Paraplatin

Drug type: Paraplatin is an anticancer drug ("antineoplastic" or "cytotoxic") chemotherapy drug. Paraplatin is classified as an "alkylating agent."

What Paraplatin is used for:

• Paraplatin is used to treat ovarian cancer.
• Paraplatin is also used for other types of cancer, including lung, head and neck, endometrial, esophageal, bladder, breast, and cervical; central nervous system or germ cell tumors; osteogenic sarcoma; and as preparation for a stem cell or bone marrow transplant.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Paraplatin is given:

• Paraplatin is usually given by infusion into a vein (intravenous, IV).
• Paraplatin can also be given intraperitoneal, directly into the peritoneal cavity in the abdomen.
• The amount of Paraplatin you receive depends on many factors, including your height and weight, your general health or other health problems, and how your body responds to it. Your doctor will determine your dose and schedule.

Side effects of Paraplatin:

Important things to remember about the side effects of Paraplatin:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration.
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
• The side effects of Paraplatin and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects).

The following side effects are common (occurring in greater than 30%) for patients taking Paraplatin:

• Low blood counts (including red blood cells, white blood cells and platelets).
  
  Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
  Onset: None reported
  Nadir: 10-14 days
  Recovery: None reported
  
• Nausea and vomiting usually occurring within 24 hours of treatment
• Taste changes
• Hair loss
• Weakness
• Blood test abnormalities: Abnormal magnesium level

These are less common (occurring in 10-29%) side effects for patients receiving Paraplatin:

• Burning sensation at the injection site
• Abdominal pain
• Diarrhea
• Constipation
• Mouth sores.
• Infection
• Peripheral neuropathy: Although uncommon, a serious side effect of decreased sensation and paresthesia (numbness and tingling of the extremities) may be noted. Sensory loss, numbness and tingling, and difficulty in walking may last for at least as long as therapy is continued. These side effects may become progressively more severe with continued treatment, and your doctor may decide to decrease your dose.
• Central neurotoxicity: Infrequent but patients over age 65 are at increased risk. Symptoms include dizziness, confusion, visual changes, ringing in the ears.
• Nephrotoxicity (see kidney problems): More frequent when Paraplatin is given in high doses or to people with kidney problems.
• Hearing loss (ototoxicity) - loss of high pitched sounds.
• Abnormal blood electrolyte levels (sodium, potassium, calcium).
• Abnormal blood liver enzymes (SGOT, Alkaline phosphatase) (see liver problems).
• Cardiovascular events. Although infrequent, heart failure, blood clots and strokes have been reported with Paraplatin use. Less than 1% were life-threatening.
• Allergic reaction may occur. It would occur during the actual transfusion. This may include itching, rash, shortness of breath or dizziness (especially in patients who have received cisplatin).

Nadir: 21 days.

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

• Fever of 100.5(F (38(C) or higher, or chills (possible signs of infection).
• Difficulty breathing or shortness of breath.
• Chest pain.

• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools or urine
• Diarrhea (4-6 episodes in a 24-hour period)
• Nausea (interferes with ability to eat and unrelieved with prescribed medications).
• Vomiting (vomiting more than 4-5 times in a 24-hour period)
• Severe abdominal pain
• Lip or mouth sores (painful redness, swelling or ulcers)
• Extreme fatigue (unable to carry on selfcare activities)
• Muscle cramps or twitching
• Change in hearing
• Dizziness, confusion or visual changes

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting Paraplatin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc. Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
• Paraplatin may be inadvisable if you have a history of severe allergic reaction to cisplatin, Paraplatin, other platinumcontaining formulations or mannitol.
• Do not receive any kind of immunization or vaccination without your doctor's approval while taking Paraplatin.
• Decreased sensation, numbness and tingling in fingers and toes may become progressively worse with repeated doses of Paraplatin. It is important to report this to your doctor.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Paraplatin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking Paraplatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-care tips:

• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• Get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

• You will be monitored regularly by your doctor while you are taking Paraplatin. Tests will include complete blood counts, electrolytes, kidney function tests and liver enzymes.
• Because drug toxicity is seen as numbness and tingling of fingers and toes, a periodic physical examination, which includes a check of your reflexes, is necessary to detect the need for decreased dosages.

How Paraplatin works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in p lace that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer. Although these drugs are divided into groups, there is some overlap among some of the specific drugs. The following are the types of chemotherapy:

Alkylating agents

Alkylating agents are most active in the resting phase of the cell. These drugs are cell-cycle nonspecific. There are several types of alkylating agents.

• Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
• Ethylenimines: Thiotepa and Hexamethylmelamine.
• Alkylsulfonates: Busulfan.
• Hydrazines and Triazines: Procarbazine, Dacarbazine and Temozolomide.
• Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier. They can be useful in treating brain tumors.
• Metal salts: Paraplatin, Cisplatin, and Oxaliplatin.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.