Cisplatin

What cisplatin looks like Back to top

Cisplatin is a colourless fluid.

How it is given Back to top

Cisplatin is given as a drip (infusion) in one of the following ways:

• through a fine tube inserted into a vein, usually in the back of your hand (cannula)
• through a fine, plastic tube inserted under the skin and into a vein near your collarbone (central line)
• into a fine tube inserted into a vein in the crook of your arm (PICC line).

The infusion can take up to eight hours. You'll usually be given cisplatin as an outpatient but occasionally you may have to be an inpatient.

Chemotherapy is usually given as a course of several sessions (cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer you're being treated for. Cisplatin is sometimes given alongside other chemotherapy drugs as part of a combination treatment (regimen)|. Your nurse or doctor will discuss your treatment plan with you.

Before you begin your treatment your doctor will arrange for you to have blood tests. You'll usually be given anti-sickness drugs before and/or during your treatment.

Possible side effects Back to top

Each person's reaction to chemotherapy is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone who has cisplatin and may be different if you're having more than one type of chemotherapy drug|.

We have outlined the most common side effects but haven't included those that are rare and unlikely to affect you. If you notice any effects that are not listed below, discuss them with your doctor or nurse.

Feeling sick (nausea) and being sick (vomiting)

This may begin soon after the treatment is given and can last for a few days. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting|. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective.

Some anti-sickness drugs can cause constipation|. Let your doctor or nurse know if this is a problem.

Your kidneys may be affected

This doesn't usually cause any symptoms, and the effect is generally mild. Rarely, cisplatin may cause permanent damage to the kidneys unless treatment with it is stopped.

Before each treatment, your kidneys will be checked with a blood test. You’ll be given fluid through a drip (infusion) before and after the treatment to keep your kidneys working normally. You may be asked to measure and record what you drink and the amount of urine you pass. It’s important to tell your nurse or doctor if you pass less urine than usual.

If necessary, you may be given medicine to help you pass urine. You may be asked to drink extra fluid before and after treatment. It's important to do this so let your doctor know if this is a problem – for example, if you're feeling sick.

Numbness or tingling in hands or feet 

This is due to the effect cisplatin has on nerves and is known as peripheral neuropathy|. You may also notice that you have difficulty doing up buttons or with similar fiddly tasks.

Tell your doctor if you notice any numbness or tingling in your hands or feet. It's important to report your symptoms to your doctor as they may be controlled by slightly lowering the dose of the drug.

This side effect usually improves slowly for a few months after the treatment has finished. Sometimes symptoms can persist, talk to your doctor if this happens.

Changes in hearing

You may have ringing in the ears (tinnitus), and you may lose the ability to hear some high-pitched sounds. Hearing loss can be more severe with higher doses and longer courses of treatment. Very occasionally, your sense of balance may be affected.

Any hearing loss and balance changes, if they occur, may be permanent. However, tinnitus usually improves when treatment ends. Tell your doctor if you notice any loss of hearing or tinnitus.

Taste changes

You may notice that food tastes different|. Normal taste usually comes back after treatment finishes. A dietitian or specialist nurse at your hospital can give you advice about ways of coping with this side effect.

Less common side effects Back to top

Risk of infection

Cisplatin can reduce the number of white blood cells, which help fight infection. White cells are produced by the bone marrow. If the number of your white blood cells is low you'll be more prone to infections|. A low white blood cell count is called neutropenia.

Neutropenia begins seven days after treatment, and your resistance to infection is usually at its lowest 10–14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.

Contact your doctor or the hospital straight away if:

• your temperature goes above 38ºC (100.4ºF)
• you suddenly feel unwell even with a normal temperature.

You'll have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (blood count) is still low. 

Bruising and bleeding

Cisplatin can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You may need to have a platelet transfusion| if your platelet count is low.

Anaemia

Cisplatin can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired| and breathless|. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion| if the number of red blood cells becomes too low.

Loss of appetite

Some people lose their appetite| while they’re having chemotherapy. This can be mild and may only last a few days. If it doesn’t improve you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight|.

Diarrhoea 

This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea|.

Allergic reaction

Signs of an allergic reaction include skin rashes and itching, a high temperature (fever), shivering, reddening of the face, dizziness, headaches, breathlessness, anxiety, and a feeling that you want to pass urine. You'll be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse know about any side effects you have.

Additional information Back to top

Risk of developing a blood clot

Cancer can increase the risk of developing a blood clot (thrombosis), and chemotherapy may increase this risk further.

A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it’s important to tell your doctor straight away if you notice any of these symptoms. Most clots can be treated with drugs that thin the blood. The doctor or nurse can give you more information.

Other medicines

Some medicines, including those you can buy in a shop or chemist, can be harmful to take when you're having chemotherapy. Tell your doctor about any medicines you're taking, including over-the-counter drugs, complementary complementary therapies| and herbal drugs|.

Fertility

Your ability to become pregnant or father a child may be affected by having this treatment. It's important to discuss fertility| with your doctor before starting treatment.

Contraception

It's not advisable to become pregnant or father a child while taking cisplatin as it may harm the developing baby. It’s important to use effective contraception while taking this drug and for at least a few months afterwards. You can discuss this with your doctor or nurse.

It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after chemotherapy.

Non-cancer admission

If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you're having chemotherapy treatment. You should tell them the name of your cancer specialist so that they can ask for advice.

Emergency contacts

It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. Your chemotherapy nurse or doctor will give you details of who to contact for advice. This should include ‘out-of hours’ contact details if you need to call someone at evenings, overnight or at the weekend.

References Back to top

This section is based upon our Cisplatin fact sheet, which has been compiled using information from a number of reliable sources, including:

• Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
• electronic Medicines Compendium. (accessed October 2011).
• British National Formulary. 62nd edition. 2011. British Medical Association and Royal Pharmaceutical Society of Great Britain.
• Perry MC. The Chemotherapy Source Book. 4th edition. 2007. Lippincott Williams and Wilkins.