At what CrCl is cisplatin contraindicated?

Cisplatin is generally held when CrCl falls below 60 mL/min due to cumulative nephrotoxicity risk. Many centers substitute carboplatin when CrCl is 40–60 mL/min. Cisplatin is absolutely contraindicated in dialysis-dependent patients.

What pre-hydration protocol prevents cisplatin nephrotoxicity?

Standard pre-hydration: 1–2 L IV NS over 1–2 hours before cisplatin, followed by 1–2 L post-hydration. Mannitol-assisted diuresis (12.5 g IV) is used at some centers. Amifostine 910 mg/m2 provides additional nephroprotection but increases hypotension.

Cisplatin Creatinine-Adjusted Dose

Adjust cisplatin dose based on creatinine clearance, holding for CrCl below 60 mL/min, and calculating dose reduction for CrCl 60–90 mL/min to minimize nephrotoxicity.

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Cisplatin Creatinine-Adjusted Dose

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Frequently Asked Questions

At what CrCl is cisplatin contraindicated?

What pre-hydration protocol prevents cisplatin nephrotoxicity?