♦Cisplatin
(sis’-pla-teen)
CDDP, Platinol
Pregnancy Category D
Mechanism of Action
Cisplatin is a widely used heavy metal, cell cycle-nonspecific agent that interferes with cell division by binding to DNA and functioning as an alkylating agent.
Indications
♦ Metastatic testicular tumors
♦ Metastatic ovarian tumors
♦ Advanced carcinoma of the bladder
Metabolism/Excretion
Metabolized in the liver and mostly excreted in the urine; in-significant amounts of fecal excretion.
Dosage Range
Adult
♦ Metastatic testicular tumor: 20 mg/m2 IV daily for 5 days.
♦ Metastatic ovarian tumor: As a single agent, 100 mg/m2 IV once every 4 weeks. In combination with cy-clophosphamide, 75 to 100 mg/m2 on day 1 every 4 weeks. The cyclophosphamide dosage is given at 600 mg/m2 on day 1 once every 4 weeks. In combination therapy, the cisplatin and cyclophosphamide doses are given sequentially.
♦ Advanced bladder carcinoma: Cisplatin should be given as a single agent. The dosage range is 50 to 70 mg/m2 IV once every 3 to 4 weeks, depending on prior treatment with radiation, chemotherapy, or both. The patient must be prehydrated with 1 to 2 L of fluid given over 6 to 8 hours. Adequate urine output should be maintained for 24 hours. A repeat course should not be given until the following parameters are at acceptable levels: serum creatinine <1.5 mg/100 mL; BUN <25 mg/mL; platelets≥100,000/mm3; WBC count≥4000 mm/m3; and an audiogram within normal limits.