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Carboplatin

    DEA Class; Rx

    Common Brand Names; Paraplatin

    • Antineoplastics, Alkylating; 
    • Antineoplastics, Platinum Analog

    Platinum alkylating antineoplastic agent; on a molar basis, carboplatin is 45 times less cytotoxic than cisplatin; as effective as cisplatin in ovarian, non-small cell and small cell lung cancers; not recommended for routine treatment of testicular or head and neck cancers.

     

    Indicated for the treatment of ovarian cancer.

    For treatment of non-small cell lung cancer (NSCLC).
    For treatment of head and neck cancer.
    For treatment of testicular cancer.

    Severe hypersensitivity to carboplatin, other platinum compounds, mannitol

    Severe myelosuppression, significant bleeding

    Severe renal dysfunction

    Pregnancy/lactation

    • 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%)

    Pediatric patients, elderly, renal impairment, hearing impairment, neuropathy, neuromuscular disease, prior cisplatin treatment, concomitant neurotoxic agents, concomitant ototoxic agents

    Less nephrotoxic than cisplatin

    Avoid pregnancy

    Ototoxicity may occur

    Caution in patients with renal impairment; patients with renal failure are at increased risk for bone marrow suppression

    Carboplatin has limited nephrotoxic potential, but concomitant treatment with aminoglycosides has resulted in increased renal and/or audiologic toxicity, and caution must be exercised when a patient receives both drugs; clinically significant hearing loss has been reported to occur in pediatric patients when carboplatin was administered at higher than recommended doses in combination with other ototoxic agents

    Therapy can induce emesis, which can be more severe in patients previously receiving emetogenic therapy; the incidence and intensity of emesis have been reduced by using premedication with antiemetics; although no conclusive efficacy data exist, lengthening the duration of single intravenous administration to 24 hours or dividing the total dose over 5 consecutive daily pulse doses has resulted in reduced emesis

    Although peripheral neurotoxicity is infrequent, its incidence is increased in patients older than 65 years and in patients previously treated with cisplatin; pre-existing cisplatin-induced neurotoxicity does not worsen in about 70% of the patients receiving carboplatin as secondary treatment

    Loss of vision, which can be complete for light and colors, has been reported after use of carboplatin with doses higher than those recommended in the package insert; vision appears to recover totally or to a significant extent within weeks of stopping these high doses

    As in the case of other platinum-coordination compounds, allergic reactions to carboplatin have been reported; these may occur within minutes of administration and should be managed with appropriate supportive therapy; there is increased risk of allergic reactions including anaphylaxis in patients previously exposed to platinum therapy

    High dosages of carboplatin (more than 4 times the recommended dose) have resulted in severe abnormalities of liver function tests

    Injection may cause fetal harm when administered to a pregnant woman

    Not known whether carboplatin is excreted in human milk; because there is possibility of toxicity in nursing infants secondary to treatment of the mother, it is recommended that breast-feeding be discontinued if the mother is treated

    The suggested maximum tolerated dose (MTD) for carboplatin is dependent on performance status, other chemotherapy agents or radiation given in combination, and disease state. The dosing of carboplatin may vary from protocol to protocol. If questions arise, clinicians should consult the appropriate references to verify the dose.

    Adults

    Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Geriatric

    Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Adolescents

    Safety and efficacy have not been established. Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Children

    Safety and efficacy have not been established. Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Infants

    Safety and efficacy have not been established. Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Neonates

    Safety and efficacy have not been established. Maximum dosage information is not available. For doses calculated using the Calvert formula with an estimated GFR, it is recommended to use a maximum GFR = 125 mL/min in the calculation.

    Carboplatin

    lyophilized powder for reconstitution

    • 150mg

    injectable solution

    • 10mg/mL (in vials of 50, 150, 450, and 600 mg)