What is cisplatin? How does it interact with other drugs?

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 use of cisplatin may cause the body to develop potentially dangerous deficiencies of potassium and magnesium. Taking supplements of these nutrients may be advisable.

Melatonin

Effect: Possible Helpful Interaction

Weak preliminary evidence hints that use of melatonin may
reduce side effects and increase 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
because of the creation of free radicals, dangerous, naturally
occurring substances that can damage many cells. For this reason, treatment with
antioxidants has been proposed for preventing toxic side
effects. However, as yet 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 use of vitamin E
might help prevent nerve injury (peripheral neuropathy) caused by cisplatin, but
because this was an open study, its results are not reliable. Another open study
found possible benefits with selenium.

In open studies, the placebo effect and other confounding factors can play a significant role. In a better-designed, double-blind, placebo-controlled study of forty-eight people undergoing cancer treatment with cisplatin, participants were given either 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. Note that there are concerns that use of 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 the kidney toxicity of cisplatin and also 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 for treatment of nausea. However, one study failed to find ginger helpful for nausea caused by cisplatin.

Bibliography

Argyriou, A. A., et al. “Vitamin E for Prophylaxis Against Chemotherapy-Induced Neuropathy.” Neurology 64 (2005): 26-31.

Maestri, A., et al. “A Pilot Study on the Effect of Acetyl-L-Carnitine in Paclitaxel- and Cisplatin-Induced Peripheral Neuropathy.” Tumori 91 (2005): 135-138.

Manusirivithaya, S., et al. “Antiemetic Effect of Ginger in Gynecologic Oncology Patients Receiving Cisplatin.” International Journal of Gynecological Cancer 14 (2004): 1063-1069.

Rockwell, S., Y. Liu, and S. Higgins. “Alteration of the Effects of Cancer Therapy Agents on Breast Cancer Cells by the Herbal Medicine Black Cohosh.” Breast Cancer Research and Treatment 90 (2005): 233-239.

Sieja, K., and M. Talerczyk. “Selenium as an Element in the Treatment of Ovarian Cancer in Women Receiving Chemotherapy.” Gynecologic Oncology 93 (2004): 320-327.

Van de Loosdrecht, A. A., J. A. Gietema, and W. T. van der Graaf. “Seizures in a Patient with Disseminated Testicular Cancer Due to Cisplatin-Induced Hypomagnesaemia.” Acta Oncologica 39 (2000): 239-240.

Weijl, N. I., et al. “Supplementation with Antioxidant Micronutrients and Chemotherapy-Induced Toxicity in Cancer Patients Treated with Cisplatin-Based Chemotherapy.” European Journal of Cancer 40 (2004): 1713-1723.