Cisplatin (drug interactions)
Cisplatin is a chemotherapy medication primarily used to treat various cancers, including those of the testicles, bladder, lungs, stomach, esophagus, and ovaries. Understanding its potential drug interactions is crucial for patients undergoing treatment. Certain substances, such as black cohosh, may reduce the effectiveness of cisplatin, while supplements like magnesium and potassium can help counteract deficiencies that cisplatin may cause. Melatonin shows promise in possibly reducing side effects and enhancing the efficacy of cisplatin-based chemotherapy, though evidence remains preliminary.
Antioxidants have been suggested to mitigate cisplatin's toxic effects; however, their use is controversial, as they may also compromise the drug's effectiveness. Milk thistle may offer protective benefits against kidney toxicity, but human studies are lacking. Additionally, acetyl-L-carnitine has shown potential in alleviating peripheral neuropathy symptoms associated with cisplatin, while ginger does not appear to help with chemotherapy-induced nausea. Patients should exercise caution by consulting healthcare providers before combining cisplatin with other herbs or supplements, especially those known to pose risks, such as garlic and ginkgo biloba, due to potential bleeding concerns.
Cisplatin (drug interactions)
DEFINITION: A chemotherapy drug used to treat cancer of the testicles, bladder, lung, stomach, esophagus, and ovaries, and other forms of cancer.
INTERACTIONS: Acetyl-L-carnitine, antioxidants, black cohosh, ginger, magnesium, melatonin, milk thistle, potassium, antioxidants, garlic, ginkgo biloba, various prescription medications
TRADE NAME: Platinol
Black Cohosh
Effect: Possible Harmful Interaction
The herb black cohosh is often used for menopausal symptoms. Because women receiving cancer chemotherapy may experience menopausal symptoms, black cohosh may appear a promising option. However, one test-tube study found that use of black cohosh may decrease the effectiveness of cisplatin.
Magnesium and Potassium
Effect: Possibly Helpful Interaction
There is some evidence that cisplatin use may cause the body to develop potentially dangerous deficiencies of potassium and magnesium. Supplementing these nutrients may be advisable.
Melatonin
Effect: Possible Helpful Interaction
Weak preliminary evidence suggests that melatonin may reduce side effects and increase the efficacy of chemotherapy regimens that include cisplatin.
Antioxidants
Effect: Possible Helpful Interaction
It has been suggested that many of the undesired effects of cisplatin are caused by the creation of free radicals, dangerous, naturally occurring substances that can damage many cells. For this reason, treatment with antioxidants has been proposed to prevent toxic side effects. However, there is no more than minimal evidence for benefit. One animal study tested a combination of substances with strong antioxidant properties (vitamin E, Crocus sativus, and Nigella sativa) and found evidence that this mixture reduced the kidney toxicity of cisplatin. A small human trial found evidence that vitamin E might help prevent nerve injury (peripheral neuropathy) caused by cisplatin. Still, because this was an open study, its results are not reliable. Another open study found possible benefits with selenium.
The placebo effect and other confounding factors can play a significant role in open studies. In a better-designed, double-blind, placebo-controlled study of forty-eight people undergoing cancer treatment with cisplatin, participants were given either a placebo or a combination of vitamin E, vitamin C, and selenium in hopes of reducing toxicity to the ears and kidneys. No significant benefits were seen. Some concerns are that using antioxidants could potentially decrease the effectiveness of some forms of chemotherapy. For this reason, experts strongly suggest that people on cancer chemotherapy not use antioxidants or any herbs or supplements except in consultation with a physician.
Milk Thistle
Effect: Possible Helpful Interaction
Animal and test-tube studies hint that the herb milk thistle might decrease cisplatin's kidney toxicity and possibly increase cisplatin efficacy.
However, no studies in humans have been reported.
Acetyl-L-carnitine
Effect: Possible Helpful Interaction
One study found evidence that the supplement acetyl-L-carnitine might reduce symptoms of peripheral neuropathy caused by cisplatin.
Ginger
Effect: No Benefit
The herb ginger is widely used to treat nausea. However, one study failed to find it helpful for nausea caused by cisplatin.
Other Interactions
There is some indication that garlic and ginkgo biloba may increase the risk of bleeding when taken with cisplatin. However, no double-blind, placebo-controlled human studies are available. When taking cisplatin, patients should avoid nephrotoxic and ototoxic drugs that can further damage the kidneys or ears. They should also avoid seizure medications, live vaccines, and other chemotherapy drugs.
Bibliography
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"Cisplatin Dosing, Indications, Interactions, Adverse Effects, and More." Medscape, reference.medscape.com/drug/platinol-aq-cisplatin-342108. Accessed 10 Sept. 2024.
"Cisplatin (Intravenous Route) Side Effects." Mayo Clinic, 1 Aug. 2024, www.mayoclinic.org/drugs-supplements/cisplatin-intravenous-route/side-effects/drg-20062953?p=1. Accessed 10 Sept. 2024.
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