Cisplatin
Cisplatin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Cisplatin
ATX code: L01XA01
Active ingredient: cisplatin (cisplatinum)
Manufacturer: LENS-PHARM (Russia), RONTs im. N. N. Blokhin RAMS (Russia), Serum Institute of India Ltd. (India)
Description and photo update: 2018-21-11
Cisplatin is an alkylating drug.
Release form and composition
The dosage form of the release of Cisplatin is a concentrate for preparing a solution for infusion (in vials of 10, 25 or 50 ml, in a cardboard box 1 bottle).
Composition of 1 ml of concentrate:
- active substance: cisplatin - 0.001 g;
- auxiliary components: water for injection, sodium chloride, hydrochloric acid.
Pharmacological properties
Pharmacodynamics
Cisplatin, the active substance of the drug, is a platinum derivative with antitumor properties. The mechanism of its action is due to the ability to penetrate the cell, bind with deoxyribonucleic acid (DNA), thereby forming cross-links having the structure of DNA, and disrupt its functioning.
Through the formation of chelating compounds with nucleic acid molecules, the cis-complexes of platinum form stable bonds in the strands of the DNA helix. As a result, the synthesis of nucleic acids is suppressed, and the cell dies. The synthesis of ribonucleic acid and protein is suppressed to a lesser extent.
The anti-tumor effect is also promoted by the immunosuppressive effect.
Pharmacokinetics
Characteristics of cisplatin:
- absorption: after a rapid intravenous (IV) infusion (the rate of administration varies from 15 minutes to 1 hour) immediately and in the maximum concentration appears in the blood; with prolonged intravenous infusion (infusion rate 6-18 hours), the concentration increases gradually and reaches a maximum by the end of the administration;
- distribution: in the highest concentrations found in the liver, kidneys and prostate gland; only cisplatin, which is not bound to proteins, has a cytotoxic property; 2 hours after a three-hour infusion, 90% of the platinum is bound; with a repeated course of therapy, there is an accumulation of platinum, it is found in tissues for 6 months after the last dose; with daily administration of the drug, there is a possibility of accumulation of free platinum in the blood;
- Excretion: T½ (half-life) varies from 2 to 72 hours, with renal failure it can reach 240 hours; after 1 hour, most of the agent is excreted unchanged through the kidneys, a small part through the digestive tract.
Indications for use
- germ cell tumors (in men and women);
- lymphoma;
- melanoma;
- neuroblastoma;
- osteosarcoma;
- Cancer: cervix, esophagus, bladder, ovary, testicle, lung (small cell and non-small cell), neck and head (squamous).
Contraindications
- impaired renal function;
- nephrourolithiasis;
- polyneuritis;
- inhibition of hematopoiesis;
- hyperuricemia;
- hearing loss;
- pregnancy and lactation;
- individual intolerance to the components contained in Cisplatin.
Instructions for the use of Cisplatin: method and dosage
The solution prepared from the concentrate is injected intravenously (IV) in the form of an infusion for 6-8 hours.
For the introduction of Cisplatin, needles and infusion systems that include aluminum parts must not be used. This is due to the fact that aluminum reacts with cisplatin, causing precipitation and diminishing the effect of the drug.
The recommended dose for monotherapy is 0.05–0.1 g per 1 m 2 every 21–28 days or 0.015–0.02 g per 1 m 2 daily for 5 days every 21–28 days.
Before starting treatment (8-12 hours before the dose), hydration is performed using 1-2 liters of fluid. Next, the concentrate is dissolved in 2 liters of 5% dextrose and ½ or ⅓ of saline, which contains 37.5 g of mannitol.
It is important to be careful when handling the drug, use gloves when injecting it. Contact with the skin can lead to the development of skin reactions. In case of accidental contact of the drug on the mucous membrane or skin, it is important to immediately wash it off thoroughly with soap and water. The precautions established for cytotoxic drugs are also followed for cisplatin.
Side effects
- use of usual doses: urticaria, rash, angioedema, hypomagnesemia, azoospermia, amenorrhea, hyperuricemia, hypocalcemia, convulsions, neuritis, neuropathy, disturbed color perception, anemia, thrombocytopenia, leukopenia, stomatitis, anorexia, arterial pressure decrease, nausea, unexpressed kidney damage (detected in the second week of therapy);
- the use of high doses: nephrotoxicity, ototoxicity.
Overdose
The main symptoms: impaired hearing, vision, kidney and liver function, indomitable vomiting.
Therapy: symptomatic treatment. In the first three hours of the onset of symptoms, hemodialysis is effective.
special instructions
It is important to consult your doctor before using Cisplatin.
Application during pregnancy and lactation
The drug is contraindicated for use during pregnancy and lactation.
With impaired renal function
According to the instructions, Cisplatin is contraindicated in case of impaired renal function.
Drug interactions
The effect of drugs / substances on cisplatin when used in combination:
- cephalosporins, loop diuretics, aminoglycosides: enhance its nephrotoxic, neurotoxic and ototoxic effects;
- antipsychotics (thioxanthenes), anthelmintics (phenothiazines) and antihistamines: mask the symptoms of its ototoxicity;
- mannitol: reduces its excretion in the urine.
The combination therapy of cisplatin with uricosuric drugs increases the risk of developing nephropathy.
Analogs
Analogs of Cisplatin are: Platinum, Carboplatin, Platidiam, Oncoplatin, Displanor, Oxaliplatin.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cisplatin
According to reviews, Cisplatin is an effective treatment for ovarian tumors. Patients tolerate the drug in different ways (depending on their age and initial state of health). Vomiting is the most common side effect.
Price for Cisplatin in pharmacies
The price of Cisplatin is currently unknown. In pharmacies, you can buy Cisplantin-Teva concentrate for the preparation of a solution for infusion (100 ml in a bottle) at a price of 867 to 1109 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
