Dangerous Drug: Cisplatin (CDDP)(sis’ pla tin)
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Platinum agent
Therapeutic Actions
Cytotoxic: Heavy metal that inhibits cell replication by alkylating DNA; cell cycle nonspecific.
Indications
Metastatic testicular tumors: Combination therapy with bleomycin sulfate and vinblastine sulfate after surgery or radiotherapy
Metastatic ovarian tumors: As single therapy in resistant patients or in combination therapy with doxorubicin or cyclophosphamide after surgery or radiotherapy
Advanced bladder cancer: Single agent for transitional cell bladder cancer no longer amenable to surgery or radiotherapy
Unlabeled uses: Lung cancer; endometrial cancer; osteogenic sarcoma; liver cancer; breast cancer; squamous cell carcinoma of the head, neck, cervix; brain tumor; esophageal cancer; carcinoma of adrenal cortex
Contraindications and Cautions
Contraindicated with allergy to cisplatin, platinum-containing products; hematopoietic depression; impaired renal function; hearing impairment; pregnancy; lactation.
Use cautiously with hepatic impairment, peripheral vascular disease.
Available Forms
Injection—1 mg/mL
Dosages
Dose is often given in combination with another chemotherapeutic drug.
Adults
Metastatic testicular tumors: Remission induction: Cisplatin, 20 mg/m2 per day IV for 5 consecutive days (days 1–5) every 3 wk for three courses of therapy; bleomycin, 30 units IV weekly (day 2 of each wk)
for 12 consecutive doses; vinblastine, 0.15–0.2 mg/kg IV twice weekly (days 1 and 2) every 3 wk for four courses.
Maintenance: Vinblastine, 0.3 mg/kg IV every 4 wk for 2 yr.
Metastatic ovarian tumors: 75–100 mg/m2 IV once every 4 wk. For combination therapy, administer sequentially: Cisplatin, 75–100 mg/m2 IV once every 3–4 wk; cyclophosphamide, 600 mg/m2 IV once every 4 wk. Single dose: 100 mg/m2 IV once every 4 wk.
Advanced bladder cancer: 50–70 mg/m2 IV once every 3–4 wk; in heavily pretreated (radiotherapy or chemotherapy) patients, give an initial dose of 50 mg/m2 repeated every 4 wk. Do not give repeated courses until serum creatinine is lower than 1.5 mg/dL or BUN is lower than 25 mg/dL or until platelets exceed 100,000/mm3 and WBCs exceed 4,000/mm3. Do not give subsequent doses until audiometry indicates hearing is within normal range.
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