Platinum-Based Chemotherapy Pregnancy: No adequate data in pregnant women; suspected to cause serious birth defects and animal studies show reproductive toxicity. Should not be used during pregnancy unless the clinician considers the risk justified. Effective contraception required in both sexes during and for at least 6 months after treatment. Contraindicated during breast-feeding.

Cisplatin

Brand names: Cisplatin (generic)

Cisplatin is a platinum-based cytotoxic chemotherapy agent widely used in solid tumours, including bladder and other urological cancers.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Monotherapy: single dose of 50 to 120 mg/m2 body surface every 3 to 4 weeks; OR 15 to 20 mg/m2/day for five days, every 3 to 4 weeks

Route: Intravenous infusion (over 6 to 8 hours)

Frequency: Every 3 to 4 weeks (single-dose regimen) or daily for 5 days per cycle

Max: Monotherapy single dose up to 120 mg/m2 every 3 to 4 weeks (per SPC regimen)

Urology/uro-oncology context (e.g. bladder, testicular). Dose depends on primary disease, expected response, and whether used as monotherapy or in combination; directions apply to adults and children. In combination chemotherapy the cisplatin dose must be reduced (typical dose 20 mg/m2 or more once every 3-4 weeks). Must be given only under the direction of oncologists in specialist units. Mandatory hydration from 2-12 hours before until at least 6 hours after administration (IV sodium chloride 0.9% or 0.9% saline/5% glucose 1:1); forced diuresis with mannitol required when dose exceeds 60 mg/m2. Should not be given more frequently than once every 3-4 weeks. Avoid all aluminium-containing IV sets/needles/syringes. Do not repeat courses until serum creatinine <130 micromol/L (1.5 mg/100 mL), urea acceptable, WBC >4000/microL, platelets >100000/microL, and audiogram normal. US labelling (cross-check only, not UK SPC) cites advanced bladder cancer as a single agent at 50 to 70 mg/m2 IV every 3 to 4 weeks and metastatic testicular tumours at 20 mg/m2 IV daily for 5 days per cycle in combination.

Dose adjustments

Renal

Contraindicated in pre-existing renal impairment. In renal dysfunction the dose should be reduced adequately. Do not repeat courses until serum creatinine is below 130 micromol/L (1.5 mg/100 mL) and blood urea below 25 mg/100 mL (9 mmol/L).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to cisplatin, other platinum-containing compounds, or any excipient
Pre-existing renal impairment (nephrotoxicity is cumulative)
Pre-existing hearing impairment (cumulatively ototoxic)
Myelosuppressed patients and dehydrated patients
Breast-feeding; concurrent yellow fever vaccine

Side effects

Haematological: bone marrow failure, thrombocytopenia, leukopenia, anaemia (very common)
Gastrointestinal: nausea, vomiting, anorexia, diarrhoea
Ototoxicity / hearing impairment (may be more severe in children)
Nephrotoxicity / renal failure, hyperuricaemia
Hyponatraemia (very common); fever

Interactions

Aminoglycoside antibiotics (potentiate nephrotoxicity)
Other potentially nephrotoxic drugs (special care required)
Yellow fever vaccine (contraindicated concurrently)

Clinical monograph

How it works

It forms platinum-DNA cross-links that interfere with DNA replication and transcription, leading to tumour cell death.

Prescribing in practice

It is markedly nephrotoxic and requires adequate hydration, and often forced diuresis, with careful renal function and electrolyte management to limit kidney damage.
Causes severe emetogenicity, ototoxicity, peripheral neuropathy and myelosuppression that may necessitate dose modification.
Administer only under specialist oncology supervision with effective antiemetic prophylaxis and electrolyte replacement.

Monitoring

Monitor renal function, serum electrolytes including magnesium, full blood count, and hearing or neurological symptoms during treatment.

Counselling the patient

Maintain a good fluid intake as advised to protect your kidneys.
Report new hearing changes or ringing in the ears, numbness or tingling, or signs of infection.

Evidence & guidelines

Cisplatin-based chemotherapy is established standard care in several urological cancers, supported by extensive trial evidence and NICE guidance.

Reference: NICE NG127 (Testicular Cancer); EAU Testicular Cancer Guidelines 2024; EAU Bladder Cancer Guidelines 2024; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Carboplatin · Platinum-Based Chemotherapy

Pathways