Adult Dosing
Metastatic testicular tumors
- 20 mg/m2 IV qd x 5 days per cycle in combination with other approved chemotherapeutic agents
- Max: 100 mg/m2/cycle
- Repeat therapy q3 wks
Metastatic ovarian tumors
Combination therapy
- 75-100 mg/m2 IV per cycle q4 wks in combination with cyclophosphamide
- Max: 100 mg/m2/cycle
Monotherapy
- 100 mg/m2 IV per cycle q4 wks
- Max: 100 mg/m2/cycle
Advanced bladder cancer
Monotherapy
- 50-70 mg/m2 IV per cycle q3-4 wks based on the extent of prior radiotherapy and/or prior chemotherapy
- Max: 100 mg/m2/cycle
Note: Maintain adequate hydration and urine output before, during, and x24 hours after dose
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Administer only under the supervision of a qualified physician experienced in cancer chemotherapy at medical facilities adequately equipped to provide appropriate therapy and manage complications [US Black Box Warning]
- Therapy may cause cumulative nephrotoxicity, myelosuppression, nausea, vomiting, ototoxicity predominantly in children, and anaphylactic-like reactions [US Black Box Warning]
- Prevent inadvertent overdose: doses >100 mg/m2/cycle once q3-4 wks are rarely used. Avoid cisplatin overdose due to confusion with carboplatin or prescribing practices that fail to differentiate daily doses from total dose per cycle [US Black Box Warning]
- Cumulative nephrotoxicity potentiated by aminoglycoside antibiotics may occur. Elderly patients may be more susceptible to nephrotoxicity. Therefore, prior to initiating therapy and prior to each subsequent course, measure serum creatinine, blood urea nitrogen (BUN), creatinine clearance, and magnesium, sodium, potassium, and calcium levels
- At the recommended dosage, cisplatin should not be given more frequently than once every 3 to 4 weeks
- Patients in whom regimens using higher doses of cisplatin or greater dose frequencies than those recommended are employed may suffer from severe neuropathies that may be irreversible. Elderly patients may be more susceptible to peripheral neuropathy
- Loss of motor function has also been reported
- Anaphylactic-like reactions may occur within minutes of cisplatin administration. Epinephrine, corticosteroids, and antihistamines may be used to alleviate symptoms
- Cisplatin can cause fetal harm when administered to a pregnant woman. Cisplatin is mutagenic in bacteria and produces chromosome aberrations in animal cells in tissue culture
- Aluminum reacts with cisplatin causing precipitate formation and a loss of potency; therefore, do not use needles or intravenous sets containing aluminum parts for preparation or administration
- Perform weekly peripheral blood counts and regular liver function tests and neurologic examinations during therapy. Also perform audiometric testing prior to initiating therapy and prior to each subsequent dose
Cautions: Use cautiously in
- Neuromuscular diseases
- Concurrent neurotoxic agents
- Concurrent ototoxic agents
Supplemental Patient Information
- Apprise patients about the potential hazard to the fetus if used during pregnancy. Advise patients to avoid becoming pregnant during therapy
Pregnancy Category:D
Breastfeeding: Contraindicated during maternal antineoplastic therapy. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 5th April. Manufacturer advises mothers receiving cisplatin not to breastfeed.
