Cisplatin Pfizer Drug Interactions

Cisplatin is mostly used in combination with antineoplastic drugs having similar cytotoxic effects. In these circumstances additive toxicity is likely to occur.
Other known drug interactions are reported as follows.
Nephrotoxic Drugs: Potentially nephrotoxic drugs such as aminoglycoside antibiotics or loop diuretics when given concurrently or within 1-2 weeks after cisplatin administration, may exacerbate the nephrotoxic effects of cisplatin. Concomitant use of other potentially nephrotoxic drugs (e.g. amphotericin B) is not recommended during cisplatin therapy.
The renal toxicity of ifosfamide may be greater when used with cisplatin or in patients who have previously been given cisplatin.
Ototoxic Drugs: Concurrent and/or sequential administration of potentially ototoxic drugs such as aminoglycoside antibiotics or loop diuretics may exacerbate the ototoxic effects of cisplatin, especially in the presence of renal impairment.
Ifosfamide may increase hearing loss due to cisplatin.
Renally Excreted Drugs: Literature data suggest that cisplatin may alter the renal elimination of bleomycin and methotrexate (possibly as a result of cisplatin-induced nephrotoxicity) and enhance their toxicity. Reduction of the lithium blood levels was noticed in a few cases after treatment with cisplatin combined with bleomycin and etoposide. It is therefore recommended to monitor the lithium values.
Anticonvulsant Agents: Plasma levels of anticonvulsant agents may become subtherapeutic during cisplatin therapy. In patients receiving cisplatin and phenytoin, serum concentrations of the latter may be decreased, possibly as a result of decreased absorption and/or increased metabolism. In these patients, serum levels of antiepileptics should be monitored and dosage adjustments made as necessary.
Antigout agents: Cisplatin may raise the concentration of blood uric acid. Thus, in patients concurrently receiving antigout agents such as allopurinol, colchicine, probenecid or sulfinpyrazone, dosage adjustment of these drugs may be necessary to control hyperuricemia and gout.
Anticoagulants: It is advisable to check the international normalised ratio (INR) when oral anticoagulants such as coumarins/warfarin are used simultaneously with cisplatin.
Paclitaxel: Administration of cisplatin prior to an infusion with paclitaxel may reduce the clearance of paclitaxel by 33% and can therefore intensify neurotoxicity.