cisplatin
Cisplatin is an anticancer treatment option that’s used for certain types of testicular cancer, ovarian cancer, and bladder cancer. It’s also commonly used off-label for many other types of cancers. Cisplatin can be used by itself, but it’s also often used with other anticancer medications. Cisplatin is given as an infusion through the vein by a healthcare provider. This medication can cause serious kidney problems, so it’s important to stay well hydrated during treatment.
What is Cisplatin?
What is Cisplatin used for?
- Advanced testicular cancer
- Advanced ovarian cancer
- Advanced bladder cancer
How Cisplatin works
Cisplatin is a type of anticancer medication called an alkylating agent. It’s also called platinum-based chemotherapy because it contains the metal platinum. It works by damaging the cancer cells’ genetic material (DNA), which leads to cell death.
Drug facts
Side effects of Cisplatin
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Vomiting
- Changes in hearing
- Abnormal blood cell counts
- Numbness or tingling in the hands or feet
Cisplatin serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infections: repeated fevers, chills, cough, trouble breathing, severe diarrhea, vomiting, painful or frequent urination
- Serious bleeds: bleeding or bruising that doesn’t stop or go away, large amount of bleeding, blood in the urine, throwing up blood, bloody or black and tarry stool
- Kidney problems: blood in the urine (pink or red urine), dark urine, painful urination, difficulty urinating
The following Cisplatin side effects have also been reported
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.
Check with your doctor immediately if any of the following side effects occur:
More common
Black, tarry stools
blood in urine or stools
burning, numbness, tingling, or painful sensations
change in frequency of urination or amount of urine
cough or hoarseness
difficulty in breathing
dizziness
drowsiness
feeling of fullness in the ears
fever or chills
increased thirst
loss of appetite
loss of balance
loss of hearing
lower back or side pain
nausea or vomiting
painful or difficult urination
pinpoint red spots on skin
ringing or buzzing in the ears
swelling of the feet or lower legs
trouble in hearing
unsteadiness or awkwardness
unusual bleeding or bruising
weakness in the arms, hands, legs, or feet
Incidence not known
Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
bleeding gums
blindness
blue-yellow color blindness
blurred vision
chest pain or discomfort
decreased vision
fast heartbeat
general body swelling
headache
leg pain
nosebleeds
pain or discomfort in the arms, jaw, back or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pale skin
sweating
unusual tiredness or weakness
yellow eyes or skin
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:
Incidence not known
hair loss or thinning
indigestion
loss of appetite
muscle cramps
rash
swelling or inflammation of the mouth
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cisplatin
Pros
- Recommended treatment option for certain types of testicular cancer, ovarian cancer, and bladder cancer
- Only need to get infusions every few weeks
- Usually given in the outpatient setting (at an infusion center or clinic)
Cons
- Infusions can take several hours (includes the time to get IV fluids before and after the infusion)
- Can cause a lot of nausea and vomiting
- Not safe while pregnant or breastfeeding
Pharmacist tips for Cisplatin
- It’s important to stay hydrated since cisplatin can be harmful to your kidneys. You should drink plenty of liquids during your infusion and when you’re at home. You’ll also receive an infusion of fluids during your appointment.
- You’ll need to get blood work done regularly while receiving this medication. Cisplatin can lower your blood cell counts and make you more at risk of bleeding or developing an infection. Follow the lab schedule your provider gives you. Tell your care team if you develop a fever.
- It’s usually easier to prevent nausea and vomiting from cisplatin treatment than it is to treat it when it happens. Take your anti-nausea medications as your provider instructs you to, and continue to take them as needed to help with your symptoms. Let your healthcare team know if you can’t eat or drink normally because of nausea or vomiting, so they can help you better manage your symptoms.
- You’ll have your magnesium levels checked as part of your lab work before your cisplatin infusion. This is because the medication can lower your magnesium levels, which can sometimes cause weakness, muscle cramping, tremors, and an irregular heartbeat. Let your provider know if you experience any of these symptoms. You might have to take magnesium supplements or receive IV magnesium if your levels are low.
- If you can become pregnant, you should use birth control while receiving cisplatin and for 14 months after the last dose. This medication can cause harm to an unborn baby.
- If you’re a man with a partner who can get pregnant, you should also use birth control measures, such as condoms, while you’re receiving cisplatin. Continue using birth control for 11 months after your last dose. It’s possible for cisplatin to cause harm to the unborn baby of your partner if you’re taking this medication.
