Cisplatin
Mechanism :
Cisplatin is a platinum coordination compound that is used as a cancer chemotherapeutic agent. Cisplatin produces predominantly interstrand DNA cross-links rather than DNA-protein cross-links. This effect is apparently cell-cycle nonspecific.
Indication :
- Osteogenic sarcoma
- Neuroblastoma stage IV
- Liver tumors
- Infant brain tumor
- Intracranial germ cell tumor
Contraindications :
Cisplatin is contraindicated in patients with pre-existing renal impairment. Cisplatin should not be employed in myelosuppressed patients, or patients with hearing impairment. Cisplatin is contraindicated in patients with a history of allergic reactions to cisplatin or other platinum-containing compounds.
Dosing :
Osteogenic Sarcoma/Neuroblastoma (off-label):
90 mg/m² IV every 3 weeks or 30 mg/m² IV every week.
Brain Tumours, Recurrent (off-label):
60 mg/m² IV daily for 2 consecutive days every 3-4 weeks.
Adverse Effect :
Alopecia, nephrotoxicity, tinnitus, hearing loss, myelosuppression, leukopenia, anemia, thrombocytopenia, nausea and vomiting.
Interaction :
Anticonvulsant agents: May reach sub therapeutic levels during cisplatin therapy.
Nephrotoxic drugs: risk of acute reduction in GFR
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.