Cisplatin (Intravenous)

Used for the treatment of cancer of the ovaries, bladder or testicles, Cisplatin is a chemotherapy treatment.

Overview:

Cisplatin is a chemotherapy treatment that belongs to the group of alkylating agent medications. Cisplatin is used in the treatment of cancers affecting the testicles, ovaries and bladder.

Cisplatin works by interfering with the growth of cancerous cells, which the body can then eventually destroy with the aid of this treatment. The normal growth of healthy cells will also be affected by this treatment, which means that other side effects will occur. Some of these side effects can be serious and require medical attention. Others would not usually be of concern.

In some cases, other side effects can take months or years after the medication is used to occur. Before beginning treatment with Cisplatin, you should discuss the risks of use in detail with your doctor in relation to the benefits of taking this medication.

Cisplatin should only ever be administered by a trained doctor or under the immediate supervision of a doctor. This medication is available as a pre-mixed solution or as a powder to be reconstituted into a solution. This medication should not be administered to pregnant women and women undergoing treatment should also avoid becoming pregnant during use.

Condition treated:

  • Ovarian cancer
  • Bladder cancer
  • Testicular cancer

Type of medicine

  • Alkylating agent
  • Chemotherapy

Side Effects:

This medication works by attacking the growth of cells. As the medication cannot distinguish between healthy and cancerous cells, this medication will also impact the division of healthy cells. As such, some unwanted side effects can occur. Although not all of these side effects may occur, if they do then they may require you to seek medical attention.

Some of the side effects that can occur may not occur for months or years after the treatment is used. Effects that are delayed in this manner can include certain other types of cancer including leukemia. You should discuss all of these possible effects with your doctor before beginning treatment.

You should check with your doctor immediately if you experience any of the following side effects:

Occurring less commonly:

  • Black or tar-colored stools
  • Blood appearing in urine or stools
  • Coughing or hoarseness that is accompanied by a fever or chill
  • Dizziness, faintness or fainting soon after taking dose
  • Feverishness or chills
  • Increased heartbeat after a dose
  • Lower back pain or side pain that is accompanied by feverishness or a chill
  • Pain or difficulty when passing urine that is accompanied by feverishness or a chill
  • Pain or redness around the site injection
  • Red spots on the skin
  • Swollen face occurring after the dose
  • Unusual bleeding
  • Unusual bruising
  • Wheezing

The following side effects may occur that do not necessarily require immediate medical attention. Ensure that you inform your doctor as soon as possible if you experience the following:

Occurring more commonly:

  • Joint pain
  • Loss of balance or coordination
  • Ringing in the ears not heard by others
  • Swollen feet or lower legs
  • Troubled hearing
  • Unusual tiredness
  • Unusual weakness

Occurring less commonly:

  • Convulsions or seizures
  • Loss of or change to usual sense of taste
  • Loss of reflexes or speed of reaction
  • Numb or tingling feelings in fingers or toes
  • Troubled walking

Occurring only rarely:

  • Agitation or confusion
  • Blurring of the vision
  • Changed ability to see colors
  • Muscle cramping
  • Sores on mouth or lips

Other common side effects can occur that would not normally necessitate medical attention. The following side effects are likely to occur and should be expected, but do not usually necessitate interaction from a doctor. Your healthcare professional may be able to help you to alleviate these side effects and if they become bothersome or are ongoing then you should inform your doctor. You should not stop taking the treatment because of these side effects:

  • Loss of hunger
  • Nausea
  • Vomiting

Following the cessation of use of this medication, side effects can still continue to occur. During this period you should be alert to side effects and should contact your doctor immediately when you notice them.

Other side effects that have not been listed herein may also occur. If you notice any other side effects then you should contact your medical professional. If you are worried about your immediate wellbeing then you should contact the emergency services.

Dosage:

This medication is sometimes used in conjunction with other medicines. If you are using a combination of medications then it is important that you take each one at the right time as directed by your doctor.

