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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Cisplatin - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Cisplatin">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2024/09/15">
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<meta name="citation_pmid" content="30000655">
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<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK501595/">
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<meta name="citation_keywords" content="cisplatin">
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<meta name="citation_keywords" content="Biocisplatinum">
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<meta name="citation_keywords" content="Cisplatine">
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<meta name="citation_keywords" content="Cisplatino">
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<meta name="citation_keywords" content="Cisplatinum">
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<meta name="citation_keywords" content="Fauldiscipla">
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<meta name="citation_keywords" content="Lederplatin">
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<meta name="citation_keywords" content="Platiblastin">
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<meta name="citation_keywords" content="Platinoxan">
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<meta name="citation_keywords" content="Abiplatin">
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<meta name="citation_keywords" content="Briplatin">
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<meta name="citation_keywords" content="Cismaplat">
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<meta name="citation_keywords" content="Cisplatyl">
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<meta name="citation_keywords" content="Neoplatin">
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<meta name="citation_keywords" content="Platidiam">
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<meta name="citation_keywords" content="Platinex">
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<meta name="citation_keywords" content="Platinol">
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<meta name="citation_keywords" content="Platosin">
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<meta name="citation_keywords" content="cis-Platinum">
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<meta name="citation_keywords" content="cis-Platin">
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<meta name="citation_keywords" content="LiPlaCis">
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<meta name="citation_keywords" content="Cisplatine Mylan">
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<meta name="citation_keywords" content="CP Ethypharm">
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<meta name="citation_keywords" content="Platinol-AQ">
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<meta name="citation_keywords" content="IA-call">
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<meta name="citation_keywords" content="Peyrone's chloride">
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<meta name="citation_keywords" content="DDPt">
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<meta name="citation_keywords" content="cis-Platinum(II)">
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<meta name="citation_keywords" content="cis-DDP">
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<meta name="citation_keywords" content="cisPt(II)">
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<meta name="citation_keywords" content="CACP">
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<meta name="citation_keywords" content="CDDP">
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<meta name="citation_keywords" content="CPDC">
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<meta name="citation_keywords" content="CPDD">
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<meta name="citation_keywords" content="CPPD">
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<meta name="citation_keywords" content="Cisplatino [Spanish]">
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<meta name="citation_keywords" content="DDP (antitumor agent)">
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<meta name="citation_keywords" content="Platidiam Lachema BRNO">
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<meta name="citation_keywords" content="Cisplatine [INN-French]">
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<meta name="citation_keywords" content="Cisplatinum [INN-Latin]">
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<meta name="citation_keywords" content="cis-Diaminedichloroplatinum">
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<meta name="citation_keywords" content="cis-Dichlorodiaminoplatinum">
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<meta name="citation_keywords" content="Platinum diamminodichloride">
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<meta name="citation_keywords" content="Cisplatino [INN-Spanish]">
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<meta name="citation_keywords" content="cis Diamminedichloroplatinum">
