Medication Guide App

Carboplatin Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Ovarian Cancer

Single agent therapy for use in the treatment of recurrent ovarian cancer:
360 mg/m2 by intravenous injection on day 1 every 4 weeks (alternatively, the carboplatin dose may be calculated by the Calvert formula below). In general, however, single intermittent courses of carboplatin should not be repeated until the neutrophil count is at least 2000 and the platelet count is at least 100,000.

Combination therapy (with cyclophosphamide) for use in the treatment of advanced ovarian cancer (an effective combination for previously untreated patients):

carboplatin 300 mg/m2 by intravenous injection on day 1 every four weeks for six cycles (alternatively, the carboplatin dose may be calculated by the Calvert formula below).

cyclophosphamide 600 mg/m2 by intravenous injection. on day 1 every 4 weeks for six cycles.

Intermittent courses of carboplatin in combination with cyclophosphamide should not be repeated until the neutrophil count is at least 2000 and the platelet count is at least 100,000.

Calvert formula: Another approach for determining the initial dose of carboplatin is the use of the following mathematical formula, which is based on a patient's preexisting renal function or renal function and desired platelet nadir. (Renal excretion is the major route of elimination for carboplatin.) The use of this dosing formula, as compared to empirical dose calculation based on body surface area, allows compensation for patient variations in pretreatment renal function that might otherwise result in either underdosing (in patients with above average renal function) or overdosing (in patients with impaired renal function).

A simple formula for calculating dosage, based upon a patient's glomerular filtration rate (GFR in mL/min) and carboplatin target area under the concentration versus time curve (AUC in mg/mL/min), has been proposed by Calvert.

Calvert formula for carboplatin dosing: Total Dose (mg)=(target AUC) × (GFR + 25)
Note: With the Calvert formula, the total dose of carboplatin is calculated in mg, not mg/m2 .

The target AUC of 4-6 mg/mL/min using single agent carboplatin appears to provide the most appropriate dose range in previously treated patients.

In order to avoid potential toxicity due to overdosing, if a patient's GFR is estimated based on serum creatinine measured by the standardized Isotope Dilution Mass Spectrometry (IDMS) method rather than using an actual GFR measurement, a capping of the dose of carboplatin for the desired exposure (AUC) has been recommended.
Maximum carboplatin dose (mg) = target AUC (mg x min/mL) x (150 mL/min)

The maximum dose is based on a GFR estimate that is capped at 125 mL/min for patients with normal renal function. No higher estimated GFR values should be used.
For example:
For a target AUC = 6, the maximum dose is 6 x 150 = 900 mg
For a target AUC = 5, the maximum dose is 5 x 150 = 750 mg
For a target AUC = 4, the maximum dose is 4 x 150 = 600 mg

Usual Adult Dose for Cervical Cancer

(In combination with other chemotherapeutic agents as a part of the BIC regimen)
200 mg/m2 IV on day 1
The cycle is repeated every 21 days.

Usual Pediatric Dose for Malignant Disease

(Not approved by FDA)

Pediatric Calvert Formula:
Total dose (mg) = [Target AUC (mg/mL/min)] x [GFR (mL/min) + (0.36 x body weight in kg)]

Note: With the Calvert formula, the total dose of carboplatin is calculated in mg, not mg/m2 .

The target AUC varies with the number of agents in the regimen and if the patient has been treated previously or not.

Solid Tumor:
300-600 mg/m2 once every 4 weeks.

Brain Tumor:
175 mg/m2 once weekly for 4 weeks with a 2 week recovery between courses. The dose should then be adjusted based on platelet and neutrophil count values.

Bone Marrow Transplant Preparative Regimen:
500 mg/m2/day for 3 days.

Renal Dose Adjustments

Patients with Impaired Kidney Function:
Patients with creatinine clearance values below 60 mL/min are at increased risk of severe bone marrow suppression. In renally-impaired patients who received single agent carboplatin therapy, the incidence of severe leukopenia, neutropenia, or thrombocytopenia has been about 25% when the dosage modifications in the table below have been used.

If a patient has a baseline creatinine clearance of 41-59 mL/min, then the recommended dose for this patient on day 1 is 250 mg/m 2.

If a patient has a baseline creatinine clearance of 16-40 mL/min, then the recommended dose for this patient on day 1 is 200 mg/m 2.

The data available for patients with severely impaired kidney function (creatinine clearance below 15 mL/min) are too limited to permit a recommendation for treatment.

These dosing recommendations apply to the initial course of treatment. Subsequent dosages should be adjusted according to the patient's tolerance based on the degree of bone marrow suppression.

Liver Dose Adjustments

Data not available

Dose Adjustments

Pretreatment platelet count and performance status are important prognostic factors for severity of myelosuppression in previously treated patients. The suggested dose adjustments for single agent or combination therapy shown in the table below are modified from controlled trials in previously treated and untreated patients with ovarian carcinoma. Blood counts were done weekly, and the recommendations are based on the lowest posttreatment platelet or neutrophil value.

Platelets Neutrophils Adjusted Dose (from prior course)
> 100,000 > 2000 125%
50-100,000 500-2000 No Adjustment
< 50,000 < 500 75%
*Percentages apply to carboplatin as a single agent or to both carboplatin and cyclophosphamide in combination. In the controlled studies, dosages were also adjusted at a lower level (50% to 60%) for severe myelosuppression. Escalations above 125% were not recommended for these studies.

Precautions

Aluminum reacts with carboplatin causing precipitate formation and loss of potency, therefore, needles or intravenous sets containing aluminum parts that may come in contact with the drug must not be used for the preparation or administration of carboplatin.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Carboplatin is contraindicated in patients with severe renal impairment (CrCl less than 20 mL/min).

Other Comments

Carboplatin is usually administered by an infusion lasting 15 minutes or longer. No pre- or posttreatment hydration or forced diuresis is required.

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