AlternativeCisplatin (generic IV)

Cisplatin

Platinum alkylating agent

Curative-intent radiosensitiser for cervical cancer (Ch-RT).

IV

First-line for

  • Locally advanced cervical cancer (with radiotherapy)
  • Ovarian germ cell tumours (BEP)
  • Recurrent/metastatic cervical cancer

Mechanism

Forms intra- and inter-strand DNA cross-links → cell-cycle arrest, apoptosis.

"Cisplatin causes 4 -oto/-nephro/-neuro/-emeto"

  • Ototoxicity: irreversible high-frequency hearing loss
  • Nephrotoxicity: mandatory pre-hydration and Mg replacement
  • Peripheral neuropathy — cumulative
  • Emetogenicity: highest — triple antiemetic

Dosing

Cervical Ch-RT
40 mg/m² IV weekly × 5–6 during EBRT
BEP
20 mg/m²/day IV × 5 days, cycles q3w

Contraindications

  • AbsolutePre-existing renal impairment (CrCl <60)
  • AbsoluteSevere hearing impairment
  • AbsoluteT1 pregnancy

Side effects

  • Severe nausea/vomiting
  • Nephrotoxicity, hypomagnesaemia
  • Ototoxicity
  • Peripheral neuropathy
  • Myelosuppression

Fetal & maternal notes

  • Avoid in T1 (teratogenic)
  • T2/T3 use in cervical cancer possible with MDT; achieve delivery >3 weeks after last cycle

Key interactions

  • Aminoglycosides / loop diuretics

    Avoid

    Additive oto- and nephrotoxicity

  • Phenytoin

    Caution

    ↓ phenytoin levels

Clinical pearls

  • 💡 Aggressive pre-hydration and antiemetic bundle (5HT3 + dexamethasone + NK1)
  • 💡 Baseline audiogram and monitor GFR each cycle

Content last reviewed: REPLACE_ME (e.g. 2026-07)

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For educational use only

Not medical advice. Verify dosing against the BNF and your local trust guidelines before prescribing.