- Cisplatin might affect your ability to have a baby. If you or your partner is thinking about having a child in the future, talk to your provider about your different options before starting cisplatin. These options can include sperm banking or egg freezing.
Common questions about Cisplatin
Cisplatin is only approved by the FDA to treat certain types of testicular, ovarian, and bladder cancers. But according to the National Comprehensive Cancer Network (NCCN) guidelines, it can be used off-label to treat many other types of cancers. Other cancers that the NCCN guidelines recommend cisplatin for include certain small cell and non-small cell lung cancers, cervical cancer, head and neck cancers, and gallbladder cancer. Cisplatin is also recommended as part of treatment for certain metastatic breast cancers and stomach cancers. In these cases, the benefit and safety of using cisplatin off-label is supported by strong evidence from clinical trials. Talk with your provider about whether cisplatin can be used to treat your cancer.
How long the cisplatin infusion takes will vary from person to person. It depends on your treatment regimen and your cisplatin dose. You’ll also need to receive an infusion of fluids before, during, and after you get cisplatin, so that adds time to your appointment. At the very least, you can expect to be at the infusion center for several hours to receive your treatment. For this reason, make sure you bring something with you to your appointment to help pass the time.
Let your provider know if you experience nausea or vomiting while receiving cisplatin. They can suggest ways to help you manage these side effects both with and without medications. You’ll be prescribed anti-nausea medications while you’re getting treatment for your cancer. Follow the directions your provider gives you on how to take them, and continue to take them as needed to help with your symptoms. Besides medications, you can also try eating smaller, more frequent meals; drinking plenty of fluids to stay hydrated; and avoiding strong smells. Your provider might also recommend complementary therapies, such as acupuncture, acupressure, hypnosis, or other relaxation techniques.
One of the easiest ways to lower your chances of developing an infection while you’re receiving cisplatin is to wash your hands often. You should also avoid crowded places and people who are sick. To avoid food-borne illnesses, make sure to wash raw fruits and vegetables before eating, and cook foods thoroughly. It’s important to follow these tips during chemotherapy because cisplatin will lower your blood cell counts, weaken your immune system, and make you more likely to develop an infection. This can be a serious problem because it’s also harder to fight off infections with a weakened immune system.
If you have kidney problems, you might be at higher risk for side effects from cisplatin. Your body might have a harder time getting rid of cisplatin through the urine. This can lead to higher levels of the medication in your body and a higher risk of toxicity. You also might be at higher risk for kidney damage that cisplatin can cause. Let your provider know if you have problems with your kidneys, as you’ll need to be monitored more closely and might need a lower dose of cisplatin.
Breastfeeding isn’t recommended while you’re getting treated with cisplatin. Limited data show that some cisplatin can pass into human breast milk and has a potential risk of causing serious harm to nursing babies. Talk to your provider if you have any questions about other ways to feed your baby while receiving cisplatin.
How to save using GoodRx
Risks and warnings for Cisplatin
Cisplatin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to kidneys
- Risk factors: Higher doses of cisplatin | Longer courses of treatment | History of kidney problems | People over 65 years of age | Taking other medications that can cause kidney injury | Not staying well hydrated
Cisplatin can cause harm to the kidneys. In some cases, it can be severe enough to cause kidney failure. To lessen this risk, you’ll be given an infusion of fluids before, during, and after each cisplatin infusion. Your provider will closely check your kidney function while you’re receiving treatment. Reach out to your provider right away if you experience blood in the urine, pain or problems while urinating, or changes in the color or cloudiness of the urine. These can be signs of a serious kidney problem.
Nerve problems
- Risk factors: Higher doses of cisplatin | Longer courses of treatment | People over 65 years of age
Cisplatin can cause new or worsening nerve problems in your arms, hands, legs, and feet. They can start after your first dose of cisplatin, but also even weeks after your last infusion. Sometimes, the nerve problems can continue after stopping treatment. Let your provider know if you experience numbness, pain, burning, a feeling of "pins and needles," tremors, problems with balance, or weakness in your arms or legs.
Nausea and vomiting
Cisplatin is known to cause significant nausea and vomiting. Usually, the nausea and vomiting can start a few hours after your infusion and last up to 3 days. Sometimes, the effects can still linger 1 week after treatment. To try and prevent nausea and vomiting before it happens, you’ll be given anti-nausea medications before and after your infusion. Make sure you follow your provider’s instructions on how to take your anti-nausea medications when you get home.
