Adult: In cases of epithelial origin: In previously untreated patients: Initially, 400 mg/m2 as a single agent given via IV infusion over 15 minutes to 1 hour. In patients with risk factors (e.g. previous myelosuppressive treatment and/or poor performance status): Reduce initial dose by 20-25%. Subsequent doses are adjusted based on the nadir of the white cell and platelet counts; treatment must not be given more frequently than every 4 weeks. Alternative dosing recommendation: In patients with recurrent cases: As a single agent: 360 mg/m2 on Day 1 every 4 weeks. In previously untreated patients: In combination with cyclophosphamide: 300 mg/m2 on Day 1 every 4 weeks for 6 cycles. Dosing interruption or dose reduction may be required according to individual safety or tolerability. Treatment protocols may vary among countries or individual products (refer to country- or product-specific guidelines).
Intravenous Small cell lung cancer
Adult: In previously untreated patients: Initially, 400 mg/m2 as a single agent given via IV infusion over 15 minutes to 1 hour. In patients with risk factors (e.g. previous myelosuppressive treatment and/or poor performance status): Reduce initial dose by 20-25%. Subsequent doses are adjusted based on the nadir of the white cell and platelet counts; treatment must not be given more frequently than every 4 weeks. Dosing interruption or dose reduction may be required according to individual safety or tolerability. Treatment protocols may vary among countries or individual products (refer to country- or product-specific guidelines).
What are the brands available for Carboplatin in Hong Kong?
Initially, 200 mg/m2. Subsequent doses are adjusted based on patient's tolerance.
41-59
Initially, 250 mg/m2. Subsequent doses are adjusted based on patient's tolerance.
Dosage recommendations may vary among countries and individual products (refer to detailed product guidelines).
Reconstitution
Solution for IV infusion: Further dilute with dextrose 5% in water or NaCl 0.9% inj to make a final concentration of as low as 0.5 mg/mL. Instructions for reconstitution may vary among individual products and between countries (refer to specific product guidelines).
Incompatibility
Incompatible with needles, syringes, catheters and IV administration sets containing Al parts.
Contraindications
Hypersensitivity to carboplatin or history of severe allergic reactions to cisplatin or other platinum-containing compounds. Severe myelosuppression, bleeding tumours. Lactation.
Special Precautions
Patient with herpes zoster, existing or recent chicken pox or recent chicken pox exposure, other infections. Renal impairment. Elderly. Pregnancy.
Adverse Reactions
Significant: Bone marrow suppression (e.g. leucopenia, thrombocytopenia, neutropenia), anaemia; nausea, vomiting, hepatic function abnormalities, peripheral neuropathy, nephrotoxicity, ototoxicity, visual disturbances (e.g. loss of vision), reversible posterior leucoencephalopathy syndrome, tumour lysis syndrome. Blood and lymphatic system disorders: Haemorrhage. Cardiac disorders: Cardiac failure. Gastrointestinal disorders: Abdominal pain, diarrhoea, constipation, stomatitis, dysgeusia. General disorders and administration site conditions: Asthenia. Infections and infestations: Infections. Investigations: Decreased CrCl, decreased blood K, Na, Ca or Mg; increased blood uric acid, creatinine or bilirubin. Nervous system disorders: Paraesthesia, sensory disturbances, decreased osteotendinous reflexes. Respiratory, thoracic and mediastinal disorders: Bronchospasm, respiratory disorder, ILD. Skin and subcutaneous tissue disorders: Alopecia. Potentially Fatal: Hypersensitivity or anaphylactic reactions, haemolytic uraemic syndrome, hepatic veno-occlusive disease.
Women of childbearing potential and men with partners who could become pregnant must use proven birth control methods during therapy and for at least 6 months after stopping the treatment.
Monitoring Parameters
Monitor serum electrolytes, CBC (with differential and platelet count), serum creatinine and BUN, CrCl, LFTs. Perform audiology evaluations. Assess for signs and symptoms of hypersensitivity reactions.
Drug Interactions
Increased risk of nephrotoxicity and ototoxicity with aminoglycosides (e.g. amikacin, gentamicin, tobramycin) and loop diuretics. May decrease serum concentration of phenytoin. Increases anticoagulant effect of warfarin. May potentiate the renal effects of nephrotoxic drugs. May increase the severity of bone marrow depression with other bone marrow-suppressing agents. May cause myalgia, arthralgia and fatigue with paclitaxel. Increased incidence of nausea and vomiting with other emetogenic agents. Potentially Fatal: May enhance the adverse effects of live or live-attenuated vaccines.
Action
Description: Mechanism of Action: Carboplatin, an analogue of cisplatin, is a platinum-containing antineoplastic agent. It binds to deoxyribonucleic acid (DNA) to form intrastrand cross-links, which cause changes in DNA conformation and affecting DNA replication. Pharmacokinetics: Distribution: Widely distributed into body tissues and fluids, with highest concentrations in the kidney, liver, skin and tumour tissues (platinum). Crosses the placenta and enters breast milk. Volume of distribution: 16 L. Plasma protein binding: Irreversible (platinum). Metabolism: Minimally metabolised in the liver into aquated and hydroxylated compounds. Excretion: Mainly via urine (approx 70% as unchanged drug, 3-5% as platinum). Terminal elimination half-life: Approx 6 hours (free platinum).
Chemical Structure
Carboplatin Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 426756, Paraplatin. https://pubchem.ncbi.nlm.nih.gov/compound/Paraplatin. Accessed Sept. 24, 2024.
Storage
Intact vials: Store between 15-30°C. Protect from light. This is a cytotoxic drug. Follow applicable procedures for receiving, handling, administration, and disposal. Storage recommendations may vary among individual products and between countries (refer to specific product guidelines).
L01XA02 - carboplatin ; Belongs to the class of platinum-containing antineoplastic agents. Used in the treatment of cancer.
References
Anon. Carboplatin. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 02/07/2024.Brayfield A, Cadart C (eds). Carboplatin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/07/2024.Carbopa 10 mg/mL Injection (Accord Healthcare Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 02/07/2024.Carboplatin 10 mg/mL Intravenous Infusion (Hospira UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 02/07/2024.Carboplatin Injection, Solution (Hospira, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 02/07/2024.Carboplatin. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 02/07/2024.Carboplatin. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 02/07/2024.Joint Formulary Committee. Carboplatin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/07/2024.Pfizer New Zealand Limited. DBL Carboplatin Injection data sheet 25 August 2023. Medsafe. http://www.medsafe.govt.nz. Accessed 02/07/2024.
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