WARNING

Cisplatin injection, a chemotherapy medication, can be effective in treating various cancers, but it also carries significant risks:

• Kidney Damage: Cisplatin can cause kidney toxicity, leading to impaired kidney function or even acute kidney injury.
• Nausea and Vomiting: Common side effects include severe nausea and vomiting, which can be difficult to manage and may require additional medications.
• Bone Marrow Suppression: Cisplatin can suppress bone marrow function, reducing the production of blood cells (white blood cells, red blood cells, and platelets), which can increase the risk of infections, anemia, and bleeding.
• Nerve Damage: It can cause peripheral neuropathy, which may result in tingling, numbness, or pain in the hands and feet.
• Hearing Loss: Cisplatin can lead to irreversible hearing loss, particularly at higher doses or with prolonged use.
• Allergic Reactions: Some individuals may experience allergic reactions, ranging from mild rash to severe anaphylaxis.
• Electrolyte Imbalance: It can disturb electrolyte levels in the body, such as magnesium, potassium, and calcium, which can lead to abnormal heart rhythms and other complications.
• Increased Risk of Secondary Cancers: Long-term use of cisplatin may increase the risk of developing secondary cancers later in life.

Due to these risks, cisplatin is typically administered under close medical supervision with monitoring of kidney function, electrolytes, and blood counts. Treatment often involves balancing the benefits of the medication against the potential risks and managing side effects as they occur.

Why is this medication prescribed?

Cisplatin injection is prescribed primarily for its effectiveness in treating various types of cancers. It is commonly used in the treatment of:

• Testicular Cancer: Cisplatin is a key component in chemotherapy regimens for testicular cancer, often used in combination with other drugs like bleomycin and etoposide.
• Ovarian Cancer: It is used as part of chemotherapy protocols for ovarian cancer, usually in combination with other drugs like paclitaxel.
• Bladder Cancer: Cisplatin is used in chemotherapy treatments for bladder cancer, often combined with drugs like gemcitabine.
• Lung Cancer: It may be used in certain types of lung cancer, such as non-small cell lung cancer, as part of chemotherapy regimens.
• Head and Neck Cancer: Cisplatin is sometimes used in the treatment of head and neck cancers, usually in combination with radiation therapy.

How should this medicine be used?

Cisplatin is typically administered by healthcare professionals in a hospital or clinic setting due to its potential side effects and the need for careful monitoring. Here are key aspects of its administration:

• Dosage: The dosage of cisplatin varies depending on the type of cancer being treated, the patient’s overall health, and other factors. It is usually calculated based on body surface area.
• Administration: Cisplatin is given intravenously (IV), either as a slow infusion or sometimes as a short infusion depending on the protocol. It should not be given as an intramuscular injection.
• Frequency: The frequency of cisplatin administration depends on the specific chemotherapy regimen prescribed by the oncologist. Treatment schedules may involve cycles of chemotherapy with periods of rest in between.
• Precautions: Before and during cisplatin treatment, patients often receive pre-medications to prevent or minimize side effects such as nausea and vomiting. Adequate hydration before and after treatment is also crucial to help protect the kidneys.
• Monitoring: During treatment with cisplatin, healthcare providers monitor kidney function (through blood tests such as creatinine and electrolyte levels), blood counts (to check for bone marrow suppression), and other potential side effects.
• Side Effect Management: Management of side effects such as nausea, vomiting, and potential neuropathy is an integral part of cisplatin treatment. Patients are closely monitored for any signs of allergic reactions or severe adverse effects.

It’s important for patients to follow their oncologist’s instructions carefully and to communicate any concerns or side effects experienced during treatment.

Other uses for this medicine

Apart from its primary indications for treating cancers such as testicular, ovarian, bladder, lung, and head and neck cancers, cisplatin injection may also be used off-label or in clinical trials for other types of cancers. These may include:

• Esophageal Cancer: Cisplatin is sometimes used in combination with other drugs for the treatment of esophageal cancer.
• Cervical Cancer: It may be part of chemotherapy regimens for advanced or recurrent cervical cancer.
• Mesothelioma: Cisplatin is used in combination with other chemotherapy agents for mesothelioma, a cancer of the lining of the lungs or abdomen often associated with asbestos exposure.
• Neuroblastoma: In pediatric oncology, cisplatin may be used in treating certain types of childhood cancers like neuroblastoma.
• Germ Cell Tumors: It can also be used in the treatment of germ cell tumors outside of the testicles, such as in the mediastinum (thymus gland area).
• Sarcomas: Cisplatin may be part of chemotherapy regimens for certain types of sarcomas, such as osteosarcoma and soft tissue sarcomas.

