Carboplatin information from DrugsUpdate
L - Contraindicated in lactation
Carboplatin is a chemotherapy drug used against some forms of cancer (mainly ovarian carcinoma, lung, head and neck cancers). It was introduced in the late 1980s and has since gained popularity in clinical treatment due to its vastly reduced side-effects compared to its parent compound cisplatin. Cisplatin and carboplatin, as well as oxaliplatin, interact with DNA, akin to the mechanism of alkylating agents.
Carboplatin is not protein bound; platinum from carboplatin is irreversibly protein bound. Vd is 16 L.
Aquated to produce the active species.
Initial t ½ is 1.1 to 2 h. Postdistribution t ½ is 2.6 to 5.9 h. Cl is 4.4 L/h. 71% is excreted in the urine in 24 hours.
Renal Function Impairment
In those with Ccr less than 60 mL/min, the total body and renal Cl decreases as the Ccr decreases. Dosage reduction is recommended.
Thrombocytopenia, neutropenia, leukopenia, anaemia; nausea, vomiting, central neurotoxicity, peripheral neuropathies, ototoxicity; elevation of ALT, AST, blood urea and bilirubin levels, electrolyte disturbances; alopecia; asthenia, pain; cardiac failure, embolism and cerebrovascular accidents may occur; mucositis.
Potentially Fatal: Bone marrow suppression and anaphylactic reactions.
May be cumulative and transfusions required.
Bone marrow suppression
Leukopenia, neutropenia, and thrombocytopenia are dose dependent and are the dose-limiting toxicities; they may result in infection or bleeding.
Vomiting is another frequent drug-related side-effect and usually ceases within 24 h of treatment. The incidence and intensity of emesis have been reduced by antiemetic premedication.
Anaphylactic-like reactions may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines may alleviate symptoms.
Ensure CBC with differential and platelet count are monitored frequently (at least weekly) during treatment and, when appropriate, until recovery is achieved. Ensure that carboplatin dose is adjusted based on lowest posttreatment platelet or neutrophil value following manufacturer's guidelines.
Ensure electrolytes are evaluated before starting therapy and periodically thereafter during prolonged treatment. Be prepared to treat abnormalities if clinically indicated.
Monitor patient for signs or symptoms of infection or bleeding. Inform health care provider immediately if noted and be prepared to treat appropriately (eg, IV antibiotics, colony stimulating factors, transfusions).
Neonates; diminished renal function; neurotoxicity; liver function impairment
Increased risk of ototoxicity when used with aminoglycosides
Advanced ovarian carcinoma
Adult: As a single agent in previously untreated patients: 400 mg/m2. As a single agent in previously treated patients with recurrent disease: 360 mg/m2. When used with cyclophosphamide in previously untreated patients: 300 mg/m2. Doses to be given by IV infusion over 15-60 minutes and not more frequently than every 4 wk. Subsequent doses should be adjusted based on nadir of WBC and platelet counts.
List of Contraindications
Contraindicated in pregnancy.
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Contraindicated in lactation
Safety and effectiveness in pediatric patients have not been established
Of the 789 patients in initial treatment combination therapy studies (NCIC and SWOG), 395 patients were treated with Carboplatin in combination with cyclophosphamide. Of these, 141 were over 65 years of age and 22 were 75 years or older. In these trials, age was not a prognostic factor for survival. In terms of safety, elderly patients treated with Carboplatin were more likely to develop severe thrombocytopenia than younger patients.
In a combined database of 1942 patients (414 were 65 years of age) that received single-agent Carboplatin for different tumor types, a similar incidence of adverse events was seen in patients 65 years and older and in patients less than 65. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Because renal function is often decreased in the elderly, renal function should be considered in the selection of Carboplatin dosage.
Previous allergy; pregnancy, lactation; allergy to other platinum compounds; severe bone marrow depression; significant bleeding, aluminium containing needles and IV sets.
Intravenous: Store at 25°C