During use of this treatment, you should drink an increased amount of fluids so that you are able to pass urine more frequently. This will help to prevent you from suffering any kidney problems that can occur from the treatment reaching high concentrations in the kidneys.

This medication can cause nausea and vomiting. This is normal and you should continue with the use of this medication despite these side effects. Your healthcare professional may be able to assist you in lessening these effects, especially if they are ongoing, extreme and bothersome.

The dose of this treatment will differ for each patient and will be calculated by your doctor depending on a range of factors. The following is for guidance only:

  • Normal dose for adults with testicular cancer

o 20mg/m2 once daily for 5 days.

  • Normal dose for adults with ovarian cancer

o 75-100mg/m2 once per 4 weeks

  • Normal dose for adults with bladder cancer

o 50-70mg/m2 once per 3-4weeks

  • Normal dose for adults with neuroblastoma

o 60-100mg/m2 once per 3-4 weeks

  • Normal dose for adults with osteogenic sarcoma

o 60-100mg/m2 once per 3-4 weeks

  • Normal dose for adults with brain/intracranial tumor

o 60mg/m2 once daily for two consecutive days per 3-4 weeks

  • Normal dose for adults with bone marrow transplantation

o 165mg/m2 over a 72 hour period

  • Normal dose for adults with blood cell transplantation

o 165mg/m2 over a 72 hour period

  • Normal dose for adults with non-small cell lung cancer

o 60-100mg/m2 once per 21 days

  • Normal dose for adults with cervical cancer

o 40mg/m2 once weekly

Interactions:

Certain medications can interact with one another in the body and in some cases this means that they should not be taken together. Some medications can react violently, causing severe side effects in the patient, whilst others can stop treatments from working or can increase exposure to infection or side effects from other treatments.

You should inform your doctor of any and all medications that you might be taking whether they are prescribed, over the counter or other medications.

The following treatments should not be used with Cisplatin as this medication lowers the body's immune system and can increase the risk of infection from exposure to the cultures:

  • Varicella Virus Vaccine
  • Live Rubella Virus Vaccine
  • Live Rotavirus Vaccine
  • Live Mumps Virus Vaccine
  • Live Measles Virus Vaccine

Use of the following medications would not normally be recommended in patients who are being treated with Cisplatin:

  • Yellow Fever Vaccine
  • Vinorelbine
  • Valproic Acid
  • Typhoid Vaccine
  • Topotecan
  • Thioctic Acid
  • Smallpox Vaccine
  • Rituximab
  • Poliovirus Vaccine, Live
  • Paclitaxel
  • Influenza Virus Vaccine, Live
  • Furosemide
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Cholera Vaccine, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Adenovirus Vaccine

Use of the following medications with Cisplatin can increase the risk of certain side effects occurring in the patient. The use of both may still be the best treatment for you, but your doctor may wish to adjust the frequency of use or the dose given:

  • Warfarin
  • Tobramycin
  • Phenytoin
  • Lithium
  • Fosphenytoin
  • Docetaxel
  • Aldesleukin

The use of this medication can also be impacted by other medical conditions from which the patient might suffer. It is important that you inform your doctor of all medical conditions from which you have suffered in the past and are currently suffering from. This is particularly important if you suffer from any of the following conditions:

  • Chickenpox
  • Herpes zoster

o Conditions pose severe risk of spreading to other parts of the body

  • History of gout
  • History of kidney stones

o Treatment may cause a recurrence of conditions

  • Hearing problems

o Can be worsened by treatment

  • Infection

o Will decrease the ability of the body to fight infection

  • Kidney disease

o Effects of treatment can be worsened by slower removal of medication from the body

Other interactions not listed herein can also occur from the use of Cistplatin. Ensure that you have informed your doctor of your full medical history before beginning treatment.

Warnings

Before the beginning use of this treatment, you should weigh the benefits of doing so against the risks of use. Discuss all of the factors affecting use with your doctor and ensure that the following has all been considered.

Allergies: Inform your doctor of any allergic reactions you have had to medications in the past. You should also inform them of any allergies you have suffered from, to dyes, preservative, foods or animals.

