WARNING

Cisplatin (Cis-DDP) is a chemotherapy drug used to treat various types of cancers. While it can be effective, it also carries several risks and potential side effects:

• Nephrotoxicity: Cisplatin can damage the kidneys, leading to impaired kidney function or even kidney failure. Adequate hydration and monitoring of kidney function are crucial during treatment.
• Ototoxicity: It can cause damage to the inner ear, leading to hearing loss or ringing in the ears (tinnitus). The risk increases with higher doses and cumulative exposure.
• Neurotoxicity: Cisplatin may cause nerve damage, leading to symptoms such as numbness, tingling, or weakness, particularly in the extremities.
• Gastrointestinal Effects: Common side effects include nausea, vomiting, diarrhea, and loss of appetite. These can range from mild to severe and may require supportive care.
• Bone Marrow Suppression: Cisplatin can suppress bone marrow function, leading to decreased production of blood cells (red blood cells, white blood cells, and platelets), which may increase the risk of infections, anemia, and bleeding.
• Allergic Reactions: Some individuals may experience allergic reactions to cisplatin, ranging from mild rash or itching to more severe reactions like difficulty breathing or swelling of the face and throat.
• Long-term Effects: There is a risk of long-term complications such as secondary cancers, particularly if the cumulative dose of cisplatin is high.
• Other Side Effects: Fatigue, hair loss, changes in taste sensation, and skin reactions are also possible.

Before starting cisplatin treatment, patients should discuss these risks with their healthcare provider to weigh the potential benefits against the potential side effects and to understand the necessary precautions and monitoring required during treatment.

Why is this medication prescribed?

Cisplatin (Cis-DDP) is prescribed primarily for its role as a chemotherapy drug used in the treatment of various types of cancers. It is particularly effective against:

• Testicular Cancer: Cisplatin is a cornerstone of chemotherapy regimens used to treat testicular cancer, often in combination with other drugs like etoposide and bleomycin.
• Ovarian Cancer: It is used as part of first-line chemotherapy for advanced ovarian cancer, typically in combination with other chemotherapy agents such as paclitaxel.
• Bladder Cancer: Cisplatin is commonly used in combination with other drugs like gemcitabine or methotrexate for treating bladder cancer, both in early and advanced stages.
• Lung Cancer: It can be part of the treatment regimen for non-small cell lung cancer, often combined with other chemotherapy drugs or used in combination with radiation therapy.
• Head and Neck Cancer: Cisplatin is used in the treatment of various head and neck cancers, either as a single agent or in combination with other chemotherapy drugs or radiation therapy.

How should this medicine be used?

Cisplatin (Cis-DDP) is a chemotherapy medication used to treat various types of cancers, including testicular, ovarian, bladder, lung, head and neck cancers, and others. Here are some key points on how cisplatin is typically used:

• Administration: Cisplatin is usually administered intravenously (IV) in a hospital or clinic setting. It is given directly into a vein over a specific period, typically a few hours.
• Dosage: The dosage of cisplatin depends on various factors such as the type of cancer being treated, the patient’s overall health, and any previous treatments received. The dosage is carefully calculated by healthcare providers based on these factors.
• Frequency: Treatment schedules vary but cisplatin is often given once every few weeks, allowing the body time to recover from the side effects before the next dose.
• Combination Therapy: Cisplatin is often used in combination with other chemotherapy drugs or treatments (like radiation therapy) to enhance its effectiveness. The specific combination therapy depends on the type and stage of cancer.
• Pre-medication: Before receiving cisplatin, patients may be given medications to help prevent or minimize side effects such as nausea and vomiting.
• Monitoring: During treatment, regular blood tests are done to monitor the patient’s blood cell counts and kidney function, as cisplatin can affect these.
• Side Effects Management: Cisplatin can cause various side effects including nausea, vomiting, hair loss, fatigue, and kidney damage. Healthcare providers will monitor for these and provide supportive care to manage symptoms.
• Follow-up: After treatment, patients are usually monitored closely for any signs of cancer recurrence or long-term side effects from the treatment.

It’s important for patients to discuss all aspects of cisplatin treatment with their healthcare team, including potential side effects, expected outcomes, and any concerns they may have.

