Indications & Dose: ADVANCED BLADDER CANCER Mono therapy IV Adult 50-70mg/m2 as inf over 15-120min q3-4wk. Patients who have been extensively pretreated 50-70mg/m2 q4wk | METASTATIC OVARIAN CANCER Combination therapy IV Adult 75-100mg/m2 over 15-120min q4wk with cyclophosphamide | Mono therapy IV Adult 100mg/m2 over 15-120min q4wk | METASTATIC TESTICULAR TUMORS Combination therapy IV Adult Remission induction: 20mg/m2/day infused over 15min-2h for 5 consecutive days q3wk for 3 or 4 courses of therapy along with bleomycin & etoposide

Precautions: Electrolyte abnormalities, renal impairment, elderly

ADR: Serious: Nephrotoxicity, ototoxicity, neurotoxicity, myelosuppression, blurred vision, SIADH, thrombophlebitis, hemolytic uremic syndrome, electrolyte disturbances, optic neuritis, pancreatitis, reversible posterior leukoencephalopathy syndrome, heart block, HF, papilledema, neutropenic typhlitis, thrombotic thrombocytopenic purpura, MI, Others: Nausea & vomiting, liver enzymes increased, tissue irritation, skin ulceration

DDI: Serious Verapamil absorption modestly reduced, Megestrol antagonizes the drug effects, Etoposide clearance reduced, Bleomycin increases pulmonary toxicity, Fluorouracil increases risk of cardiotoxicity, Vinorelbine increases risk of granulocytopenia, Probenecid/Hydrochlorothiazide increases risk of nephrotoxicity, Amphotericin-B increases risk of renal impairment, Cyclophosphamide increases risk of renal toxicity, Methotrexate inhibits drug clearance, Valproic acid leads to hematological toxicity, Semaxanib leads to high incidence of thromboembolic events, Paclitaxel leads to severe myelosuppression, Aminoglycosides potentiates renal toxicity

Monitor: Renal function, electrolytes, audiography, neurologic exam, LFTs, CBC & platelet count, urinalysis