Generic Name

Carboplatin

Precaution

Neonates; diminished renal function; neurotoxicity; liver function impairment. Lactation: not known if excreted in breast milk; do not nurse

Indication

Ovarian carcinoma, Lung cancer

Contra Indication

Previous allergy; pregnancy, lactation; allergy to other platinum compounds; severe bone marrow depression; significant bleeding, aluminium containing needles and IV sets.

Dose

N/A

Side Effect

>10% Leukopenia (26-97%),Neutropenia (21-96%),Nausea (81-93%),Vomiting (81-93%),Anemia (14-90%),Magnesium loss (43-61%),Thrombocytopenia (33-66%),Alopecia (2-49%),Asthenia (11-41%),Elevated alkaline phosphatase (29-37%),Central neurotoxicity (5-26%),Elevated AST (19-20%),Peripheral neuropathy (6-15%) 1-10% Immune hypersensitivity reaction (2-9.2%),Elevated bilirubin (5%) Frequency Not Defined Visual disturbance (rare) Potentially Fatal: Bone marrow suppression and anaphylactic reactions.

Pregnancy Category

Mode of Action

Carboplatin is an alkylating agent which binds covalently to DNA. It modifies the cell cycle by interfering with DNA structure and function.

Interaction

Increased risk of ototoxicity when used with aminoglycosides.

Pregnancy Category Note

Pregnancy Category: D Lactation: not known if excreted in breast milk; do not nurse

Adult Dose

Intravenous Small cell lung cancer; Advanced ovarian carcinoma Adult: IV As single agent in treatment-naive patients: 400 mg/m2; As single agent in previously treated patients: 360 mg/m2; W/ cyclophosphamide in treatment-naive patients: 300 mg/m2. Doses to be given not more frequently than every 4 wk. Adjust subsequent doses based on nadir of WBC and platelet counts. Hepatic Impairment Dose adjustment may not be necessary; not studied

Child Dose

Solid tumor 300-600 mg/m² IV q4Weeks Sarcoma (bone/soft tissue) 400 mg/m²/day for 2 days every 21 days Brain tumor 175 mg/m² qWeek x 4 weeks with a 2 weeks recovery period between courses Bone marrow transplant preparative regimen 500 mg/m²/day x 3 days Retinoblastoma 1-2 mL subconjunctival injection of 10 mg/mL solution per dose

Renal Dose

Renal impairment: CrCl (ml/min) >40 Recommended dose: 400 mg/m2. 20-39 Recommended dose: 250 mg/m2.

Administration

IV Preparation Single-dose lyophilized powder (reconstitution require) Reconstitute powder with sterile water for injection, D5W, or 0.9% NaCl to yield a final concentration of 10 mg/mL Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl Multidose premixed injectable solution Available as a 10 mg/mL aqueous solution Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl IV Administration Administer IV over 15 min or continuous IV infusion over 24 hr May also be administered intraperitoneally When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression and to enhance efficacy Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can cause precipitate formation and loss of potency)