CISPLASOL 50ML INJ

Cisplatin's primary mechanism of action is its ability to cause DNA damage and trigger cell death in cancer cells. It achieves this by forming both inter• and intra-strand cross-links with DNA, primarily at the N7 position of guanine bases. These cross-links result in DNA damage and bending, which leads to the activation of DNA repair mechanisms. If the DNA damage is extensive and cannot be repaired, it induces cell cycle arrest and ultimately triggers apoptosis, or programmed cell death. Cisplatin is particularly effective in the S phase of the cell cycle when cells are actively synthesizing DNA, as it interferes with the replication process, leading to the accumulation of DNA damage and subsequent cell death.

Cisplatin

Platinum-based antineoplastic agent

Injection

The following are the uses of Cisplatin Injection:

• Used for treating solid malignant tumours, primarily in the testicles and ovaries.
• Used for testicular cancer treatment, offering high cure rates.
• Used for ovarian cancer, often in combination with other drugs, to improve survival rates.
• Used for treating advanced bladder cancer, sometimes as a primary treatment.
• Used for managing head and neck cancers, often in combination with radiation therapy.
• Used for lung cancer, particularly non-small cell lung cancer, as a standard treatment option.
• Used for cervical cancer treatment, enhancing survival rates when combined with other therapies.
• Used for rare cancers like germ cell tumours and mesothelioma, providing effective control.

In the case of an overdose of Cisplatin Injection, prompt medical intervention is necessary. Symptoms may include severe nausea, vomiting, kidney damage, and hearing loss. Immediate treatment focuses on supportive care, managing hydration, and addressing electrolyte imbalances. Medical professionals should closely monitor vital signs and kidney function, and consider administering diuretics and antiemetics to alleviate symptoms and prevent further complications.

In the case of a missed dose of Cisplatin Injection, it is important to consult your healthcare provider for guidance. Do not administer a double dose to make up for a missed one, as this may increase the risk of side effects. If you realize you've missed a dose, contact your doctor or nurse promptly. They will advise you on whether to reschedule the dose or adjust the timing of subsequent doses to ensure the treatment remains effective while minimizing potential risks.

To administer Cisplatin Injection, prepare the medication under aseptic conditions, and inject it intravenously as a slow infusion over a period of 6 to 8 hours, ensuring proper hydration and diuresis to minimize potential side effects.

Here are the conditions and circumstances under which Cisplatin Injection should not be administered:

• Allergic reactions • Should not be used if the patient has a known allergy to Cisplatin or any other platinum-containing compounds.
• Hearing impairment • Contraindicated in patients with pre-existing severe hearing loss or significant hearing impairment.
• Kidney disease • Not recommended for individuals with severe kidney disease or significantly impaired renal function.
• Myelosuppression • Should be avoided in patients with pre-existing severe bone marrow suppression or myelosuppression.
• Pregnancy and breastfeeding • Cisplatin is contraindicated during pregnancy as it may cause fetal harm. It should also not be used by breastfeeding mothers due to potential risks to the infant.
• Electrolyte imbalance • Not suitable for patients with severe electrolyte abnormalities, especially hypomagnesemia (low magnesium levels).
• Neuropathy • Should be used with caution in patients with pre-existing peripheral neuropathy, and avoided if the neuropathy is severe.

The side effects of Cisplatin Injection may include:

• Nausea and vomiting, which can be severe.
• Kidney damage, as it may affect kidney function.
• Hearing loss or tinnitus, ranging from mild to severe.
• Neurological issues like numbness, tingling, or peripheral neuropathy.
• Fatigue and general weakness.
• Decreased appetite and weight loss.
• Low blood cell counts, which can lead to anemia and increased risk of infections.
• Skin reactions, including rash, itching, or skin discoloration.

Following are the precautions and warnings for Cisplatin Injection:

• This medication is highly toxic and should be handled with extreme care by trained medical professionals only.
• Cisplatin can cause severe kidney damage; regular monitoring of kidney function is essential during treatment.
• It may lead to permanent hearing loss; patients should be monitored for hearing changes.
• Nausea and vomiting are common side effects; anti-emetics should be used to prevent these symptoms.
• Blood tests are required to monitor blood cell counts and electrolyte levels before and during treatment.
• Not recommended for use in pregnant women due to potential harm to the fetus.
• Breastfeeding is not advised while on Cisplatin treatment, as it may pass into breast milk.
• Patients should inform their doctor about all medications they are taking to avoid potential drug interactions.

Following are the drug interactions for Cisplatin Injection:

• Concomitant use with other nephrotoxic drugs (e.g., aminoglycosides, nonsteroidal anti-inflammatory drugs) can increase the risk of kidney damage and acute renal failure.
• Cisplatin may enhance the ototoxic effects of aminoglycoside antibiotics, potentially leading to hearing loss.
• The myelosuppressive effects can be increased when combined with other myelosuppressive agents, such as doxorubicin, cyclophosphamide, or radiation therapy.
• When used with other ototoxic medications, such as loop diuretics (furosemide) or aminoglycosides, the risk of hearing impairment is heightened.
• Anticonvulsants like phenytoin may decrease the effectiveness of Cisplatin by increasing its clearance.
• Cisplatin can reduce the efficacy of certain vaccines, so live virus vaccines should be avoided during and shortly after treatment.
• It may interact with other platinum-based compounds, such as carboplatin, potentially increasing the risk of cumulative toxicities.

Following are the food interactions for Cisplatin Injection:

• Avoid consuming alcohol during and after treatment with Cisplatin Injection, as it can increase the risk of side effects, particularly kidney damage and hearing loss.
• Grapefruit and grapefruit juice should be consumed with caution as they may affect the metabolism of Cisplatin, potentially altering its effectiveness.
• High-sodium foods should be limited as Cisplatin can cause sodium retention, leading to increased blood pressure.
• Avoid foods rich in potassium, such as bananas, oranges, and tomatoes, as Cisplatin can affect potassium levels.
• Limit dairy products, especially if you have a history of lactose intolerance, as Cisplatin may cause gastrointestinal issues.
• Ensure adequate hydration by drinking plenty of fluids, as Cisplatin can cause dehydration and electrolyte imbalances.
• Avoid foods with high levels of antioxidants during treatment, as they might reduce the effectiveness of Cisplatin.
• There is no specific diet recommended, but maintaining a balanced and nutritious diet is beneficial during cancer treatment.

Cisplatin Injection should be stored and disposed of with utmost care to ensure safety and prevent environmental contamination. Store the injection at room temperature, between 20-25°C (68-77°F), in its original packaging, protected from light and moisture. Do not freeze the medication as it may affect its potency. Always check the expiration date and discard any unused or expired vials. Proper disposal is crucial; do not dispose of in regular trash or flush down the toilet. Contact your healthcare provider or pharmacist for guidance on safe disposal methods to protect the environment and prevent accidental exposure. Keep the medication out of children's reach to avoid accidental injection.

Following are the quick tips for Cisplatin Injection:

• Administer under medical supervision; do not self-inject.
• Ensure accurate dosage calculation and preparation by trained medical professionals.
• Cisplatin is a potent drug; follow the prescribed dosage and treatment duration.
• Stay well-hydrated before and after treatment to reduce kidney-related side effects.
• Regular kidney function tests are necessary during treatment.
• Inform your doctor about any pre-existing kidney or hearing issues.
• Avoid contact with skin or eyes; handle with care and dispose of properly.