Cisplatin

Generic Name: Cisplatin

Cisplatin Injection (cisplatin injection (cisplatin (cisplatin injection) injection) ) is a sterile aqueous solution, available in 50, 100 and 200 mL multiple dose vials, each mL containing 1 mg of cisplatin (cisplatin injection) and 9 mg sodium chloride in water for injection. HCI and/or sodium hydroxide added to adjust pH to 3.5 to 4.5.

Cisplatin (cisplatin injection) (cis-diamminedichloroplatinum) is a heavy metal complex containing a central atom of platinum surrounded by two chloride atoms and two ammonia molecules in the cis position. It is a white powder with the molecular formula PtCl2H6N2, and a molecular weight of 300.05. It is soluble in water or saline at 1 mg/mL and in dimethylformamide at 24 mg/mL. It has a melting point of 207°C.

CISPLATIN Structural Formula Illustration

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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:

Less common

  • Black, tarry stools
  • blood in urine or stools
  • cough or hoarseness accompanied by fever or chills
  • dizziness or faintness (during or shortly after a dose)
  • fast heartbeat (during or shortly after a dose)
  • fever or chills
  • lower back or side pain accompanied by fever or chills
  • painful or difficult urination accompanied by fever or chills
  • pain or redness at place of injection
  • pinpoint red spots on skin
  • swelling of face (during or shortly after a dose)
  • unusual bleeding or bruising
  • wheezing (during or shortly after a dose)

Check with your doctor as soon as possible if any of the following side effects occur:

More common

  • Joint pain
  • loss of balance
  • ringing in ears
  • swelling of feet or lower legs
  • trouble in hearing
  • unusual tiredness or weakness

Less common

  • Convulsions (seizures)
  • loss of reflexes
  • loss of taste
  • numbness or tingling in fingers or toes
  • trouble in walking

Rare

  • Agitation or confusion
  • blurred vision
  • change in ability to see colors (especially blue or yellow)
  • muscle cramps
  • sores in mouth and on lips

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:

More common

  • Nausea and vomiting (severe)

Less common

  • Loss of appetite

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 healthcare professional.

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 medicine.

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.

  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rotavirus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Varicella Virus Vaccine

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.

  • Adenovirus Vaccine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Cholera Vaccine, Live
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Furosemide
  • Influenza Virus Vaccine, Live
  • Paclitaxel
  • Poliovirus Vaccine, Live
  • Rituximab
  • Smallpox Vaccine
  • Thioctic Acid
  • Topotecan
  • Typhoid Vaccine
  • Valproic Acid
  • Vinorelbine
  • Yellow Fever Vaccine

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.

  • Aldesleukin
  • Docetaxel
  • Fosphenytoin
  • Lithium
  • Phenytoin
  • Tobramycin
  • Warfarin

Other Interactions

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:

Allergies

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.

Pediatric

Hearing problems and loss of balance are more likely to occur in children, who are usually more sensitive to the effects of cisplatin.

Geriatric

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.

Pregnancy

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.

Breastfeeding

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 while breastfeeding.

All Relative Medicines

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CISPLATIN
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(10ml vial Inj.) of 10mg/10ml
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CISPLATIN
CYTOPLATIN

(1vial Inj.) of 50mg
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CISPLATIN
CYTOPLATIN

(1vial Inj.) of 10mg
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CISPLATIN
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(vial Inj.) of 10mg
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CISPLATIN
PLATIKEM

(vial Inj.) of 50mg
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CISPLATIN
ONCOPLATIN-AQ

(20ml Inj.) of 10mg/20ml
Rs. 80.25 INR
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CISPLATIN
CISPLAN

(vial Inj.) of 50mg/vial
Rs. 364.80 INR
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CISPLATIN
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(vial Inj.) of 10mg/vial
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CISPLATIN
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(50ml vial Inj.) of 10mg/10ml
Rs. 275.00 INR
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CISPLATIN
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(20ml Inj.) of 10mg
Rs. 95.35 INR
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CISPLATIN
PLATINEX

(50ml Inj.) of 10mg/10ml
Rs. 347.80 INR
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