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<meta name="citation_keywords" content="cis-Diamminedichloroplatinum">
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<meta name="citation_keywords" content="cis-Dichlorodiammineplatinum">
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<meta name="citation_keywords" content="CCRIS 221">
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<meta name="citation_keywords" content="UNII-Q20Q21Q62J">
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<meta name="citation_keywords" content="cis-Platinous diaminodichloride">
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<meta name="citation_keywords" content="cis-Platinum diamminedichloride">
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<meta name="citation_keywords" content="cis-Diaminodichloroplatinum(II)">
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<meta name="citation_keywords" content="cis-Dichlorodiaminoplatinum(II)">
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<meta name="citation_keywords" content="SPI 77">
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<meta name="citation_keywords" content="cis-Diamminedichloroplatinum(II)">
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<meta name="citation_keywords" content="cis-Dichlorodiammineplatinum(II)">
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<meta name="citation_keywords" content="cis-Dichlorodiamminoplatinum(II)">
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<meta name="citation_keywords" content="cis-Dichlorodiamine platinum(II)">
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<meta name="citation_keywords" content="cis-Platinous diammine dichloride">
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<meta name="citation_keywords" content="HSDB 3939">
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<meta name="citation_keywords" content="cis-Dichlorodiammine platinum(II)">
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<meta name="citation_keywords" content="cis-Platinum(II) diaminedichloride">
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<meta name="citation_keywords" content="cis-Platinum(II) diaminodichloride">
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<meta name="citation_keywords" content="NCI-C55776">
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<meta name="citation_keywords" content="Platinum, diamminedichloro-, cis-">
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<meta name="citation_keywords" content="Q20Q21Q62J">
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<meta name="citation_keywords" content="cis-Diammineplatinum(II) dichloride">
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<meta name="citation_keywords" content="cis-Platinum(II) diamminedichloride">
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<meta name="citation_keywords" content="cis-Platinum(II) diamine dichloride">
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<meta name="citation_keywords" content="EINECS 239-733-8">
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<meta name="citation_keywords" content="NK 801">
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<meta name="citation_keywords" content="TR 170">
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<meta name="citation_keywords" content="NSC 119875">
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<meta name="citation_keywords" content="NSC-119875">
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<meta name="citation_keywords" content="Platinum(II), diamminedichloro-, cis-">
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<meta name="citation_keywords" content="1,2-Diaminocyclohexaneplatinum II citrate">
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<meta name="citation_keywords" content="Platinum, diamminedichloro-, (SP-4-2)-">
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<meta name="citation_keywords" content="AI3-62048">
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<meta name="citation_keywords" content="PDD">
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<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/">
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<meta name="DC.Title" content="Cisplatin">
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<meta name="DC.Type" content="Text">
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<meta name="DC.Publisher" content="National Institute of Child Health and Human Development">
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<meta name="DC.Date" content="2024/09/15">
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<meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK501595/">
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<meta name="description" content="Most sources consider that mothers receiving antineoplastic therapy should not breastfeed, especially with alkylating agents such as cisplatin.[1] Excretion of platinum into milk occurs, but results from case reports are inconsistent. Platinum in milk may increase with repeated courses of chemotherapy. The exact form(s), and toxicity of platinum excreted into breastmilk are also not known. The nursing infant would receive platinum compounds orally rather than intravenously and oral absorption of platinum compounds by infants is not known. It appears that it is not safe to breastfeed after cisplatin chemotherapy, and breastfeeding should probably be discontinued.">
