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Cisplatin Injection

[19 June 2012]

Products Affected - Description

Cisplatin injection 1 mg/mL solution

Reason for the Shortage

  • Bedford discontinued cisplatin in May, 2011 to concentate on the manufacturing of other products.1
  • Teva could not provide a reason for the shortage.2
  • APP states the shortage was due to increased demand.3
  • BMS discontinued Platinol powder for injection in April, 2011 for business reasons.4

Available Products

Cisplatin injection 1 mg/mL solution, APP
50 mL vials (NDC 63323-0103-51)
100 mL vial (NDC 63323-0103-65)
200 mL vial (NDC 63323-0103-64)
 
Cisplatin injection 1 mg/mL solution, Teva
50 mL vial (NDC 00703-5747-11)
100 mL vial (NDC 00703-5748-11)

Estimated Resupply Dates

All presentations are available at this time.

    Implications for Patient Care

    • Cisplatin is a platinum-based alkylating agent. It is labeled for use as a single agent for the treatment of advanced transitional cell bladder cancer, and in combination with other antineoplastic agents for the treatment of metastatic testicular cancer and metastatic ovarian cancer.5-7
    • Cisplatin is used off-label for a variety of neoplastic diseases including squamous cell head and neck cancer, squamous cell ovarian cancer, lung cancer, osteosarcoma, esophageal cancer, adrenal cortex carcinoma, breast cancer, endometrial cancer, or liver cancer, and in patients undergoing hematopoietic stem cell transplantation. It has also been used off-label in children for the treatment of brain tumors and osteosarcoma.5-7
    • Cisplatin is typically used in combination with other antineoplastic agents.5-7

    Safety

    • Chemotherapy agents, such as cisplatin, pose additional safety risks both for patients and for healthcare workers handling these agents.5,6
    • Use additional caution when processing orders for chemotherapy drugs, especially when switching between chemotherapy agents or when processing orders for chemotherapy agents with which staff may be unfamiliar (eg, those not normally prescribed at a specific institution).5,6

    Alternative Agents & Management

    • The choice of an alternative agent must be patient-specific and based on renal function, liver function, and the neoplasm type and location. No single agent can be substituted for cisplatin.5-7
    • Consider evaluating the health-care system’s total supply of cisplatin before beginning patients on combination chemotherapy regimens containing cisplatin. If adequate supplies are not available, select an alternative regimen.
    • Consult a Hematology/Oncology specialist for patient- and neoplasm-specific recommendations.
    • Refer to the ASHP Guidelines on Managing Drug Product Shortages for more guidance on developing a multidisciplinary plan when the supply must be allocated. 

    Related Shortages

    References

    1. Bedford (personal communications). February 9 and 18, March 16, May 6 and 19, June 16, July 1, 6, 12, and 28, August 16 and 30, September 7 and 23, November 10, December 17, 2010; January 11, April 4, and May 3, 2011.
    2. Teva (personal communications). February 9 and 19, March 17, May 6 and 19, June 16, July 2, 7, 12, 16, 20, and 28, August 16 and 30, September 7 and 22, October 13, November 11, December 17, 2010; January 10, February 15, March 8 and 16, April 4, 7 and 20, August 15, October 10 and 27, November 17, and December 13, 2011; January 4, February 22, April 2, and June 18, 2012.
    3. APP (personal communications). February 9 and 19, March 16, May 6 and 19, June 16, July 1, 6, 12, 16, 19, 22, and 23, August 18 and 27, September 9 and 22, November 12, December 17, 2010; January 18, February 16, March 9, April 4 and 20, May 4, June 22, August 17 and 31, September 20, October 12 and 25, November 17, and December 14, 2011; January 4, February 22, April 4, and June 19, 2012.
    4. BMS (personal communications). August 16, 2011. 
    5. Beckwith MC, Tyler LS, eds. Cancer Chemotherapy Manual. St. Louis, MO: Wolters Kluwer Health Inc. 2010.
    6. Antineoplastic agents. In: McEvoy GK, ed. AHFS 2010 Drug Information. Bethesda, MD: American Society of Health-Systems Pharmacists; 2010: 902-1260.
    7. Drug Facts and Comparisons Online. St. Louis, MO: Wolters Kluwer Health Inc. September 2010.

    Updated

    Updated June 19, 2012 by Michelle Wheeler, Pharm.D., Drug Information Specialist. Created September 10, 2010, by Michelle M. Wheeler, Pharm.D., and M. Christina Beckwith, Pharm.D., Drug Information Specialists. Copyright 2012, Drug Information Service, University of Utah, Salt Lake City, UT.

    Disclaimer

    This information is provided through the support of Novation to ASHP solely as a service to its members, which shall not use this information for their further commercial use. The content was prepared by the Drug Information Center of University of Utah. Novation, ASHP, and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, which respect to such information, and specifically disclaim all such warranties. Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither Novation, ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this bulletin. Neither Novation, ASHP nor University of Utah endorses or recommends the use of any drug.

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