DOSAGE AND ADMINISTRATION
Note: Needles or intravenous sets containing aluminum parts that may come in contact with PLATINOL should not be used for preparation or administration. Aluminum reacts with PLATINOL, causing precipitate formation and a loss of potency.
Metastatic Testicular Tumors
The usual PLATINOL dose for the treatment of testicular cancer in combination with other approved chemotherapeutic agents is 20 mg/m2 IV daily for 5 days per cycle.
Metastatic Ovarian Tumors
The usual PLATINOL dose for the treatment of metastatic ovarian tumors in combination with CYTOXAN is 75–100 mg/m2 IV per cycle once every 4 weeks (DAY 1).
The dose of CYTOXAN when used in combination with PLATINOL is 600 mg/m2 IV once every 4 weeks (DAY 1).
For directions for the administration of CYTOXAN, refer to the CYTOXAN package insert.
In combination therapy, PLATINOL and CYTOXAN are administered sequentially.
As a single agent, PLATINOL should be administered at a dose of 100 mg/m2 IV per cycle once every 4 weeks.
Advanced Bladder Cancer
PLATINOL should be administered as a single agent at a dose of 50–70 mg/m2 IV per cycle once every 3 to 4 weeks depending on the extent of prior exposure to radiation therapy and/or prior chemotherapy. For heavily pretreated patients an initial dose of 50 mg/m2 per cycle repeated every 4 weeks is recommended.
All Patients
Pretreatment hydration with 1 to 2 liters of fluid infused for 8 to 12 hours prior to a PLATINOL dose is recommended. The drug is then diluted in 2 liters of 5% Dextrose in 1/2 or 1/3 normal saline containing 37.5 g of mannitol, and infused over a 6- to 8-hour period. If diluted solution is not to be used within 6 hours, protect solution from light. Adequate hydration and urinary output must be maintained during the following 24 hours.
A repeat course of PLATINOL should not be given until the serum creatinine is below 1.5 mg/100 mL, and/or the BUN is below 25 mg/100 mL. A repeat course should not be given until circulating blood elements are at an acceptable level (platelets ≥100,000/mm3, WBC ≥4000/mm3). Subsequent doses of PLATINOL should not be given until an audiometric analysis indicates that auditory acuity is within normal limits.
As with other potentially toxic compounds, caution should be exercised in handling the powder and preparing the solution of cisplatin. Skin reactions associated with accidental exposure to cisplatin may occur. The use of gloves is recommended. If PLATINOL powder or PLATINOL solution contacts the skin or mucosa, immediately and thoroughly wash the skin with soap and water and flush the mucosa with water.
PREPARATION OF INTRAVENOUS SOLUTIONS
The 50 mg vials should be reconstituted with 50 mL of Sterile Water for Injection, USP. Each mL of the resulting solution will contain 1 mg of PLATINOL.
Reconstitution as recommended results in a clear, colorless to slight yellow solution.
The reconstituted solution should be used intravenously only and should be administered by IV infusion over a 6- to 8-hour period (see DOSAGE AND ADMINISTRATION).
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
NOTE TO PHARMACIST: Exercise caution to prevent inadvertent PLATINOL overdosage. Please call prescriber if dose is greater than 100 mg/m2 per cycle. Aluminum and flip-off seal of vial have been imprinted with the following statement:
CALL DR. IF DOSE>100 MG/M2/CYCLE.
STABILITY
Unopened vials of dry powder are stable for the lot life indicated on the package when stored at room temperature (25° C, 77° F).
The reconstituted solution is stable for 20 hours at room temperature (25° C, 77° F). Solution removed from the amber vial should be protected from light if it is not to be used within six hours.
Important Note: Once reconstituted, the solution should be kept at room temperature (25° C, 77° F). If the reconstituted solution is refrigerated a precipitate will form.
Procedures for proper handling and disposal of anticancer drugs should be considered. Several guidelines on this subject have been published.1-8 There is no general agreement that all of the procedures recommended in the guidelines are necessary or appropriate.
To minimize the risk of dermal exposure, always wear impervious gloves when handling vials containing PLATINOL for injection. This includes all handling activities in clinical settings, pharmacies, storerooms, and home healthcare settings, including during unpacking and inspection, transport within a facility, and dose preparation and administration.
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