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<meta name="og:title" content="Cisplatin">
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<meta name="og:type" content="book">
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<meta name="og:description" content="Most sources consider that mothers receiving antineoplastic therapy should not breastfeed, especially with alkylating agents such as cisplatin.[1] Excretion of platinum into milk occurs, but results from case reports are inconsistent. Platinum in milk may increase with repeated courses of chemotherapy. The exact form(s), and toxicity of platinum excreted into breastmilk are also not known. The nursing infant would receive platinum compounds orally rather than intravenously and oral absorption of platinum compounds by infants is not known. It appears that it is not safe to breastfeed after cisplatin chemotherapy, and breastfeeding should probably be discontinued.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501595_"><span class="title" itemprop="name">Cisplatin</span></h1><p class="fm-aai"><a href="#_NBK501595_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 5 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 15663-27-1</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134991833" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134991833" alt="image 134991833 in the ncbi pubchem database" /></a><div id="LM70.Drug_Levels_and_Effects"><h2 id="_LM70_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM70.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Most sources consider that mothers receiving antineoplastic therapy should not breastfeed, especially with alkylating agents such as cisplatin.[<a class="bibr" href="#LM70.REF.1" rid="LM70.REF.1">1</a>] Excretion of platinum into milk occurs, but results from case reports are inconsistent. Platinum in milk may increase with repeated courses of chemotherapy. The exact form(s), and toxicity of platinum excreted into breastmilk are also not known. The nursing infant would receive platinum compounds orally rather than intravenously and oral absorption of platinum compounds by infants is not known. It appears that it is not safe to breastfeed after cisplatin chemotherapy, and breastfeeding should probably be discontinued.</p><p>Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.[<a class="bibr" href="#LM70.REF.2" rid="LM70.REF.2">2</a>] Women who receive chemotherapy during pregnancy are more likely to have difficulty nursing their infant.</p></div><div id="LM70.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Platinum was not detected (<100 mcg/L) in the milk of one patient at any time after an IV infusion of 100 mg/sq. m (130 mg) of cisplatin.[<a class="bibr" href="#LM70.REF.3" rid="LM70.REF.3">3</a>]</p><p>In another patient, trough milk platinum was 900 mcg/L at 19.5 hours after her second daily dose of cisplatin 20 mg/sq. m infused intravenously over 4 hours. The simultaneous plasma platinum level was 800 mcg/L.[<a class="bibr" href="#LM70.REF.4" rid="LM70.REF.4">4</a>] Note: the original report stated a cisplatin dose of 30 mg/sq. m, but this was later corrected to 20 mg/sq. m in a published erratum.</p><p>A patient was given cisplatin 60 mg/sq. m (100 mg) infused intravenously over 3 hours. Samples from two cycles of therapy found average peak milk platinum concentrations of about 125 mcg/L occurred at 30 minutes after the dose and about 112 mcg/L at 18 hours after the dose. Milk platinum levels were about 10% of simultaneous plasma levels at all time points over the 18-hour sampling periods of two cycles.[<a class="bibr" href="#LM70.REF.5" rid="LM70.REF.5">5</a>]</p><p>Three patients with cervical cancer received cisplatin 20 mg/sq. m during pregnancy as part of their treatment. All women had a cesarean section and hysterectomy between 31 and 35 weeks of gestation, followed by another course of chemotherapy. Breastmilk samples "in the first days of lactation" were obtained and analyzed, although the time since the last cisplatin dose and the time since surgery were not specified. Cisplatin concentrations in breastmilk samples were 0.2, 1.4, and 5.5 mg/L, which were 0.9%, 2.3% and 9% of concentrations in maternal blood at the time of surgery.[<a class="bibr" href="#LM70.REF.6" rid="LM70.REF.6">6</a>]</p><p>Two women were treated with unspecified doses of cisplatin for treatment of cervical cancer every 2 weeks during pregnancy. The time of the last dose before delivery was not clearly specified in the abstract. Breastmilk samples were obtained daily on days 1 to 4 postpartum. Cisplatin was measured by flameless atomic absorption spectrophotometry. Platinum was undetectable (lower limit of assay not specified) in all of the samples.[<a class="bibr" href="#LM70.REF.7" rid="LM70.REF.7">7</a>]</p><p>A woman was given her first dose of 70 mg (40 mg/sq. m) of cisplatin intravenously at 6 weeks postpartum for treatment of cervical cancer discovered during pregnancy. Fifteen milk samples were obtained between 4 and 70 hours after the dose. Total platinum was measured in milk. The first sample at 4.25 hours after the dose contained about 16 mcg/L of platinum. Concentrations fell with a half-life of 10.2 hours until 17 hours after the dose. Between 17 and 57 hours after the dose, platinum was detectable (>2.5 mcg/L), but not quantifiable (<5 mcg/L) in milk. Platinum was undetectable (<2.5 mcg/L) at 66 and 70 hours after the dose. The authors estimated that a breastfed infant would be exposed systemically to between 0.08 and 0.12% of a therapeutic dose and that resumption of breastfeeding would be possible at 72 hours after a dose of this size.