Introduction
Cesalin 10 is used in the treatment of ovarian, cervical and testicular cancer. It shows its working by stopping or slowing down the growth of cancer cells.
Cesalin 10 is given as an injection into veins by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
Injection site reaction (pain, swelling, redness), nausea and vomiting are some common side effects of this medicine. Hearing problem or ear damage is serious side effect of this medicine, hence your doctor might check you for hearing test before and after the treatment. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and kidney.
Before taking this medicine, let your doctor know about kidney disease as medicine affect the functioning of the kidney. Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. It makes men infertile, hence men should take doctor advice about the freezing of sperm before the treatment.
Uses of Cesalin 10
- Ovarian cancer
- Cervical cancer
- Testicular cancer
Side effects of Cesalin 10
Common
- Injection site reactions (pain, swelling, redness)
- Increased risk of infection
- Ear disorder
- Vomiting
- Nausea
- Decreased blood cells (red cells, white cells, and platelets)
- Renal impairment
- Peripheral neuropathy (tingling and numbness of feet and hand)
- Kidney damage
- Hearing loss
- Ringing in ear
How to use Cesalin 10
Your doctor or nurse will give you this medicine. Kindly do not self-administer.
How Cesalin 10 works
Cesalin 10 is an anti-cancer medication. It works by damaging the genetic material (DNA and RNA) of the cancer cells which stops their growth and multiplication.
What if you forget to take Cesalin 10?
If you miss a dose of Cesalin 10, please consult your doctor.
Indication
Lymphomas, Sarcomas, Carcinomas, Small cell lung cancer, Ovarian cancer, Germ cell tumors, Metastatic Testicular Tumors, Metastatic Ovarian Tumors, Advanced Bladder Cancer
Administration
IV Preparation
Further dilution stability is dependent on chloride ion concentration & should be mixed in solutions of NS (at least 0.3% NaCl)
Further dilution in NS, D5/½NS or D5/NS to a concentration of 0.05-2 mg/mL are stable for 72 hr at 4-25°C in combination with mannitol
May administer 12.5-50 g mannitol/L
Standard dilution: dose/250-1000 mL NS, D5W/NS or D5/½NS
IV Administration
Perform pretreatment hydration
Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can react causing precipitate formation & loss of potency)
Administration rate has varied from a 15-120 min infusion, 1 mg/min infusion, 6-8 hr infusion, 24 hr infusion, or per protocol
Maximum rate of infusion: 1 mg/min in patients with CHF
When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression & to enhance efficacy
Adult Dose
Metastatic Testicular Tumors
Usual dose in combination with other approved chemotherapeutic agents is 20 mg/m²/day IV for 5 days/cycle
Pretreatment hydration: 1-2 L fluid infused for 8-12 hr before dose
May use concomitant amifostine to decrease nephrotoxicity
Do not repeat course until SCr <1.5 mg/dL [<133 micromoles/L] or BUN <25 mg/dL [<8.93 mmol/L] or WBC >4000/mm³ AND platelets >100 k/mm³
Advanced Bladder Cancer
50-70 mg/m² IV cycle q3-4Weeks, depending on prior radiation therapy or chemotherapy; for heavily pretreated patients, give 50 mg/m²/cycle initially; repeat q4Weeks
Pretreatment hydration: 1-2 L fluid infused for 8-12 hr before dose
May use concomitant amifostine to decrease nephrotoxicity
Do not repeat course until SCr <1.5 mg/dL [<133 micromoles/L] or BUN <25 mg/dL [<8.93 mmol/L] or WBC >4000/mm³ AND platelets >100 k/mm³
Metastatic Ovarian Carcinoma
75-100 mg/m² IV per cycle q4Weeks with cyclophosphamide (600 mg/m² IV q4Weeks); administer sequentially
Off-label: 90-270 mg/m² intraperitoneal; retain for 4 hr before draining; repeat q3Weeks (may coadminister systemic Na thiosulfate)
Pretreatment hydration: 1-2 L fluid infused for 8-12 hr before dose
May use concomitant amifostine to decrease nephrotoxicity
Do not repeat course until SCr <1.5 mg/dL [<133 micromoles/L] or BUN <25 mg/dL [<8.93 mmol/L] or WBC >4000/mm³ AND platelets >100 k/mm³
Renal Dose
Renal Impairment
CrCl 10-50 mL/min: Decrease dose 50%
CrCl <10 mL/min: Contraindicated
Contraindication
Patients with severe renal or auditory disorder, known hypersensitivity, severe bone marrow suppression, peripheral neuropathy, pregnancy, lactation.
Mode of Action
Cisplatin modifies cell cycle by interfering with DNA structure and function. Effects are most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs e.g. fluorouracil. It has a narrow therapeutic margin and is highly toxic.
Precaution
Patients with renal or hepatic disorder, myelosuppression. Monitor renal, neurological and auditory function. Perform blood counts regularly. Maintain adequate hydration before and 24 hr after admin to minimise nephrotoxicity.
Lactation: excreted in breast milk; do not nurse
Side Effect
>10%
Nausea (76-100%),Vomiting (76-100%),Nephrotoxicity (28-36%),Ototoxicity, especially in children (31%),Myelosuppression (25-30%),Anaphylaxis (1-20%),Alopecia
Frequency Not Defined
Cerebral herniation,Encephalopathy,Leukoencephalopathy and reversible posterior leukoencephalopathy syndrome,Seizure,Peripheral neuropathy (dose and duration dependent),Diarrhea,Electrolyte changes,Hyperuricemia,Hepatotoxicity,Local tissue irritation
Potentially Fatal: Rarely, renal damage due to inadequate hydration during therapy. Very rarely life-threatening myelosuppression. Anaphylactoid reactions (rare) and cardiac abnormalities.
Pregnancy Category Note
Pregnancy
Based on human data from published literature, cisplatin can cause fetal harm when administered to pregnant women; data demonstrates transplacental transfer of cisplatin
Exposure associated with oligohydramnios, intrauterine growth restriction, and preterm birth; cases of neonatal acute respiratory distress syndrome, cytopenias, and hearing loss reported
Verify the pregnancy status of females of reproductive potential before initiating prior to initiation of cisplatin for injection
Contraception
Females: Advise females of reproductive potential to use effective contraception during treatment and for 14 months following the last dose
Males: Advise male patients with female partners of reproductive potential to use effective contraception during treatment and for 11 months after the last dose
Infertility
Females: Use associated with cumulative dose-dependent ovarian failure, premature menopause, and reduced fertility
Males: Use associated with a cumulative dose-dependent impairment of spermatogenesis (oligospermia, azoospermia; possibly irreversible) and reduced fertility
Lactation
Limited data from published literature report the presence of drug in human milk; because of potential for serious adverse reactions in a breastfed child and because of potential for tumorigenicity, advise lactating women not to breastfeed during treatment
Interaction
Synergistic with 5-fluorouracil and etoposide. Efficacy increased and toxicity reduced when combined with radioprotecting agent WR 2721. At doses ?100 mg, cisplatin is an ideal drug to combine with other cytotoxic drugs; unlike other antineoplastic drugs, it causes little myelosuppression.
Potentially Fatal: Potentiates nephrotoxicity with aminoglycosides. Increased toxicity when combined with other cytotoxic drugs.