#高警訊藥品

抗腫瘤藥物 (晚期難治性膀胱瘤、晚期難治性卵巢瘤、難治性頭頸部鱗狀細胞瘤)
Advanced Bladder cancer, Advanced ovarian cancer, Testicular cancer
#仿單變更2021

Platinum Analog Antineoplastic Agent:
Cisplatin is a planar coordinate dichlorodiamino compound of platinum in the +II valence state. It is aquated in vivo to a positively charged species that can alkylate nucleophilic sites in DNA such as purine and pyrimidine bases

1. Distribution: Rapidly into tissue; High concentrations in kidneys, liver, ovaries, uterus, and lungs
2. Excretion: Urine (>90%)
3. Elimination half-life: 60-70hr

1. History of allergic reactions to cisplatin, other platinum-containing compounds, or any component of the formulation
2. Preexisting renal impairment
3. Myelosuppressed patients
4. Hearing impairment patients

D; Adverse events associated with cisplatin containing regimens include oligohydramnios, intrauterine growth restriction and preterm birth; acute respiratory distress syndrome, cytopenias, and hearing loss have been reported in the neonate.

Contraindicated; cisplatin can be found in breast milk.

Common:
Severe nausea, vomiting, renal failure, peripheral neuropathy, ototoxicity, hypomagnesaemia, Azoospermia<2021/8/16>
Warning:
1. Bone marrow suppression: Monitor blood counts (PLT>100,000/mm³ and WBC>4,000/mm³ prior to cisplatin initiation, each subsequent treatment course, and as clinically indicated. Severe anemia with infusion packed red cells need has been reported.
2. Anaphylaxis: symptoms include facial edema, wheezing, tachycardia, and hypotension; occurred within minutes of administration.
3. Ototoxicity: may be associated with an increased risk of ototoxicity in children administered conventional cisplatin doses; pediatric patients should receive audiometric testing at baseline, prior to each dose, and for several years after discontinuing therapy.<2021/8/16>

Bladder cancer, advanced:
50 to 70 mg/m² every 3 to 4 weeks; for heavily pretreated patients, administer 50 mg/m² every 4 weeks
Ovarian cancer, advanced:
75 to 100 mg/m² once every 3 to 4 weeks
Testicular cancer, advanced:
20 mg/m² once daily for 5 days repeated every 3 weeks (in combination with bleomycin and etoposide)

1. CrCl 10 to 50 mL/min: Administer 75% of dose
2. CrCl <10 mL/min: Administer 50% of dose
3. Hemodialysis: Partially cleared by hemodialysis
4. Ensure adequate hydration before, during, and following administration:
(1) Before treatment: IV 2L NS or D5W/NS, infuse for 2 hours; may IV drip 375mL mannitol(10%) in the last 30 minutes
(2) After treatment: IV 2L NS or D5W/NS within 6-12 hours

Cisplatin undergoes nonenzymatic metabolism and high uptake in liver. May increase SGOT; use with caution.