Other uses for this medicine

• Metastatic Cancers: Cisplatin is used in the treatment of metastatic cancers, where cancer has spread from its original site to other parts of the body.
• Neoadjuvant Therapy: Sometimes, cisplatin is used before surgery or radiation therapy to shrink tumors (neoadjuvant therapy) and make them easier to remove or treat with subsequent therapies.
• Adjuvant Therapy: After surgery or other primary treatments, cisplatin may be used to kill any remaining cancer cells (adjuvant therapy) and reduce the risk of cancer recurrence.
• Pediatric Cancers: Cisplatin is also used in children for certain types of cancers, although dosages and treatment protocols are carefully adjusted for pediatric patients.

What special precautions should I follow?

Special Precautions for Cisplatin (Cis-DDP):

• Kidney Function Monitoring: Cisplatin can cause kidney damage, so it’s essential to monitor kidney function before, during, and after treatment. Your healthcare team will regularly check your blood urea nitrogen (BUN) and creatinine levels.
• Fluid Intake: Drinking plenty of fluids before and after cisplatin administration helps protect the kidneys. Your healthcare provider may recommend specific fluid intake guidelines.
• Nausea and Vomiting: Cisplatin commonly causes nausea and vomiting. Your healthcare team will prescribe medications to prevent and manage these symptoms. Follow their instructions carefully.
• Electrolyte Imbalance: Cisplatin can affect electrolyte levels (such as potassium, magnesium, and calcium) in your body. Blood tests will monitor these levels, and supplements may be prescribed if necessary.
• Hearing Loss: Cisplatin can lead to hearing loss, especially with prolonged or high-dose treatment. Your healthcare provider may monitor your hearing periodically.
• Peripheral Neuropathy: Some patients may develop tingling, numbness, or pain in their hands and feet (peripheral neuropathy) with cisplatin treatment. Your healthcare team will monitor for these symptoms and provide supportive care.
• Fertility Concerns: Cisplatin can affect fertility in both men and women. If fertility preservation is a concern, discuss options with your healthcare provider before starting treatment.
• Pregnancy: Cisplatin should not be used during pregnancy due to potential harm to the fetus. Effective contraception is advised during treatment and for some time afterward.
• Allergic Reactions: Inform your healthcare team about any allergies you have, especially to platinum-based medications, as cisplatin can cause allergic reactions in some individuals.

Always follow your healthcare provider’s instructions closely when receiving cisplatin treatment. They will tailor your treatment plan to maximize its effectiveness while minimizing potential side effects and risks. Regular communication with your healthcare team is crucial to ensure the best possible outcome during and after treatment.

What special dietary instructions should I follow?

• Hydration: Drink plenty of fluids (water is best) throughout the day, especially on the days before, during, and after cisplatin treatment. This helps maintain kidney function and minimize the risk of dehydration.
• Electrolyte Balance: Eat foods rich in potassium, magnesium, and calcium to help maintain electrolyte balance. Examples include bananas, oranges, leafy greens, nuts, seeds, dairy products, and whole grains.
• Protein: Ensure adequate protein intake to support overall health and recovery. Lean meats, fish, poultry, beans, lentils, tofu, and dairy products are good sources of protein.
• Avoid Alcohol and Caffeine: Limit or avoid alcohol and caffeine, as they can contribute to dehydration.

What should I do if I forget a dose?

• Contact Your Healthcare Provider: Notify your healthcare team as soon as possible. They will provide guidance on whether the missed dose needs to be rescheduled or if adjustments to your treatment plan are necessary.
• Follow Instructions: Follow any specific instructions given by your healthcare provider regarding the missed dose. They may need to adjust the timing of your next dose or provide additional medications or tests.
• Do Not Double Dose: Do not attempt to compensate for the missed dose by taking extra medication without consulting your healthcare provider first.
• Maintain Communication: Keep open communication with your healthcare team throughout your treatment. They are there to help manage your care and ensure the best possible outcomes.

What side effects can this medication cause?

