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
AvoidAdditive 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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