[<a class="bibr" href="#LM70.REF.8" rid="LM70.REF.8">8</a>]</p><p>A breastfeeding woman was started on cisplatin 70 mg intravenously once a week for 3 weeks for invasive squamous cell carcinoma at 5 months postpartum. She pumped her milk 3 to 4 times daily and discarded it for the first 5 days after each dose and continued to collect milk for several months. Platinum elimination from milk was biphasic. A milk total platinum concentration of about 7 mcg/L was found on day 11. The concentration decreased to 0.6. mcg/L on day 96 and then increased again by day 129 to about 5 mcg/L. Platinum was detectable in milk for at least 159 days after the first dose.[<a class="bibr" href="#LM70.REF.9" rid="LM70.REF.9">9</a>]</p><p>A postpartum patient was diagnosed with an ovarian germ cell tumor. Her treatment consisted of 4 cycles of BEP (bleomycin, etoposide on day 1 and cisplatin 90 mg on days 1 and 2), with the cycle repeated every 21 days. Using an electric pump, she collected 98 complete 24-hour samples of breastmilk after chemotherapy that were analyzed for platinum. Reported cisplatin concentrations in the milk samples were calculated based on the measured platinum concentrations using the molecular weight of cisplatin with the assumption that all measured platinum was cisplatin. Peak milk levels after the first round of chemotherapy were about 44 mcg/L; peak levels increased to about 46 mcg/L after the second round and to about 62 mcg/L in the fourth round. After 4 rounds of chemotherapy, milk platinum levels remained elevated for more than 10 days. The authors calculated the time for the milk concentration to reach a relative infant dosage (RID) level below 1% to be 14 days after the third cycle; however, the actual platinum species in milk were not determined.[<a class="bibr" href="#LM70.REF.10" rid="LM70.REF.10">10</a>]</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM70.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Two women were treated with unspecified doses of cisplatin for treatment of cervical cancer every 2 weeks during pregnancy. They both breastfed their newborn infants. Follow-up examinations of the infants, including Bayley scale test, neurology, and echocardiography at age of 20 and 35 months revealed normal findings.[<a class="bibr" href="#LM70.REF.7" rid="LM70.REF.7">7</a>]</p></div><div id="LM70.Effects_on_Lactation_and_Breastmilk"><h3>Effects on Lactation and Breastmilk</h3><p>A study of adolescent males who had received chemotherapy for childhood malignancies found that having received cisplatin was associated with elevated serum prolactin concentrations.[<a class="bibr" href="#LM70.REF.11" rid="LM70.REF.11">11</a>] Another study of survivors of testicular cancer found that about 6% of those treated with cisplatin had abnormally high prolactin levels and 2% had abnormally low prolactin levels.[<a class="bibr" href="#LM70.REF.12" rid="LM70.REF.12">12</a>]</p><p>A telephone follow-up study was conducted on 74 women who received cancer chemotherapy at one center during the second or third trimester of pregnancy to determine if they were successful at breastfeeding postpartum. Only 34% of the women were able to exclusively breastfeed their infants, and 66% of the women reported experiencing breastfeeding difficulties. This was in comparison to a 91% breastfeeding success rate in 22 other mothers diagnosed during pregnancy, but not treated with chemotherapy. Other statistically significant correlations included: 1. mothers with breastfeeding difficulties had an average of 5.5 cycles of chemotherapy compared with 3.8 cycles among mothers who had no difficulties; and 2. mothers with breastfeeding difficulties received their first cycle of chemotherapy on average 3.4 weeks earlier in pregnancy. Of the 3 women who received a cisplatin-containing regimen, 1 had breastfeeding difficulties.[<a class="bibr" href="#LM70.REF.13" rid="LM70.REF.13">13</a>]</p></div><div id="LM70.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM70.REF.1">Pistilli
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2017;12:91-7.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/28170295" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28170295</span></a>]</div></dd></dl></dl></div></div><div id="LM70.Substance_Identification"><h2 id="_LM70_Substance_Identification_">Substance Identification</h2><div id="LM70.Substance_Name"><h3>Substance Name</h3><p>Cisplatin</p></div><div id="LM70.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>15663-27-1</p></div><div id="LM70.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Antineoplastic Agents</p><p>Platinum Compounds</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501595_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">September 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Cisplatin. [Updated 2024 Sep 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1113/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM322/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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