Composition
Inj 5 mg/ 10 mg/ 25 mg/ 50 mg/ 100 mg: Solution ready for use of 5 mg/ 10 mg/ 25 mg/ 50 mg/ 100 mg cisplatinum
Indications & Dosage
Treatment of testicular, lung, cervical, bladder, head and neck, and ovarian cancer (alone or in combination): BY IV INF: Adult: See product literature. Metastatic testicular tumours: Adults: 20 mg/m2 daily for 5 consecutive days (days 1 to 5) every 3rd week for 4 courses, 30 units of bleomycin on the 2nd day of each week for 12 consecutive doses, 0.2 mg/kg body weight of vinblastine on days 1 and 2 of every 3rd week four courses. Metastatic ovarian tumours: Adult: Once every 3 wk 50 mg/m2and 500 mg/m2of cyclophosphamide. As a monotherapy: 100 mg/m2by intravenous route every 4th wk.
Administration
Pretreatment hydration with 1-2 Litre of fluid is recommended prior to cisplatin administration, adequate hydration and urinary output (> 100 ml/hour), Should be maintained for 24 hours after administration. Aluminuim containing IV infusion sets and needles should not be used due to binding with platinum. Rate of administration has varied from a 15 to 120 mins infusion, 1 mg/min infusion, 6-8 hour infusion, 24 hour infusion or per protocol. Maximum rate of infusion: 1 mg/min in patients with CHF. When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression and to enhance efficacy. Standard IV dilution: Dose 250-1000 ml NS, D5/NS or 05/0.45% NaCI; stable for 72 hours at 4 C to 25 C (in combination with mannitol).
Compatibility
Stable in D5/NS, D51/4NS, D5NS, 1/4NS, 1/3NS, 1/4NS, NS; incompatible with sodium bicarbonate 5%.
Contraindications
Pre-existing severe renal impairment, history of allergic reactions.
Precautions
Hepatic disorders, myelosuppression, renal and hearing impairment, myelosuppression. Discontinue in case of elevated BUN and serum creatinine and decreased CrCl.
Interactions
Anti-neoplastic agents, radiotherapy
Pregnancy
Positive evidence of risk: Avoid
Lactation
Contraindicated. Discontinue breast-feeding.
Side Effects
Alopecia, bone-marrow suppression, Extravasation, hyperuricaemia ,hypomagnesaemia, myelosuppression, nephrotoxicity, oral mucositis, ototoxicity, peripheral neuropathy, severe nausea, severe vomiting, thromboembolism, tumourlysis syndrome, hearing loss, anaphylactic reactions (e.g. drug eruption), elevated GOT OPT ALP; malaise, dizziness, flush, oedema.