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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Platinum compounds

Cancer drugs built around a platinum atom that bind DNA and cross-link it, so tumour cells can no longer copy or read their genes.

Updated 2026-11-01

## What they are

Cisplatin, carboplatin and oxaliplatin: intravenous cytotoxics that form platinum–DNA adducts. They are a backbone of treatment for testicular, ovarian, lung, bladder, head and neck and colorectal cancers.

## Mechanism of action

Inside the cell the leaving groups (chloride, cyclobutane-dicarboxylate or oxalate) are replaced by water, giving a reactive, positively charged platinum complex. It binds the N7 atom of guanines and forms intrastrand and interstrand cross-links. The adducts block replication and transcription and trigger apoptosis. Oxaliplatin's bulkier adducts do not depend on mismatch repair, which helps explain its activity in colorectal cancer.

Target: DNA (N7 of guanine)

## Key points

- Cisplatin: cumulative nephrotoxicity (prevented with saline hydration and chloride diuresis), ototoxicity, severe vomiting, low magnesium.
- Carboplatin: myelosuppression (mainly thrombocytopenia) is the dose-limiting toxicity; little kidney damage. Its dose is calculated from kidney function.
- Oxaliplatin: cold-triggered acute neuropathy (throat, hands) and a cumulative sensory neuropathy; part of regimens with fluorouracil and folinic acid for colorectal cancer.
- Aluminium needles or sets must not touch them: aluminium makes platinum drugs precipitate and lose potency.
- Cisplatin has been confused with carboplatin, a mix-up that can lead to an accidental overdose.

## Drugs in this class

- [**Cisplatin** A platinum drug that cross-links DNA. Key in testicular, ovarian and bladder cancer; known for kidney damage, hearing… DNA (N7 of adjacent guanines)](https://durgical.com/en/pharmacology/cisplatin/)
- [**Carboplatin** A gentler cousin of cisplatin: the same DNA cross-links with far less kidney damage and vomiting, but more bone-marrow… DNA (N7 of guanine)](https://durgical.com/en/pharmacology/carboplatin/)
- [**Oxaliplatin** A platinum drug for colorectal cancer, given with fluorouracil and folinic acid. Cold can trigger tingling in the… DNA (adjacent guanines)](https://durgical.com/en/pharmacology/oxaliplatin/)

## Others in the class

- satraplatin

## Test yourself

Think of the answer, then tap the question to see it.

## Why is a chloride-rich (saline) infusion used around cisplatin?

High chloride keeps cisplatin in its stable, unreactive form in the urine, which reduces damage to the kidney tubules.

## Which platinum drug is limited mainly by thrombocytopenia rather than by kidney damage?

Carboplatin.

## A patient on a colorectal cancer regimen feels throat tightness and tingling when drinking something cold. Which drug is responsible?

Oxaliplatin: its acute neuropathy is triggered or worsened by cold.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - CISPLATIN injection](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=76aea034-6d58-4390-a164-36aa09c1f101) (DailyMed (U.S. National Library of Medicine), 2025); [DailyMed - CARBOPLATIN injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5abfcb87-bb02-4384-9c9d-7d0e3e809311) (DailyMed (U.S. National Library of Medicine), 2025); [DailyMed - OXALIPLATIN injection, solution, concentrate](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e51a62ba-d163-4c57-835c-8c86cf097e40) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 70 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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