Cisplatin (Cis-DDP) is a potent chemotherapy medication that can cause a variety of side effects. The severity and occurrence of these side effects can vary widely among individuals and depend on factors such as the dose, treatment duration, and overall health of the patient. Common side effects of cisplatin include:

• Nausea and Vomiting: These are among the most common side effects of cisplatin. Medications are often prescribed to prevent or reduce nausea and vomiting.
• Kidney Damage: Cisplatin can cause damage to the kidneys (nephrotoxicity). Kidney function is monitored closely during treatment to minimize this risk.
• Peripheral Neuropathy: Cisplatin can lead to nerve damage, causing symptoms such as tingling, numbness, or pain, usually in the hands and feet.
• Hearing Loss: Hearing problems, including high-frequency hearing loss, can occur with cisplatin treatment. Regular hearing tests may be recommended to monitor for changes.
• Bone Marrow Suppression: Cisplatin can suppress bone marrow function, leading to low blood cell counts. This can increase the risk of infections (due to low white blood cells), bleeding or bruising (due to low platelets), and fatigue (due to low red blood cells).
• Gastrointestinal Effects: In addition to nausea and vomiting, cisplatin can cause diarrhea, constipation, and loss of appetite.
• Hair Loss: Many patients experience hair loss (alopecia) while receiving cisplatin treatment. Hair typically grows back after treatment ends.
• Electrolyte Imbalance: Cisplatin can affect levels of electrolytes such as potassium, magnesium, and calcium in the blood. Blood tests are done to monitor and manage these levels.
• Allergic Reactions: Although rare, cisplatin can cause allergic reactions. Symptoms may include rash, itching, swelling, dizziness, and difficulty breathing.
• Fatigue: Feeling tired or fatigued is common during and after cisplatin treatment.
• Joint and Muscle Pain: Some patients may experience joint pain or muscle pain.
• Changes in Taste: Cisplatin can alter taste perception, causing a metallic taste in the mouth or changes in the way food tastes.
• Liver Function Changes: Cisplatin can affect liver function tests, although severe liver damage is rare.

It’s important to communicate openly with your healthcare team about any side effects you experience during cisplatin treatment. They can provide supportive care to manage these symptoms and adjust your treatment plan if needed to improve your quality of life during therapy.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cisplatin (Cis-DDP):

• Storage: Cisplatin is typically provided in healthcare settings (hospitals, clinics) and is stored under controlled conditions by healthcare professionals. If you are given cisplatin to take home (rare), follow specific storage instructions provided by your healthcare provider.
• Disposal: Unused cisplatin should be disposed of properly according to local regulations for hazardous waste disposal. Do not dispose of it in household trash or flush it down the toilet unless specifically instructed to do so.
• Handling Precautions: Healthcare providers who handle cisplatin should use appropriate precautions, such as wearing gloves and protective clothing, to prevent skin contact and inhalation of the drug.

In case of emergency/overdose

• In Case of Overdose: If you suspect an overdose or have received too much cisplatin, seek immediate medical attention. Overdose symptoms may include severe nausea, vomiting, kidney damage, electrolyte imbalance, and neurological symptoms. Contact your healthcare provider or go to the nearest emergency room.
• Emergency Contact: Keep emergency contact information readily available for quick access in case of overdose or any severe reaction to cisplatin.

What other information should I know?

• Monitoring: Regular monitoring of kidney function, blood cell counts, and electrolyte levels is essential during cisplatin treatment. This helps detect and manage potential side effects early.
• Fertility: Cisplatin can impact fertility, especially in men. Discuss fertility preservation options with your healthcare provider if this is a concern.
• Pregnancy and Breastfeeding: Cisplatin can harm an unborn baby, so it should not be used during pregnancy. Effective contraception should be used during treatment, and breastfeeding should be avoided.
• Follow-up Care: After completing cisplatin treatment, regular follow-up appointments with your healthcare provider are important to monitor for any long-term side effects and to check for cancer recurrence.
• Communication: Always communicate openly with your healthcare team about any concerns or questions you have regarding cisplatin treatment. They are there to help you manage your care effectively.

By understanding and following these guidelines, you can ensure safe and effective management of cisplatin treatment while minimizing potential risks and maximizing its benefits in treating your condition.