Sign Out
Cisplatin produces cumulative nephrotoxicity, which is potentiated by aminoglycoside antibiotics. The serum creatinine, BUN, creatinine clearance, and magnesium, sodium, potassium, and calcium levels should be measured prior to initiating therapy, and prior to each subsequent course. At the recommended dosage, cisplatin should not be given more frequently than once every 3 to 4 weeks.
There are reports of severe neuropathies in patients in whom regimens are employed using higher doses of cisplatin or greater dose frequencies than those recommended. These neuropathies may be irreversible and are seen as paresthesias in a stocking-glove distribution, areflexia, and loss of proprioception and vibratory sensation. Loss of motor function has also been reported.
Anaphylactic-like reactions to cisplatin have been reported. These reactions have occurred within minutes of administration to patients with prior exposure to cisplatin, and have been alleviated by administration of epinephrine, corticosteroids, and antihistamines. Since ototoxicity of cisplatin is cumulative, audiometric testing should be performed prior to initiating therapy and prior to each subsequent dose of drug.
Cisplatin is a cytotoxic anticancer drug and should be administered only by physicians experienced with cancer chemotherapeutic drugs.
Cumulative and dose related renal insufficiency is the major dose limiting toxicity of cisplatin. Renal function must return to acceptable limits before further doses are given. Other major dose related toxicities are myelosuppression, nausea and vomiting.
Ototoxicity, which may be more pronounced in children and is manifested by tinnitus, and/or loss of high frequency hearing and occasionally deafness, is significant.
Anaphylactic like reactions to cisplatin have been reported and may occur within minutes of administration. Epinephrine, steroids and antihistamines have been effectively employed to alleviate symptoms.
Exercise caution to prevent inadvertent cisplatin overdose.
Carcinogenicity and Mutagenicity: The carcinogenic effect of cisplatin was studied in BD IX rats. Cisplatin was administered i.p. to 50 BD IX rats for 3 weeks, 3 x 1 mg/kg body weight per week. Four hundred and fifty-five days after the first application, 33 animals died, 13 of them related to malignancies; 12 leukemias and 1 renal fibrosarcoma. The development of acute leukemia coincident with the use of cisplatin has rarely been reported in humans. In these reports, cisplatin was generally given in combination with other leukemogenic agents.
