Carboplatin


Generic Medicine Info
Indications and Dosage
Intravenous
Advanced ovarian carcinoma, Small cell lung cancer
Adult: Previously untreated patients: 400 mg/m2 as single short term IV infusion over 15-60 min. Therapy should not be repeated until 4 wk after the previous course and/or until the neutrophil count is at least 2,000 cells/mm3 and the platelet count is at least 100,000 cells/mm3. Patients previously treated w/ myelosuppresive therapy or patients w/ poor performance status: Reduce initial dosage by 20-25% (300-320 mg/m2).
Renal Impairment
CrCl (mL/min) Dosage
16-40 200 mg/m2.
41-59 Recommended dose: 250 mg/m2.
Incompatibility
Carboplatin reacts w/ Al causing loss of potency and forming a precipitate, do not use needles, syringes, catheters, IV admin sets containing Al parts. Incompatible w/ amphotericin B cholesteryl sulfate complex.
Contraindications
Hypersensitivity to carboplatin or other platinum-containing compd (e.g. cisplatin). Patient w/ severe bone marrow depression or significant bleeding; bleeding tumours. Concomitant use w/ yellow fever vaccine.
Special Precautions
Renal impairment. Pregnancy and lactation.
Adverse Reactions
Bone marrow suppression (thrombocytopenia, neutropenia, leucopenia), anaemia; nausea, vomiting, abdominal pain, diarrhoea, constipation, mucous membrane disorder; decreased CrCl, blood Na, K, Ca, and Mg; increased blood urea, blood alkaline phosphatase, aspartate aminotransferase, abnormal LFTs; infections, resp disorder, interstitial lung disease, haemorrhage, ototoxicity; alopecia, skin disorder, musculoskeletal disorder, asthenia, urogenital disorder; peripheral neuropathies, paraesthesia, decreased osteotendinous reflexes, visual disturbances (including vision loss), sensory disturbances, dysgeusia.
Potentially Fatal: Anaphylactic-type reactions (e.g. facial oedema, dyspnoea, tachycardia, low BP, urticaria, anaphylactic shock, bronchospasm), CV events including cardiac failure, embolism and cerebrovascular accident.
IV/Parenteral: D
Patient Counseling Information
This drug may cause nausea, vomiting, vision abnormalities and ototoxicity, if affected, do not drive or operate machinery.
Monitoring Parameters
Determine haematologic nadir by wkly blood counts during initial courses. Closely monitor hepatic and renal function tests. Neurological function including hearing assessment should also be monitored.
Drug Interactions
Additive myelosuppressive effects w/ other myelosuppressive agents. Increased risk of nephrotoxicity and/or ototoxicity w/ aminoglycosides or diuretics. Excessive immunosuppression w/ risk of lymphoproliferation w/ ciclosporin. Increased risk of exacerbation of convulsions w/ phenytoin, fosphenytoin. Enhanced adverse/toxic effects of live attenuated vaccines.
Potentially Fatal: Risk of generalised disease mortal w/ yellow fever vaccine.
Action
Description: Carboplatin is an alkylating agent which binds covalently to DNA. It modifies the cell cycle by interfering w/ DNA structure and function.
Pharmacokinetics:
Distribution: Widely distributed into body tissues and fluids, w/ highest concentrations in the kidney, liver, skin, and tumour tissue (as platinum). Volume of distribution: 16 L. Plasma protein binding: Irreversible (platinum).
Metabolism: Undergoes minimal hepatic metabolism to aquated and hydroxylated compd.
Excretion: Mainly via urine, approx a third of a dose is excreted unchanged. Terminal half-life: Approx 6 hr (as free platinum).
Chemical Structure

Chemical Structure Image
Carboplatin

Source: National Center for Biotechnology Information. PubChem Database. Carboplatin, CID=426756, https://pubchem.ncbi.nlm.nih.gov/compound/Carboplatin (accessed on Jan. 21, 2020)

Storage
Store at 25°C. Protect from light.
MIMS Class
Cytotoxic Chemotherapy
ATC Classification
L01XA02 - carboplatin ; Belongs to the class of platinum-containing antineoplastic agents. Used in the treatment of cancer.
References
Anon. Carboplatin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/01/2016.

Buckingham R (ed). Carboplatin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/01/2016.

Carboplatin Injection Solution (Teva Parenteral Medicines, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 19/01/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Carboplatin. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 19/01/2016.

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