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What is cisplatin?
Cisplatin is an antineoplastic medication. Cisplatin interferes with the growth of cancer cells and slows their growth and spread in the body. Cisplatin is used to treat various types of cancer including metastatic testicular tumors, metastatic ovarian tumors, and advanced bladder cancer. Cisplatin may also be used for purposes other than those listed in this medication guide.

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What are the possible side effects of cisplatin?

If you experience all of the following serious side effects from cisplatin, contact your doctor immediately:

• an allergic reaction (including difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• kidney damage (little or no urine production, blood in the urine);

• hearing loss or ringing in the ears;

• decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; or fever, chills, or signs of infection);

• severe nausea, vomiting, diarrhea, and loss of appetite;

• heart and circulation problems;

• gout or increased uric acid in the blood;

• numbness or tingling;

• blurred vision, altered color perception, blindness, and other visual problems;

• liver damage (abdominal pain, yellowing of the skin or eyes); or

• hair loss.

Other side effects have also been reported. Discuss with your doctor any side effect that occurs during treatment with cisplatin.

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How should I use cisplatin?
Cisplatin should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents. Your doctor will determine the correct amount and frequency of treatment with cisplatin depending upon the type of cancer being treated and other factors. Talk to your doctor if you have any questions or concerns regarding the treatment schedule. Adequate hydration is important during treatment with cisplatin. Your doctor may prescribe the administration of intravenous fluids and/or recommend additional fluid intake by mouth during treatment.

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What is the most important information I should know about cisplatin?
Cisplatin should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents. Serious side effects have been reported with the use of cisplatin including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); kidney damage (little or no urine production, blood in the urine); hearing loss or ringing in the ears; decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; or fever, chills, or signs of infection); severe nausea, vomiting, diarrhea, and loss of appetite; and others. Talk to your doctor about the possible side effects from treatment with cisplatin.

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What happens if I miss a dose?
Contact your doctor if you miss a dose of cisplatin.

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What other drugs will affect cisplatin?
Before using cisplatin, tell your doctor if you are using any of the following medicines to control seizures: carbamazepine (Tegretol, Carbatrol, Epitol); phenytoin (Dilantin); gabapentin (Neurontin); tiagabine (Gabitril); valproic acid (Depakene) or divalproex sodium (Depakote); lamotrigine (Lamictal); felbamate (Felbatol); levetiracetam (Keppra); primidone (Mysoline); zonisamide (Zonegran); topiramate (Topamax); oxcarbazepine (Trileptal); a barbiturate such as mephobarbital (Mebaral) or pentobarbital (Nembutal); or

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Cisplatin has been assigned to pregnancy category D by the FDA. Animal studies have revealed evidence of embryotoxicity and teratogenicity in mice. There are no controlled data in human pregnancy. Cisplatin should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

Out of five known cases where cisplatin was used during pregnancy, four resulted in normal healthy infants. In the fifth case, the mother had been treated with a combination of cisplatin, bleomycin, and etoposide. Both the mother (one week prior to delivery) and the infant (three days after birth) developed neutropenia. Ten days after birth, the infant began losing scalp hair and lanugo. Etoposide was felt to be the causative agent for the neutropenia and alopecia. In one study, cisplatin was administered to male rats before mating. Significant reductions were found in reproductive organ weights, sperm counts, sperm motility, fertility, and levels of testosterone.

Cisplatin is excreted into human milk. Breast-feeding is considered to be contraindicated by the manufacturer.

One case report found milk platinum levels to be one-tenth plasma levels. Another case report found milk platinum levels to be essentially the same as maternal plasma levels. The majority of platinum found in the milk is probably bound to protein and is therefore essentially inactive. Based on the confirmed presence of platinum in breastmilk, however, fetal harm is possible and breast-feeding should be discontinued during cisplatin therapy.

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Who should NOT use this medication?

• Patients with preexisting renal impairment, myelosuppression, or hearing impairment.
• Known hypersensitivity to cisplatin or other platinum-containing compounds or any ingredient in the formulation.

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What does my medication look like?
Cisplatin is available with a prescription under the brand names Platinol and Platinol-AQ. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

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What happens if I overdose?
If for any reason an overdose of cisplatin is suspected, seek emergency medical attention or contact your healthcare provider immediately. Symptoms of a cisplatin overdose tend to be similar to side effects caused by the medication, although often more severe.

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Who should not use cisplatin?
Do not use cisplatin without first talking to your doctor if you have kidney disease; poor bone marrow function; hearing impairment; or an allergy to platinum or platinum-containing products. The use of cisplatin may be dangerous if you have any of the conditions listed above. Cisplatin is in the FDA pregnancy category D. This means that cisplatin is known to be harmful to an unborn baby. Do not use cisplatin without first talking to your doctor if you are pregnant. Discuss with your doctor the appropriate use of birth control during treatment with cisplatin if necessary.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
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