Cisplatin Dosage

This dosage information may not include all the information needed to use Cisplatin safely and effectively. See additional information for Cisplatin.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Testicular Cancer

20 mg/m2 intravenously once a day for 5 days per cycle (in combination with other antineoplastic drugs)

Usual Adult Dose for Ovarian Cancer

75 to 100 mg/m2 intravenously once every 4 weeks (in combination with cyclophosphamide for the treatment of metastatic ovarian cancer).

Alternatively, 100 mg/m2 intravenously once every 4 weeks may be administered (as a single agent for the treatment of metastatic ovarian cancer).

If the ovarian cancer remains confined to the peritoneal cavity, the following regimens may be used:

60 to 90 mg/m2 in 2 liters of 0.9% sodium chloride solution or lactated Ringer's injection intraperitoneally once.

Alternatively, 90 to 270 mg/m2 in 2 liters of 0.9% sodium chloride solution or lactated Ringer's injection intraperitoneally once may be administered (to be given with intravenous sodium thiosulfate to reduce the risk of nephrotoxicity associated with this relatively high dose).

Usual Adult Dose for Bladder Cancer

50 to 70 mg/m2 intravenously once every 3 to 4 weeks (as a single agent for the treatment of advanced bladder cancer in patients WITHOUT history of extensive X-radiation or chemotherapy).

Alternatively, 50 mg/m2 intravenously over 6 to 8 hours every 4 weeks may be administered (as a single agent for the treatment of advanced bladder cancer in patients WITH history of extensive X-radiation or chemotherapy)

Usual Adult Dose for Neuroblastoma

60 to 100 mg/m2 once every 3 to 4 weeks

Usual Adult Dose for Osteogenic Sarcoma

60 to 100 mg/m2 once every 3 to 4 weeks

Usual Adult Dose for Brain/Intracranial Tumor

60 mg/m2 once a day for two consecutive days every 3 to 4 weeks

Usual Adult Dose for Bone Marrow Transplantation

Continuous infusion: High Dose: 55 mg/m2/day for 72 hours (Total Dose = 165 mg/m2)

Usual Adult Dose for Blood Cell Transplantation

Continuous infusion: High Dose: 55 mg/m2/day for 72 hours (Total Dose = 165 mg/m2)

Usual Adult Dose for Non-Small Cell Lung Cancer

60 to 100 mg/m2 intravenously on day one every 21 days (in combination with other antineoplastic drugs)

Usual Adult Dose for Cervical Cancer

(In combination with radiation therapy)
40 mg/m2 IV weekly
Maximum dose: 70 mg/week
Cisplatin is given 4 hours before radiation therapy on weeks 1 through 6

(In combination with paclitaxel)
75 mg/m2 IV on day 2
The cycle is repeated every 21 days.

(In combination with other chemotherapeutic agents as a part of the BIP regimen)
50 mg/m2 IV on day 2
The cycle is repeated every 21 days.

(In combination with other chemotherapeutic agents as a part of various regimens)
50 to 200 mg/m2 IV on day 1

Renal Dose Adjustments

According to the manufacturer and the FDA, cisplatin is contraindicated in patients with preexisting renal impairment. However, if the benefits of this drug outweigh its risks for this patient, the following guidelines may be useful:

Some clinicians have suggested the use of 75% of the regularly recommended dosage for patients with a creatinine clearance ranging from 10 to 50 mL/min.

Some clinicians have suggested the use of 50% of the regularly recommended dosage for patients with a creatinine clearance below 10 mL/min.

Liver Dose Adjustments

Data not available

Dose Adjustments

Dosages of cisplatin may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered.

Precautions

Nephrotoxicity, ototoxicity, and peripheral neuropathy tend to become more severe with repeated courses of cisplatin and with the concomitant use of paclitaxel. Frequent monitoring of this patient's renal and liver function, complete blood cell counts, and audiometric examinations as clinically appropriate is strongly recommended. In the absence of persistent abnormalities, the manufacturer recommends checking these parameters weekly to periodically.

A repeat course of cisplatin should not be given until the:
1) serum creatinine is below 1.5 mg/dl and/or the BUN is below 25 mg/dl
2) platelet count is at least 100,000 mm3
3) WBC count is at least 4,000/mm3
4) absolute neutrophil count is greater than 1500
5) an audiometric analysis indicates that auditory acuity is within normal limits

Injection site reactions may occur during the administration of cisplatin. Given the possibility of extravasation, it is recommended to closely monitor the infusion site for possible infiltration during drug administration. A specific treatment for extravasation reactions is unknown at this time.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Because hemodialysis is effective in removing cisplatin within the first 90 minutes after drug administration, it is recommended that doses be given after dialysis (if doses are scheduled on the days this patient is dialyzed).

Other Comments

To reduce the risk of cisplatin-induced nephrotoxicity, pretreatment assessment of this patient's renal function and serum electrolytes, including serum calcium, potassium and magnesium concentrations, as well as pretreatment hydration with 1 to 2 liters of fluid prior to IV cisplatin therapy is recommended. Amifostine has been approved to reduce the cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer or non-small cell lung cancer. Posttreatment hydration with normal saline containing potassium chloride and magnesium sulfate may be appropriate.

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