Trade Names:Carboplatin- Injection 10 mg/mL
Trade Names:Paraplatin- Lyophilized powder for injection 50 mg vial- Lyophilized powder for injection 150 mg vial- Lyophilized powder for injection 450 mg vialParaplatin-AQ (Canada)
Platinum coordination compound that produces predominantly interstrand DNA cross-links causing equivalent lesions and biological effects.
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 h.
In those with Ccr less than 60 mL/min, the total body and renal Cl decreases as the Ccr decreases. Dosage reduction is recommended.
Initial treatment of advanced ovarian carcinoma in combination with other chemotherapy agents. Secondary treatment for palliative treatment of patients with ovarian carcinoma recurrent after prior chemotherapy.
Small cell and non-small cell lung, head, neck, and testicular cancer.
History of severe allergic reactions to cisplatin or other platinum compounds or mannitol; severe bone marrow depression; significant bleeding.
IV 360 mg/m 2 on day 1 every 4 wk if neutrophil count is at least 2,000/mm 3 and platelet count is at least 100,000/mm 3 .Ovarian Carcinoma (Combination Therapy with Cyclophosphamide)Adults
IV Carboplatin 300 mg/m 2 plus cyclophosphamide 600 mg/m 2 , both on day 1 every 4 wk for 6 cycles. Do not repeat intermittent courses of the combination until the neutrophil count is at least 2,000/mm 3 and the platelet count is at least 100,000/mm 3 .Calvert Formula DosingAdults
IV Carboplatin may be dosed to achieve a target AUC based on the patient's glomerular filtration rate (GFR) using the Calvert formula. The desired target AUC depends on the disease and the patient's treatment status. The Calvert formula calculates the carboplatin dose in mg as follows: Total dose (mg) = target AUC (mg/mL•min) × (GFR [mL/min] + 25).Dosage Adjustments Based on Lowest Posttreatment Blood CountsAdults
IV If platelets above 100,000/mm 3 and neutrophils above 2,000/mm 3 , then give 125% of adjusted dose from prior course. If platelets are 50,000 to 100,000/mm 3 and neutrophils are 500 to 2,000/mm 3 , no dosage adjustment is necessary. If platelets below 50,000/mm 3 and neutrophils below 500/mm 3 , then give 75% of adjusted dose from prior course. Doses above 125% of the starting dose are not recommended.Renal Function Impairment (Dosage Adjustment)Adults
IV Baseline Ccr is 41 to 59 mL/min, the recommended dose on day 1 is 250 mg/m 2 ; 16 to 40 mL/min is 200 mg/m 2 ; below 15 mL/min, data too limited to permit a recommendation for treatment.
Store aqueous solution and powder for injection at controlled room temperature (59° to 86°F). Protect from light. Reconstituted solution is stable for 8 h at controlled room temperature (77°F). Reconstituted solution does not contain a preservative and any unused solution must be discarded 8 h after reconstitution. Do not save any unused solution for future use. Carboplatin aqueous solution multidose vials are stable at room temperature (77°F) for up to 14 days following initial needle entry.
Concomitant use may increase risk of nephrotoxicity or ototoxicity.Phenytoin
Serum concentrations may be decreased, resulting in a loss of therapeutic effect.
Abnormal LFTs; alkaline phosphatase; AST; total bilirubin.
Percentages are for carboplatin single agent therapy.
CV events (11%); fatal CV events including cardiac failure, embolism, cerebrovascular accidents (less than 1%); hypertension (postmarketing).
Asthenia (23%); peripheral neuropathies including mild paresthesias (6%); central neurotoxicity (5%); ototoxicity (1%); malaise (postmarketing).
Reversible vision loss.
Sodium loss (47%); magnesium loss (43%); calcium loss (31%); potassium loss (28%).
Nausea and vomiting (92%); vomiting (81%); other GI side effects (21%); anorexia (postmarketing).
Elevated BUN (22%); elevated serum creatinine (10%).
Elevated alkaline phosphatase (37%); elevated AST (19%); elevated bilirubin (5%).
Anemia (90%); leukopenia (85%); neutropenia (67%); thrombocytopenia (62%); infections, bleeding (5%).
Allergic reaction (2%).
Pain, redness, swelling (postmarketing).
Pain (23%); mucositis (1%).
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.Emesis
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.Hypersensitivity
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.Electrolytes
Ensure electrolytes are evaluated before starting therapy and periodically thereafter during prolonged treatment. Be prepared to treat abnormalities if clinically indicated.Infection/Bleeding
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).
Category D .
Undetermined. Because of possibility of toxicity in breast-feeding infants, discontinue breast-feeding.
Safety and efficacy not established.
Patients with impaired kidney function (Ccr below 60 mL/min) are at increased risk of severe bone marrow suppression.
Infrequent, but its incidence is increased in patients older than 65 yr of age and in patients previously treated with cisplatin.
Limited, but cotreatment with aminoglycosides has resulted in increased renal or audiologic toxicity. Exercise caution when patient receives both drugs.
Bone marrow suppression, hepatic toxicity.
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