How cisplatin works
Cisplatin is an inorganic platinum-containing heavy metal compound. It is a so-called cytostatic drug: It inhibits DNA synthesis in cells by senselessly cross-linking the DNA strands. This means that the DNA information cannot be read or can only be read incorrectly. Cell division is thus inhibited – the cell perishes.
Absorption, degradation and excretion
After intravenous administration, the active ingredient spreads throughout the body and also passes the blood-brain barrier. It accumulates particularly in the kidney, liver, intestine and testis.
Cisplatin and its metabolites are excreted mainly in the urine, and to a lesser extent in the bile. After about 24 hours, half of the administered dose has left the body.
When is cisplatin used?
- Testicular cancer
- Bladder Cancer
- Esophageal cancer
- Ovarian cancer
- Cervical cancer (cervical carcinoma)
- Lung cancer
- Pancreatic cancer
How cisplatin is used
Cisplatin is given to the patient by infusion. It can be used as the only drug (monotherapy) or in combination with other cancer drugs, in a wide variety of treatment protocols.
What are the side effects of cisplatin?
The side effects of cisplatin are varied and show up in a wide variety of areas of the body:
- Digestive tract: severe nausea and vomiting (even over several days), loss of appetite, diarrhea, inflammation of the mucous membranes (mucositis) and intestines (enteritis)
- Nervous system: damage to the inner ear and peripheral nerves, impaired vision and taste, optic neuritis, dizziness, rarely damage to the brain.
- Other: Infertility
What should be considered when using cisplatin?
Contraindications
Cisplatin must not be administered to:
- known allergy to cisplatin or other platinum complexes
- renal dysfunction
- acute infections
- existing hearing disorders
- severe dehydration (exsiccosis)
- Pregnancy and breastfeeding
Interactions
The cancer drug suppresses the bone marrow (myelosuppression) and thus blood formation. In combination with other myelosuppressive drugs or radiation therapy, this effect is intensified.
Simultaneous use of ifosfamide (also a cytostatic drug) increases the risk of hearing impairment.
If cisplatin is administered immediately before paclitaxel (also a cytostatic drug), this impairs its excretion.
Age restriction
Cisplatin may be administered from birth if indicated.
Pregnancy and Lactation
Seven cases of cisplatin therapy in pregnant women have been documented in the literature:
- In one case, the child was normal for age at 10 weeks’ gestation.
- The remaining five children developed without abnormalities.
Measured plasma concentrations of cisplatin in mothers during breastfeeding were identical to those in breast milk. Therefore, do not breastfeed during cisplatin therapy.
How to obtain medications containing cisplatin
Cisplatin is available by prescription in Germany, Austria, and Switzerland.
