Classifications: antineoplastic; alkylating agent; Therapeutic: antineoplastic
Pregnancy Category: D
50 mg, 150 mg, 450 mg vials
Carboplatin is a platinum compound that is a chemotherapeutic agent. It produces interstrand DNA cross-linkages, thus interfering
with DNA, RNA, and protein synthesis. Carboplatin is cell-cycle nonspecific (i.e., effective throughout the entire cell
life cycle) it induces programmed cell death.
Full or partial activity against a variety of cancers resulting in reduction or stabilization of tumor size and useful in
patients with impaired renal function, patients unable to accommodate high-volume hydration, or patients at high risk for
neurotoxicity and/or ototoxicity.
Monotherapy or combination therapy for ovarian cancer.
Combination therapy for breast, cervical, colon, endometrial, head and neck, and lung cancer; leukemia, lymphoma, and melanoma.
History of severe reactions to carboplatin or other platinum compounds, severe bone marrow depression; significant bleeding;
impaired renal function; pregnancy (category D), and lactation.
Use with other nephrotoxic drugs; coagulapathy; previous radiation therapy; renal impairment.
Route & Dosage
Adult: IV 360 mg/m2 once q4wk. May be repeated when neutrophil count is at least 2000 mm3 and platelet count is at least 100,000 mm3. If neutrophil and platelet counts are lower, dose of carboplatin should be reduced by 5075% of initial dose.
Alternatively, 400 mg/m2 as a 24-h infusion for 2 consecutive d can be used.
Clcr 4159 mL/min: dose 250 mg/m2; 1640 mL/min: dose 200 mg/m2
Hemodialysis: Initial dose not to exceed 150 mg/m2
PREPARE: IV Infusion: Do not use needles or IV sets containing aluminum. Immediately before use, reconstitute with either sterile water for injection
or D5W or NS as follows: 50-mg vial plus 5 mL diluent; 150-mg vial plus 15 mL diluent; 450-mg vial plus 45 mL diluent. All
dilutions yield 10 mg/mL. May be further diluted to a concentration as low as 0.5 mg/mL with D5W or NS.
ADMINISTER: IV Infusion: Give IV solution over 15 min or longer, depending on total amount of solution and patient tolerance. Lengthening duration
of administration may decrease nausea and vomiting.
INCOMPATIBILITIES Solution/additive: Sodium bicarbonate, fluorouracil, mesna. Y-site: Amphotericin B cholesteryl complex, lansoprazole.
- Premedication with a parenteral antiemetic ? h before and on a scheduled basis thereafter is normally used.
- Do not repeat doses until the neutrophil count is at least 2000/mm3 and platelet count at least 100,000/mm3.
- Protect from light. Reconstituted solutions are stable for 8 h at room temperature; discard solutions 8 h after dilution.
Adverse Effects (≥1%) Body as a Whole:
Hypersensitivity reactions. GI: Mild to moderate nausea and vomiting,
anorexia, hypogeusia, dysgeusia, mucositis, diarrhea
, elevated liver enzymes. Hematologic: Thrombocytopenia, leukopenia, neutropenia, anemia. Metabolic: Mild hyponatremia, hypomagnesemia, hypocalcemia, and hypokalemia. CNS:
. Special Senses:
Diagnostic Test Interference
Decreased calcium levels; mild increases in liver function tests; decreased levels of magnesium, potassium, and sodium.
may increase the risk of ototoxicity and nephrotoxicity. May decrease phenytoin
8 wk (2 cycles). Duration:
216 mo. Distribution:
Highest concentration in the liver, lung, kidney, skin, and tumors. Not bound to plasma proteins
Hydrolyzed in the serum
Primarily by the kidneys; 6080% excreted in urine within 24 h. Half-Life:
Assessment & Drug Effects
- Monitor closely during first 15 min of infusion, since allergic reactions have occurred within minutes of carboplatin administration.
- Lab tests: Baseline and periodic CBC with differential, platelet count, Hgb and Hct. Monitor kidney function periodically
with creatinine clearance tests and serum electrolytes.
- Monitor results of peripheral blood counts. Median nadir occurs at day 21. Leukopenia, neutropenia, and thrombocytopenia
are dose related and may produce dose-limiting toxicity.
- Monitor for peripheral neuropathy (e.g., paresthesias), ototoxicity, and visual disturbances.
- Monitor serum electrolyte studies, because carboplatin has been associated with decreases in sodium, potassium, calcium,
and magnesium. Special precautions may be warranted for patients on diuretic therapy.
Patient & Family Education
- Learn about the range of potential adverse effects. Strategies for nausea prevention should receive special attention.
- During therapy you are at risk for infection and hemorrhagic complications related to bone marrow suppression. Avoid unnecessary
exposure to crowds or infected persons during the nadir period.
- Report paresthesias (numbness, tingling), visual disturbances, or symptoms of ototoxicity (hearing loss and/or tinnitus).