Cisplatin Injection

[Pharmacological action] This product is a metal complex of platinum, and its action is similar to that of an alkylating agent. Its main target is DNA, and it acts on the cross-links between and within DNA chains to form a DDP-DNA complex, which interferes with DNA replication or binds to nucleoproteins and cytoplasmic proteins. It is a non-specific drug for the cycle. [Pharmacokinetics] It is absorbed very quickly after intravenous injection, arterial administration or intracavitary injection. After injection, it is widely distributed in the liver, kidney, prostate, bladder, and ovary, and can also reach the chest and abdominal cavity, and rarely passes through the blood-brain barrier. T1/2 is more than 2 days, and T1/2 can be significantly shortened if a diuretic is used in combination. This product is mainly excreted by the kidneys, filtered through the glomeruli or partially secreted by the renal tubules, and 25℅ to 45℅ is excreted in the urine within 96 hours after administration. The concentration of intracavitary organs after intraperitoneal injection is 2.5 to 8.0 times that of intravenous injection.

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Cisplatin injection is a sterile solution containing 1 mg/mL of cisplatin (cis-dichlorobis-ammine platinum), 1 mg/mL of mannitol BP and 9 mg/mL of sodium chloride BP dissolved in water for injection. The solution does not contain any preservatives.

It has a wide anti-tumor spectrum and is clinically used to treat testicular malignant tumors. It has good effects on embryonal tumors and seminoma, and has no cross-resistance with commonly used drugs. It has good effects on ovarian cancer, breast cancer and bladder cancer. It also has certain effects on head and neck cancer, lung cancer, esophageal cancer, malignant melanoma, malignant lymphoma, soft tissue sarcoma and cancerous pleural effusion and ascites. It has good effects when used in combination with other anticancer drugs.

1. General dose: 20~30mg per square meter of body surface area dissolved in 200ml of isotonic saline for intravenous drip, used for 3~5 days (total amount 150mg), repeated after 3 weeks, can be repeated for 3~4 courses. 2. High dose: 80~120mg per square meter of body surface area, hydration and diuresis at the same time, once every 3 weeks, can be repeated 3~4 times. 3. Thoracic and abdominal injection: 30~60mg each time, once every 7~10 days.

1. Digestive tract reactions: severe nausea and vomiting are the main limiting toxicity. Acute vomiting generally occurs 1 to 2 hours after administration and can last for about a week. Therefore, when using this product, it is necessary to use a strong antiemetic, such as 5-hydroxytryptamine 3 (5-HT3), receptor antagonist antiemetic ondansetron, etc., which can basically control acute vomiting; 2. Nephrotoxicity: Cumulative and dose-related poor renal function is the main limiting toxicity of cisplatin. Generally, a daily dose exceeding 90 mg/m2 is a risk factor for nephrotoxicity. It is mainly renal tubular damage. Acute damage is generally seen 10 to 15 days after medication, with increased blood urea nitrogen (BUN) and creatinine (Cr), decreased creatinine clearance, and most of them are reversible. Repeated high-dose treatment can cause persistent mild to moderate renal damage. At present, there is no effective means to prevent nephrotoxicity caused by this product except hydration; 3. Neurotoxicity: Neurological damage such as tinnitus and hearing loss caused by auditory nerve damage are more common. Peripheral neurotoxicity is related to the cumulative increase in dose, which is manifested as varying degrees of weakened or lost sensation in the hands and feet, sometimes with extremity paralysis, decreased trunk muscle strength, etc., which are generally difficult to recover. Epilepsy and papilledema or retrobulbar neuritis are less common; 4. Bone marrow suppression: Bone marrow suppression (decreased white blood cells and/or platelets) is generally mild, and the incidence is related to the dose per course of treatment. If ≤100mg/m2, the incidence is about 10-20%, and if the dose is ≥120mg/m2, it is about 40%, but it is also related to the overlap of bone marrow toxicity of other anticancer drugs in combined chemotherapy. 5. Allergic reactions: facial swelling, asthma, tachycardia, hypotension, and non-specific maculopapular rash may occur; 6. Others: abnormal heart function and changes in liver function are rare.

It is contraindicated in patients with renal impairment and pregnant women.

Precautions during pregnancy and lactation: Contraindicated for use during pregnancy.

The combined use of aminoglycoside antibiotics, amphotericin B or cephalothin with this product has an additive nephrotoxic effect; MTX and BLM are mainly excreted by the kidneys, and the renal damage caused by this product will delay the excretion of the above two drugs, resulting in increased toxicity. When probenecid is used in combination with this product, it can cause hyperuricemia; chloramphenicol or its furosemide or sodium urate increases the ototoxicity of this product; antihistamines can mask the symptoms of tinnitus, dizziness, etc. caused by this product.

Store at 15-25℃, do not refrigerate or freeze, avoid light.

20 ml: 20 mg