Cisplatin: Uses, Dosage, Side Effects, and Safety Information

Cisplatin is a platinum-based chemotherapy medicine used in combination treatment for certain cancers, including advanced testicular, ovarian, and bladder cancers. It is also used in treatment regimens for some other cancers, such as non-small cell lung cancer and head and neck cancers. Cisplatin works by damaging the DNA of cancer cells, which interferes with DNA copying and cell division. This guide covers cisplatin uses, side effects, precautions, drug interactions, use in pregnancy and breastfeeding, brand names and its approximate price in India.

Cisplatin at a Glance

Where Cisplatin Is Commonly Used

• Testicular cancer: Used in combination chemotherapy regimens for certain advanced testicular cancers.
• Ovarian cancer: Used in specific chemotherapy regimens for advanced ovarian cancer.
• Bladder cancer: Used in chemotherapy regimens for advanced bladder cancer.
• Non-small cell lung cancer (NSCLC): Used in combination treatment regimens for certain patients.
• Head and neck cancers: Used in combination treatment, including some chemoradiation regimens.

The US FDA label specifically lists advanced testicular, ovarian, and bladder cancer. Cisplatin is also used in other cancers, including some lung and head and neck cancers, depending on the treatment regimen, clinical guidelines, and country.

How Cisplatin Is Given and Typical Dosages

Cisplatin is not a pill you can take at home. It is given intravenously under the supervision of an oncology team. Patients usually receive fluids before and after the infusion, along with anti-sickness medicines, to help reduce the risk of kidney toxicity and control nausea and vomiting.

Cisplatin dosing depends on the type and stage of cancer, the treatment regimen, combination medicines, body size, kidney function, previous treatment, and other clinical factors. Examples of dosing schedules from prescribing information include:

• Testicular cancer: Around 20 mg per square meter of body surface area daily for five days, repeated every three weeks.
• Ovarian cancer: Typically 75–100 mg per square meter once every three to four weeks.
• Bladder cancer: Doses of 50–70 mg per square meter every three to four weeks.

Other doses and combination regimens are also used. The oncology team decides the exact treatment plan based on the individual cancer and clinical situation. Cisplatin is given only under medical supervision. Do not start, stop, or change your treatment on your own.

Side Effects You Might Experience with Cisplatin

• Nausea and vomiting: Cisplatin can cause significant nausea and vomiting, although anti-sickness medicines can help control these effects.
• Kidney problems: Cisplatin can cause kidney toxicity, so kidney function and hydration are monitored closely during treatment.
• Hearing problems: Some people experience ringing in the ears (tinnitus) or hearing loss. The risk can increase with repeated doses.
• Lower blood cell counts: Cisplatin can reduce blood cell counts, increasing the risk of infections and bleeding.
• Electrolyte imbalances: Levels of minerals such as magnesium, potassium, calcium, and sodium can fall and may require monitoring or supplementation.
• Nerve problems: Numbness or tingling in the hands and feet can develop and may worsen with repeated treatment. In some people, nerve problems may persist after treatment.
• Hair loss: Cisplatin can cause hair loss.
• Eye problems: Rarely, cisplatin can cause serious eye-related problems, including changes in vision.
• Allergic reactions: Serious hypersensitivity reactions can occur, sometimes during or shortly after the infusion.

Serious Side Effects: Get Medical Help Promptly

Contact your oncology team promptly if you develop:

• Fever or other signs of infection
• Unusual bleeding or bruising
• New or worsening numbness or tingling
• Ringing in the ears or hearing changes
• Vision changes
• Severe or persistent vomiting
• Signs of an allergic reaction, such as facial swelling, wheezing, difficulty breathing, or a racing heartbeat

Who Should Avoid Cisplatin or Use It with Caution?

• Severe allergy to cisplatin: Severe hypersensitivity to cisplatin is a formal contraindication in current US prescribing information. Reactions to other platinum-based medicines have also been reported, so tell your doctor about any previous reaction to a similar medicine.
• Existing kidney problems: Cisplatin can be hard on the kidneys. Significant kidney impairment may affect whether cisplatin is appropriate and may require dose modification or another treatment.
• Hearing problems: Cisplatin can worsen hearing problems and cause tinnitus or hearing loss. Your doctor may arrange hearing tests before or during treatment.
• Low blood counts or existing nerve damage: These conditions require particular caution and may affect the choice or dosing of treatment.
• Children: Hearing loss can be more severe in children, particularly young children. Hearing and, when appropriate, vestibular monitoring may be needed.
• Older adults: Older adults may be more susceptible to kidney, nerve, blood-count, and other treatment-related effects.

Contraindications and precautions can vary between cisplatin products and countries. Your oncology team will consider the specific product labeling and your overall clinical condition before treatment.

Cisplatin Considerations for Pregnancy, Breastfeeding, Liver, and Kidneys

• Pregnancy: Cisplatin can cause fetal harm and is generally avoided during pregnancy unless the oncology team determines that treatment is necessary. Tell your doctor if you are pregnant or may become pregnant before treatment.
• Breastfeeding: Breastfeeding is not advised during cisplatin treatment. Discuss feeding options with your oncology team.
• Liver: Liver enzyme changes can occur with cisplatin, but kidney function and electrolyte monitoring are particularly important during treatment. Your oncology team may monitor liver function when clinically appropriate.
• Kidneys: Cisplatin can cause significant kidney toxicity. Doctors monitor kidney function and electrolytes closely and may modify treatment if kidney function is impaired.

Cisplatin Drug Interactions

Some medicines can increase the risk of kidney or hearing toxicity when used with cisplatin, including:

• Aminoglycoside antibiotics
• Amphotericin B, an antifungal medicine
• Loop diuretics, such as furosemide, particularly when used in ways that increase the risk of hearing toxicity
• Phenytoin, a seizure medicine, because cisplatin may affect phenytoin levels and seizure control

Tell your oncology team or pharmacist about all prescription medicines, over-the-counter medicines, supplements, and herbal products you use. This list is not complete, and your treatment team will assess interactions based on your complete treatment regimen.

Popular Brands of Cisplatin

• India: Platinex
• US: Platinol was the original brand; it has been discontinued, and cisplatin is available as a generic injection.

Brand availability, strengths, formulations, and prices may vary by manufacturer and country.

Cisplatin Price in India

Cisplatin injection prices vary by strength, formulation, brand, manufacturer, pharmacy, location, and discounts.

For example:

• Platinex Injection (cisplatin 1 mg/mL): approximately ₹65 per vial
• Some 50 mg cisplatin injections: approximately ₹300–₹350 per vial

These are approximate examples only and are not universal prices for all cisplatin products. Actual prices may vary.

How HealthPil Can Help

If you’re undergoing chemotherapy or have questions about cisplatin, a qualified doctor can review your symptoms, treatment-related concerns, current medicines, and medical history and help you understand what questions to discuss with your oncology team.

Consult a qualified doctor through HealthPil for personalized medical guidance.