22. Skin cancer
23. Bile duct cancer
24. Cancer of vulva
25. Cancer of anus
26. Thyroid cancer
27. Stomach cancer
28. Endometrial cancer
29. Cancer of fallopian tube
30. Abdominal cancer

Interactions for Cisplatin
Aminoglycosides: Nephrotoxicity potentiated by aminoglycosides.
Loop diuretics: Additive ototoxic effect.
Phenytoin: Plasma levels reduced by cisplatin.
Cytotoxic drugs: Increased toxicity when combined with other cytotoxic drugs. Still ideal drug to combine since it causes very little myelosuppression.
5-Fluorouracil & Etoposide: Synergy.
Radioprotecting Agent WR 2721: Efficacy enhanced and toxicity reduced.
Typical Dosage for Cisplatin
Intravenous-
Adult-
For metastatic testicular cancer - 20mg /metre square /day for 5 days. Repeat the treatment every 3 weeks for 3 cycles or more.
For ovarian cancer -75 to100mg/metre square . Repeat every 4 weeks OR 50mg/metre square every 3 weeks.
Bladder cancer-50 to70mg/metre square once every 3 to 4 weeks.
Head and neck cancer-80 to 120mg/metre square every 3 weeks.
Cervical cancer-50mg/metre square once every 3 weeks.
Lung cancer-70 to 120mg/metre square once every 3 to 6 weeks.
Children-
Brain tumour-60mg/metre square for 2 days every 3 to 4 weeks.
Osteogenic sarcoma or neuroblastoma-90mg/metre square every 3 weeks.
Schedule of Cisplatin
G
Storage Requirements for Cisplatin
Store under refrigerator (2 - 8 degree C) and protect from light.
Effects of Missed Dosage of Cisplatin
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Cisplatin
Give supportive and symptomatic treatment. Supportive treatment includes transfusion of blood components, antibiotics and antiemetics.

Home Delivery for Cisplatin in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including cisplatin.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for cisplatin and other medicines and health products. Home delivery services for cisplatin may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take cisplatin only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for cisplatin before they complete the sale. You can get this information while placing the order for cisplatin with the pharmacy.

Cisplatin is a generic medicine name and there are several brands available for it. Some of the brands for cisplatin might be better known than cisplatin itself. If the pharmacy that's willing to deliver medicines to your home doesn't have cisplatin in stock, you can ask for one of the branded alternatives for cisplatin.