Low blood cell counts
- Risk factors: People over 65 years of age
Cisplatin can cause your red blood cell, white blood cell, and platelet counts to drop. When the number of these cells are lower than normal, you’re at risk of developing anemia, infections, and bleeding or bruising. In some cases, your blood cell counts might be low for a while. This is because your chemotherapy medications can weaken your bone marrow and affect its ability to make new blood cells like normal.
Your provider will closely check your blood counts through routine lab work when you’re receiving cisplatin. Let your provider know as soon as possible if you experience extreme tiredness, rapid breathing, fevers, chills, or bleeding and bruising that doesn’t stop or go away.
Allergic reactions
Cisplatin can cause allergic reactions (including anaphylaxis), which can be serious and sometimes life-threatening. These reactions are more likely to happen with the more cisplatin doses you receive. If you’ve had an allergic reaction to similar anticancer medications called carboplatin (Paraplatin) or oxaliplatin (Eloxatin) before, let your provider know so they can observe you more closely when starting cisplatin. Contact your provider or get medical help right away if you experience any throat tightness, trouble breathing, face swelling, fever, chills, hives, flushing, chest pain, fast heartbeat, or dizziness.
Hearing loss
- Risk factors: Children, especially those younger than 5 years old | Radiation to the brain | Taking other medications that can cause hearing loss | History of kidney problems
With repeated doses of cisplatin, you can be at higher risk for developing hearing problems, including hearing loss. This can happen during or after treatment, and it can affect one or both ears. These hearing problems can be more severe in children younger than 5 years of age. Before starting cisplatin, your provider might have you do a baseline hearing test. Then, they’ll regularly check your hearing as you continue treatment. Let your provider know if you experience any ringing in your ears or changes in hearing.
Eye problems
Though rare, some people receiving treatment with cisplatin have had eye problems. Let your provider know if you notice any blurred vision, difficulty seeing colors, vision loss, or other changes in vision. These problems are generally reversible or improve after stopping cisplatin.
Risk for developing other cancers
While rare, some people treated with chemotherapy regimens that included cisplatin have developed secondary cancers, like blood cancers (leukemias). This is when a different kind of cancer develops after you’ve received treatment for the cancer you were originally diagnosed with. Talk to your provider if you’re concerned about your risk for other cancers.
Harm to unborn baby
Cisplatin can harm an unborn baby when it’s used during pregnancy. Because of this risk, you should use birth control during treatment with cisplatin to prevent pregnancy. After treatment, continue to use birth control for another 11 months (for men) or 14 months (for women). Let your provider know right away if you or your partner becomes pregnant during this time.
Skin or tissue injury around the injection site during infusions
Sometimes, cisplatin can leak out of the veins while you receive your infusion. This can cause irritation and damage to the surrounding tissue, muscle, or skin. Your care team should administer the medication into your vein properly to avoid this problem. However, there’s still a small risk of this happening. Let your provider or nurse know right away if you feel pain, swelling, or burning around the IV site.
Cisplatin dosage
Typical dosage for Cisplatin
This medication is an injection that’s given into a vein (intravenous, IV) by a healthcare provider. Your provider will calculate your dose of cisplatin using your body surface area (BSA, in units of m2), which takes into account your body weight and height.
Your dose and infusion schedule depends on the type of cancer you have. It can also differ if you’re getting cisplatin by itself or with other anticancer medications. Your provider will discuss your treatment plan with you.
- Advanced testicular cancer: A possible dosing regimen is 20 mg/m2 given IV daily for 5 days every 3 weeks.
- Advanced ovarian cancer: A possible dosing regimen is 75 mg/m2 to 100 mg/m2 given IV every 3 to 4 weeks.
- Advanced bladder cancer: A possible dosing regimen is 50 mg/m2 to 70 mg/m2 given IV every 3 to 4 weeks.
Interactions between Cisplatin and other drugs
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, Live
- Zoster Vaccine, Live
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
- Dengue Tetravalent Vaccine, Live
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Furosemide
- Influenza Virus Vaccine, Live
- Paclitaxel
- Poliovirus Vaccine, Live
- Rituximab
- Smallpox Vaccine
- Thioctic Acid
- Trilaciclib
- Typhoid Vaccine, Live
- 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.
What are alternatives to Cisplatin?
News about Cisplatin
Cisplatin images
