Drug reference

Cisplatin

Platinum-based alkylating-like agent · Antineoplastic

Also known as Platinol, CDDP

START

Regimen-specific 50–100 mg/m² IV q3–4 weeks WITH aggressive hydration + antiemetics

TYPICAL MAX

~100 mg/m² per cycle

STOP IF

CrCl <60 / rising creatinine, ototoxicity, severe neuropathy, anaphylaxis

WATCH

Renal function + electrolytes (Mg/K) each cycle, audiometry, neuro exam, CBC, hydration

CDSCO approvedSchedule HATC L01XA01

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 1h · IV infusion
PEAK: 1h · end of infusion
t½: 30min · free platinum initial t½
DURATION: 3w · 3-week cycle

EXCRETION

Renal, slow; prolonged tissue retention

route + CYP

INTERACTIONS

12 major

incl. contraindicated

PREGNANCY

Avoid — teratogenic/fetotoxic; effective contraception during and after

FDA category + note

Top interactionssee all 12 →

Live VaccinesContraindicatedDatabaseKimi deep-research + Cla
AminoglycosideSevereTextbookKDT 7e · p746
TorsemideSevereTextbookG&G 14e · p566
AdalimumabSevereDatabaseDDInter

Available in India

42 branded formulations. Look up specific brands in the Drugs workspace.

Mechanism

Aquated cisplatin forms intra- and interstrand DNA crosslinks (predominantly 1,2-intrastrand d(GpG) adducts), distorting DNA, blocking replication/transcription and triggering apoptosis; cell-cycle non-specific.

Indications

Testicular, ovarian, bladder cancersLung (NSCLC/SCLC), head and neck, cervical, oesophageal/gastric cancersMany curative-intent combination regimens; chemoradiation sensitiser

Dosing

Adult: Regimen-specific: e.g. 50–100 mg/m² IV every 3–4 weeks, or 20 mg/m²/day ×5; always with vigorous pre/post hydration ± mannitol and antiemetics.
Pediatric: Protocol-specific (specialist oncology).
Renal adjustment: Hold/avoid if CrCl <60 mL/min or rising creatinine; reduce dose and ensure aggressive hydration; carboplatin often substituted.
Hepatic adjustment: No specific adjustment (minimal hepatic clearance).
Geriatric: Higher nephro/oto/neurotoxicity; reduce/monitor.
Max dose: ~100 mg/m² per cycle (regimen-defined)

Pharmacokinetics

Onset

Counts nadir ~day 18–23

Peak effect

End of infusion

Duration

Cycle-based

Half-life

Free platinum initial ~20–30 min; total platinum t½ days (protein-bound, prolonged)

Bioavailability

100% IV

Protein binding

>90% (irreversibly bound over time)

Metabolism

Non-enzymatic aquation to active species

Excretion

Renal (slow; tissue retention for months)

Contraindications

Pre-existing significant renal impairment
Hearing impairment
Myelosuppression
Hypersensitivity to platinum compounds
Pregnancy/breastfeeding

Side effects

Common

Severe nausea/vomiting (highly emetogenic)NephrotoxicityOtotoxicity (tinnitus, high-frequency loss)Peripheral neuropathyElectrolyte wasting (Mg, K, Ca)Myelosuppression, anaemia

Serious

Dose-limiting nephrotoxicity (tubular injury)
Irreversible ototoxicity
Severe peripheral neuropathy
Anaphylaxis/hypersensitivity
Severe myelosuppression; secondary malignancy
Cardiotoxicity; posterior reversible encephalopathy

Pregnancy & lactation

Pregnancy

Avoid — teratogenic/fetotoxic; effective contraception during and after

Lactation

Contraindicated — discontinue breastfeeding

Drug interactions

Live Vaccines

Contraindicated

Database

Immunosuppression

Avoid live vaccines

Source: Kimi deep-research + Cla

Aminoglycoside

Severe

Textbook

Increased risk of nephrotoxicity.

Avoid concurrent use.

Source: KDT 7e · p746

Torsemide

Severe

Textbook

Enhanced ototoxicity.

Not explicitly stated, but implies careful monitoring or avoidance if possible.

Source: G&G 14e · p566

Adalimumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Aldesleukin

Severe

Database

Drug interaction classified as: others.

Source: DDInter

Amikacin

Severe

Database

Increased risk of acute kidney injury and ototoxicity

Avoid concomitant use. If unavoidable, monitor renal function and auditory function extremely closely. Consider alternative antibiotics if possible during cisplatin therapy.

Source: DDInter

Aminoglycosides

Severe

Database

Additive nephro- and ototoxicity

Avoid; if essential, monitor renal function/audiometry

Source: Kimi deep-research + Cla

Amiodarone

Severe

Database

Drug interaction classified as: synergy.

Source: DDInter

Arsenic Trioxide

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Baricitinib

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Carboplatin

Severe

Database

Significantly increased risk and severity of nephrotoxicity, ototoxicity, and myelosuppression. This combination is generally not used due to cumulative toxicity.

This combination is rarely used due to severe overlapping toxicities. If considered in very specific protocols, extreme caution, intensive monitoring of renal function, audiometry, and CBCs are required. Dose reductions are likely necessary.

Source: DDInter

Certolizumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter