The Navigation Model of Therapy: Why Awareness Changes Everything
November 16, 2025
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Brand Name :
Platinol-AQ
Synonyms :
Cis-Diamminedichloroplatinum, cisplatin, Cisplatino
Class :
Antineoplastics, Alkylating Agent, Platinum Analog
Brand Name :
Platinol-AQ
Synonyms :
Cis-Diamminedichloroplatinum, cisplatin, Cisplatino
Class :
Antineoplastics, Alkylating Agent, Platinum Analog
Adult
Dosage Forms & Strengths
Injectable Solution (IV)
1 mg/mL
50 mg/50 mL
100 mg/100 mL
200 mg/200 mL
Cisplatin is used in the treatment of advanced bladder cancer with a recommended dose of 50 to 70 mg/m2 via IV administration with a duration of 3 or 4 weeks based on radiation therapy or chemotherapy previously administered
In the case of patients who are pretreated, the heavily recommended starting dose is 50 mg/m2/cycle, which is repeated every four weeks duration
Dose Adjustments
Renal Dose Adjustment
In case of renal impairment, the dose is decreased by 25% if CrCl is between 10 and 50 mL/min. If CrCl is above 10 mL/min, then administer a dose that is 50 % of the initial dose
Renal dose adjustment
In case of renal impairment, the dose is decreased by 25% if CrCl is between 10 and 50 mL/min. If CrCl is above 10 mL/min, then administer a dose that is 50 % of the initial dose:
The recommended dose of cisplatin via IV administration is 20 mg/m2/day for five days initially and then repeated every three weeks in combination with bleomycin and etoposide
Injectable Solution (IV)
1 mg/mL
50 mg/50 mL
100 mg/100 mL
200 mg/200 mL
Off-label
The recommended dose of cisplatin via IV is 90 mg/m2 every three weeks:
Off-label
The recommended dose of cisplatin is 60 mg/m2 via IV once daily for 48 hours every 3 or 4 weeks:
Refer to the adult dosingÂ
may diminish the therapeutic efficacy when combined with clobetasol propionate
When both drugs are combined, there may be an increased risk or severity of adverse effects  
nephrotoxicity associated with netilmicin may be enhanced with cisplatin
it increases the nephrotoxicity of aminoglycosides
neomycin/polymyxin B/bacitracin topical
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
tinidazole has the potential to reduce the rate of excretion of cisplatin, potentially leading to an elevation in level of serum
When cisplatin is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
nephrotoxicity associated with cisplatin may be enhanced with loop diuretics
nephrotoxicity associated with cisplatin may be enhanced with loop diuretics
nephrotoxicity associated with cisplatin may be enhanced with loop diuretics
there is an increased risk of immune-mediated nephritis if used in combination with toripalimab
cisplatin pharmacodynamically antagonistically reduces the efficacy of the influenza A (H5N1) vaccination
both cisplatin and acyclovir exacerbate ototoxicity and/or nephrotoxicity
When cisplatin is used in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine
By synergism effects, the toxicity of the other drug increases.
both drug toxicity increases by synergism action
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when thiotepa and cisplatin combine, the toxicity of both drugs increases by synergism     
when both drugs are combined, there may be an increased risk of nerve damage   
may enhance the risk of renal dysfunction due to nephrotoxicity and ototoxicity
May increase the nephrotoxicity of aminoglycoside antibiotics
May increase the nephrotoxicity of aminoglycoside antibiotics
the serum concentration of melphalan is increased with cisplatin when used in combination
the serum concentration of cisplatin is increased when used in combination with trilaciclib
both cisplatin and acyclovir exacerbate ototoxicity and/or nephrotoxicity
When cisplatin is used together in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine
Cisplatin inhibits DNA synthesis through cross-links by binding covalently to DNA bases. It is used in treating metastatic tumors, ovarian carcinoma, and advanced bladder cancer. Off-label treatments for prostate, endometrium, cervical, head, neck, squamous cell, osteogenic sarcomas, lung cancer, and bone marrow transplants.
Frequency defined
>10%
Nausea (76-100%)
Vomiting (76-100%)
Nephrotoxicity (28-36%)
Neurotoxicity
Thrombocytopenia (25-30%)
Leukopenia (25-30%)
Anemia (<40%)
Raised liver enzyme levels
Ototoxicity
1-10%
Local irritation
<1%
Hyperuricemia
Ageusia
Anaphylaxis
Alopecia
Autonomic neuropathy
Heart block
Hemolytic anemia
Hiccups
Bronchoconstriction
Cardiac arrhythmia
Cardiac failure
Cerebral arteritis
Extravasation
Hypocalcemia
Hemolytic anemia
Hypotension
Hypophosphatemia
Hyponatremia
Hypomagnesemia
Hypokalemia
Mesenteric ischemia
Myocardial infarction
Pancreatitis
Vision loss
Thrombotic thrombocytopenic purpura
Vasospasm
Thrombosis
Papilledema
Lhermitte’s sign
Increased serum amylase
Neutropenic enterocolitis
Peripheral ischemia
Leukoencephalopathy
Vision color changes
Myelosuppression
Contraindications include bone marrow suppression, extrusion, gastrointestinal toxicity, hypersensitivity, nephrotoxicity, neurotoxicity, ocular and ototoxicity, and secondary malignancies.
Pregnancy consideration:
Fetal harm is associated with cisplatin when given to pregnant women.
Breastfeeding warnings:
Limited data is available regarding the excretion of drug in breast milk.
Pregnancy category:
Category A:Â well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D:Â adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: No data is available for the drug under this category.
Pharmacology:
Pharmacodynamics:
Cisplatin inhibits DNA synthesis by denaturing strands and binding covalently to bases causing breakage after intrastrand cross-linking.
Pharmacokinetics:
Protein-bound is >90%
The half-life is 1-2 days
Patients should adequately hydrate before cisplatin therapy with (pretreatment & post treatment) hydration achieved through 5% glucose IV infusion over 2-4 hours and cisplatin injection administered over desired period.
Generic Name: cisplatin
Pronounced: sis-PLA-tin
Why do we use cisplatin?
Cisplatin treats metastatic tumors, ovarian carcinoma, advanced bladder cancer, prostate, endometrium, cervical, head, neck, squamous cell, osteogenic sarcomas, lung cancer, and bone marrow transplants.
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