|
Drug Information
Pharmacokinetics
| Indication
& Dosage | Action
| Interacations
Precautions |
Brands available in Market
Pharmacokinetics
After intravenous administration cisplatin disappears from the plasma in a biphasic manner and half-lives of 25 to 49 minutes and 58 to 73 hours have been reported for total platinum. The majority of the platinum from a dose is rapidly bound to plasma protein. Cisplatin is concentrated in the liver, kidneys, and large and small intestines. Penetration into the central nervous system appears to be poor. Excretion is mainly in the urine but is incomplete and prolonged: up to about 50% of a dose has been reported to be excreted in urine over 5 days, and platinum may be detected in tissue for several months afterwards. Cisplatin is well-absorbed following intraperitoneal administration.
IV
METASTATIC OVARIAN AND TESTICULAR CANCERS, ADVANCED BLADDER CANCER, CANCER OF HEAD AND NECK, CARCINOMA OF LUNG, SQUAMOUS CELL CARCINOMA OF OESOPHAGUS: Usually 50-120mg/m2 diluted with normal saline and given as infusionover 30 minutes or 15-20mg/m2 for 5 days. This is given once every 3-4weeks. Needles or infusion sets with aluminium part should not be used for infusion of cisplatin. Repeat doses should not be given util serum creatinine is below 1.5mg/100ml and BUN isbelow 25mg/100ml. Vigorous hydration is essential for several hours before and after cisplatin administraion with 2 or more litres o physiological saline with 20mEq/L of kCL DURING EACH SESSION. In pre-existing renal impairment cisplatin doses are reduced according to creatinine clearance.Cisplatin is give to children and elders also at these general dosage without any change.
Modifies cell cycle by interfering with DNA structure and fucntion. Effectsare most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs such as fluorouracil. Cisplatin has a narrow therapeutic margin and has high toxicity.
The concomitant use of other nephrotoxic or ototoxic drugs may exacerbate the adverse effects of cisplatin. The effects of cisplatin on renal function may also affect the pharmacokinetics of other drugs excreted by the renal route.
Nausea, vomiting, fever, anaphylatic reaction, hypokalaemia, hypomagnesaemia, haemolysis, renal damage, sterility, teratogenesis, ototoxicity, peripheral neuropathy, Raynaud’s disease, bone marrow depression.
Precaution: Hypocalcaemia, hypomagnesaemia, monitor neurological status, renal status and haematological function. Maintain hydration.
Pregnancy: Contraindicated.
Breast Feeding: Contraindicated.
Man: May be given in reduced dose
