Sanbeplatin Special Precautions

Carboplatin should only be administered to patients under the supervision of qualified physician who is experienced in the use of chemotherapeutic agents. Diagnostic and treatment facilities should be readily available for appropriate management of therapy and possible complications.
Peripheral blood counts and renal function should be monitored closely. Blood counts should be performed prior to commencement of Carboplatin therapy and weekly thereafter. Aside from monitoring toxicity, this practice will help determine the nadir and recovery of the generally seen between days 14 and 28, and days 14 and 21 respectively after initial therapy. A greater reduction in platelets is seen in patients who previously received extensive myelosuppressive chemotherapy than non-treated patients. Blood cell counts less than 2,000 cells/mm³ or platelets less than 50,000 cells/mm³ should cause consideration of postponement of Carboplatin therapy until bone marrow recovery is evident, which is usually 5 to 6 weeks. Transfusion may be required.
Renal toxicity is not usually dose-limiting. Pre-treatment and post-treatment hydration is not necessary. However, about 25% of patients show decreases in creatinine clearance and, less frequently, rises in serum creatinine and blood urea nitrogen may be seen. Impairment of renal function is more likely to be seen in patients who have previously experienced nephrotoxicity as a result of Cisplatin therapy.
Neurotoxicity such as paraesthesias and decrease deep tendon reflexes, and ototoxicity are more likely to be seen in patients who have received Cisplatin previously. Neurological evaluations and an assessment of hearing should be performed on a regular basis. Vomiting that may increase in patient getting other emetogenic treatment Aluminium-containing equipment should not be used (see INTERACTIONS).