Cisplatin interferes with DNA replication, which kills the fastest proliferating cells, which in theory are carcinogenic. Following administration, one chloride ion is slowly displaced by water to give the aquo complex cis-[PtCl(NH3)2(H2O)]+, in a process termed aquation. Dissociation of the chloride is favored inside the cell because the intracellular chloride concentration is only 3–20% of the approximately 100 mM chloride concentration in the extracellular fluid.
The water molecule in cis-[PtCl(NH3)2(H2O)]+ is
itself easily displaced by the N-heterocyclic bases on DNA. Guanine preferentially
binds. Subsequent to formation of [PtCl(guanine-DNA)(NH3)2]+,
crosslinking can occur via displacement of the other chloride, typically by
another guanine. Cisplatin crosslinks DNA in several different ways,
interfering with cell division by mitosis. The damaged DNA elicits DNA
repair mechanisms, which in turn activate apoptosis when repair
proves impossible. In 2008, researchers were able to show that the apoptosis induced
by cisplatin on human colon cancer cells depends on the mitochondrial serine-protease Omi/Htra2. Since
this was only demonstrated for colon carcinoma cells, it remains an open question
if the Omi/Htra2 protein participates in the cisplatin-induced apoptosis in
carcinomas from other tissues.
Cisplatin is administered intravenously as short-term infusion in normal saline for treatment of solid malignancies. It is used to treat various types of cancers, including sarcomas, some carcinomas (e.g., small cell lung cancer, squamous cell carcinoma of the head and neck and ovarian cancer), lymphomas, bladder cancer, cervical cancer, and germ cell tumors.
Cisplatin is particularly effective
against testicular cancer; the cure rate was improved from 10% to 85%.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Also, because of the way cancer medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Check with your doctor immediately if any of the following side effects occur:
Check with your doctor as soon as possible if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:
Other side effects not listed may
also occur in some patients. If you notice any other effects, check with your
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you
take depends on the strength of the medicine. Also, the number of doses you
take each day, the time allowed between doses, and the length of time you take
the medicine depend on the medical problem for which you are using the
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be
used at or around the time of eating food or eating certain types of food since
interactions may occur. Using alcohol or tobacco with certain medicines may
also cause interactions to occur. Discuss with your healthcare professional the
use of your medicine with food, alcohol, or tobacco.
This medicine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Hearing problems and loss of balance are more likely to occur in children, who are usually more sensitive to the effects of cisplatin.
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of cisplatin in the elderly with use in other age groups.
Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.
There are no adequate studies in women for determining
infant risk when using this medication during breastfeeding. Weigh the
potential benefits against the potential risks before taking this medication