What special precautions should I follow?

When using cisplatin injection, it is essential to follow specific precautions to minimize risks and manage potential side effects effectively. Here are some important precautions:

• Kidney Function Monitoring: Cisplatin can cause kidney toxicity. Regular monitoring of kidney function through blood tests (such as serum creatinine and blood urea nitrogen) before, during, and after treatment is crucial.
• Hydration: Adequate hydration is essential to help protect the kidneys from cisplatin-induced damage. Patients are often advised to drink plenty of fluids before and after receiving cisplatin.
• Electrolyte Monitoring: Cisplatin can affect electrolyte levels, especially magnesium, potassium, and calcium. Regular monitoring of electrolytes is necessary, and supplements may be given as needed.
• Nausea and Vomiting: Cisplatin commonly causes severe nausea and vomiting. Pre-medications (antiemetics) are usually given before treatment to prevent or reduce these symptoms.
• Neuropathy: Cisplatin can cause peripheral neuropathy, which may manifest as tingling, numbness, or pain in the hands and feet. Patients should report any unusual sensations promptly to their healthcare provider.
• Hearing Loss: Regular hearing assessments may be recommended during cisplatin treatment, as it can lead to irreversible hearing loss.
• Allergic Reactions: Although rare, allergic reactions to cisplatin can occur. Patients should be monitored closely for any signs of allergic symptoms such as rash, itching, or difficulty breathing.
• Pregnancy and Fertility: Cisplatin can harm a developing fetus, so it is not used during pregnancy unless absolutely necessary and under strict medical supervision. Both men and women of reproductive age should use effective contraception during and after treatment, as cisplatin can affect fertility.
• Follow-up Care: Patients receiving cisplatin should have regular follow-up visits with their oncologist to monitor treatment response, manage side effects, and adjust treatment as needed.

By following these precautions and guidelines, healthcare providers aim to maximize the benefits of cisplatin while minimizing its potential risks and side effects for patients undergoing chemotherapy.

What special dietary instructions should I follow?

• Hydration: It is crucial to maintain adequate hydration before, during, and after receiving cisplatin. Drinking plenty of fluids helps protect the kidneys from damage.
• Electrolytes: Eating foods rich in potassium and magnesium, unless contraindicated, can help maintain electrolyte balance. Examples include bananas, potatoes, spinach, nuts, and seeds.
• Nutrition: Ensure a balanced diet to support overall health and help manage potential side effects. If nausea or changes in taste occur, consult with a dietitian for guidance on food choices.

What should I do if I forget a dose?

If you miss a scheduled dose of cisplatin, it is important to contact your healthcare provider or oncology team immediately for guidance. Depending on the treatment protocol and timing of the missed dose, they will advise you on the best course of action. It may involve rescheduling the dose or adjusting the treatment schedule to ensure continuity and effectiveness of therapy. Never try to administer cisplatin or any other chemotherapy medication on your own or without medical supervision.

What side effects can this medication cause?

Cisplatin injection, like many chemotherapy drugs, can cause a range of side effects. These side effects can vary in severity depending on the dose, duration of treatment, individual patient factors, and whether it is used in combination with other medications. Common side effects of cisplatin injection include:

• Nausea and Vomiting: This is one of the most common side effects. It can be severe and may require pre-medications and antiemetics to manage effectively.
• Kidney Toxicity: Cisplatin can cause damage to the kidneys, leading to impaired kidney function or acute kidney injury. Regular monitoring of kidney function is essential during treatment.
• Bone Marrow Suppression: Cisplatin can suppress the bone marrow’s ability to produce blood cells, leading to:
  • Neutropenia: Reduced white blood cell count, increasing the risk of infections.
  • Thrombocytopenia: Reduced platelet count, increasing the risk of bleeding.
  • Anemia: Reduced red blood cell count, causing fatigue and shortness of breath.
• Peripheral Neuropathy: Cisplatin can cause damage to peripheral nerves, resulting in symptoms such as tingling, numbness, or pain, usually in the hands and feet.
• Hearing Loss: Cisplatin is associated with ototoxicity, which can lead to irreversible hearing loss. Regular hearing assessments are typically recommended during treatment.
• Electrolyte Imbalances: Cisplatin can disturb the balance of electrolytes in the body, such as magnesium, potassium, and calcium, which may lead to abnormal heart rhythms and other complications.
• Allergic Reactions: Although rare, cisplatin can cause allergic reactions ranging from mild rash to severe anaphylaxis.
• Gastrointestinal Issues: Apart from nausea and vomiting, cisplatin can also cause diarrhea, constipation, or mucositis (inflammation of the mucous membranes).
• Fatigue: Chemotherapy with cisplatin often causes fatigue, which can be severe and persistent.
• Hair Loss: Cisplatin may cause temporary hair loss, although this is less common compared to some other chemotherapy drugs.
• Liver Function Changes: It can sometimes lead to alterations in liver function tests.
• Cardiac Toxicity: Rarely, cisplatin can affect heart function, particularly at higher doses or with prolonged use.
• Secondary Cancers: Long-term use of cisplatin may increase the risk of developing secondary cancers later in life.

It’s important to note that not all patients will experience all of these side effects, and the severity can vary widely from person to person. Management of side effects often involves supportive care, medications to alleviate symptoms, and close monitoring by healthcare providers.

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

Storage and disposal of Cisplatin Injection:

• Storage: Cisplatin injection should be stored according to the manufacturer’s instructions. Typically, it is stored at room temperature (between 20-25°C or 68-77°F) in a dry place away from light. It should not be frozen.
• Handling: Cisplatin should be handled with care, and healthcare professionals should use appropriate precautions to prevent accidental exposure during preparation and administration.
• Disposal: Unused cisplatin injection and materials used for its administration (such as syringes and IV tubing) should be disposed of properly according to local regulations for hazardous waste disposal. This is to prevent exposure to others and to protect the environment.

In case of emergency/overdose

• Seek Immediate Medical Attention: If you suspect an overdose or experience severe side effects from cisplatin injection, such as sudden difficulty breathing, severe allergic reactions (e.g., rash, itching, swelling), or signs of kidney failure (e.g., decreased urine output, swelling in legs/feet), seek emergency medical help immediately.
• Poison Control: Contact your local poison control center or emergency services for guidance on what to do in case of overdose or accidental exposure to cisplatin.

What other information should I know?

• Patient Education: It’s important for patients and caregivers to understand the purpose of cisplatin treatment, its potential side effects, and how to manage them. Regular communication with healthcare providers is crucial throughout the treatment process.
• Follow-up Care: After receiving cisplatin injection, patients typically require regular follow-up visits with their oncologist or healthcare team. This is to monitor treatment response, manage side effects, and adjust the treatment plan as necessary.
• Fertility Considerations: Cisplatin can affect fertility in both men and women. Discuss fertility preservation options with your healthcare provider before starting treatment if having children in the future is a concern.
• Medication Interactions: Inform your healthcare provider about all medications, vitamins, and supplements you are taking, as cisplatin can interact with other drugs and affect their effectiveness or increase the risk of side effects.
• Supportive Care: Depending on the side effects experienced, supportive care such as anti-nausea medications, pain management, and nutritional support may be prescribed to improve comfort and overall well-being during treatment.
• Emotional Support: Coping with cancer treatment can be challenging emotionally. Seek support from family, friends, support groups, or counselors to help manage stress and maintain emotional well-being.
• Legal and Insurance Considerations: Ensure you understand your insurance coverage for cisplatin treatment and any legal implications regarding treatment decisions, especially if you experience adverse effects or complications.

By being well-informed about these aspects of cisplatin treatment, patients and caregivers can actively participate in their care and optimize the outcomes of chemotherapy.