Pediatric: Loss of hearing and loss of balance are more likely to occur in children than in adults.

Geriatric: It is unknown if there are any limiting factors to use in the elderly as no specific test have been carried out in this group. Elderly patients are, however, more likely to suffer from other medical conditions that may affect treatment. Be cautious of other conditions they may have including liver, heart, kidney and cardiovascular conditions.

Pregnancy: This medication should not be used in pregnant women. The treatment will impact the development of the fetus. Patients should be advised to avoid becoming pregnant during use of this treatment and should be informed of effective contraceptive practices to follow. If you have any concerns about this then you should discuss them with your doctor.

Breastfeeding: Cisplatin has been found in human milk and can be passed on to an infant. Mothers should not nurse infants when using this treatment.

Your doctor will need to carry out regular check-ups on you during the use of this treatment. This is to check for both desired and unwanted effects that may occur.

This treatment will lower the body's immune system. You should not, therefore, receive any immunizations or vaccinations without first talking to your doctor. Doing so can expose you to risk of contracting the disease that you are trying to vaccinate yourself against. Members of your household should also be told to avoid receiving the oral polio vaccination. If someone in your household does receive this then you should avoid contact with them and consider wearing a protective mask covering your face.

You will need to take steps to avoid infection when using this treatment. Consider the following:

  • Avoid contact with people who have infections.
  • Contact your doctor immediately if you develop any signs of infection including coughs, colds and hoarseness.
  • Talk to your doctor about other ways you can clean your teeth without the use of toothbrushes, picks or floss. These can cause bleeding of the gums and infection.
  • Wash your hands thoroughly before touching eyes or the inside of your nasal passage.
  •  Be careful when using sharp objects.
  • Avoid contact sports or activities where you may bruise or injure yourself.

Cisplatin can cause scarring if it seeps out of the vein and into the surrounding tissue. Inform the doctor present if you believe this is happening during receipt of a dose.

Patients receiving this treatment may also be advised to seek other advice or treatment in order to help them to cope with their medical condition. Your doctor may recommend that you visit a therapist or seek support from a cancer charity in order to help you gain access to the information and support that you need.

This treatment may also be given in conjunction with other chemotherapy or radiotherapy treatments. The use of multiple treatments may increase the risk of experiencing certain side effects that may occur.

Storage:

Cisplatin is supplied in a multiple-dose vial without preservatives. Store the vials at a controlled 20-25°C. Do not store in the refrigerator. Protect the vials from direct light. Cisplatin can be used for 28 days following opening if kept away from light, or for seven days under normal room light exposure.

Summary:

Cisplatin is used for the treatment of a range of cancers in the body. Usually, this medication is used to treat bladder cancer, ovarian cancer or testicular cancer, but it can also be used in the treatment of neuroblastoma, osteogenic sarcoma or brain/intracranial tumors.

This medication is a member of the group of medicines called alkylating agents and is a form of chemotherapy. As such this medication works by attacking the development of cells. The medication is unable to distinguish between healthy cells and cancerous cells, so this treatment will have unwanted side effects on the body. You should familiarize yourself with these and discuss them with your doctor before beginning treatment.

Some of the side effects, including the development of other cancers including leukemia, may not develop in the patient until months or even years after the treatment has been given and ended. Ensure that you understand the risks of use before beginning treatment.

This medication should not be given to pregnant women and women should avoid pregnancy during treatment with the medication. Breastfeeding infants should also not be carried out during treatment as the medication has been shown to pass into the milk of the mother and can be transferred to the infant.

The use of this medication will lower the immune system in the patient and those receiving treatment should avoid situations that may expose them to either infection or injury.

This medication can also interact with a range of other medications. You should ensure that you have informed your doctor of all medications that you are taking before beginning use of this treatment.

Patients undergoing this treatment may also have to take other chemotherapy medications at the same time. If you are taking more than one treatment then ensure that you understand when they should be taken in relation to this intravenous medication.