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.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

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

Each component has a specific meaning:

Creatinine clearance — The creatinine clearance recorded for the scenario being assessed.
Holding — The holding recorded for the scenario being assessed.

Note: Interpret the cisplatin dose adjust result against the thresholds and context described above.

How to Use

Enter the creatinine clearance, holding for the scenario you are assessing. 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. Use the cisplatin dose adjust result to inform your calculation.

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Carboplatin Calvert

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BSA DuBois