Consumer Drug Information

carboplatin

Generic Name: carboplatin (car bo PLAH tin)
Brand names: Paraplatin, Carboplatin Novaplus

What is carboplatin?

Carboplatin is an antineoplastic medication. Carboplatin interferes with the growth of cancer cells and slows their growth and spread in the body.

Carboplatin is used to treat ovarian cancer and many other types of cancer.

Carboplatin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about carboplatin?

Carboplatin should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Serious side effects have been reported with the use of carboplatin including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); kidney damage (little or no urine production, blood in the urine); hearing loss or ringing in the ears; decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; or fever, chills, or signs of infection); severe nausea, vomiting, diarrhea, and loss of appetite; and others. Talk to your doctor about the possible side effects from treatment with carboplatin.

What should I discuss with my healthcare provider before using carboplatin?

Do not use carboplatin without first talking to your doctor if you have

kidney disease;
a bleeding problem;
poor bone marrow function;
hearing impairment; or
an allergy to platinum, platinum-containing products, or mannitol.

The use of carboplatin may be dangerous if you have any of the conditions listed above.

Carboplatin is in the FDA pregnancy category D. This means that carboplatin is known to be harmful to an unborn baby. Do not use carboplatin without first talking to your doctor if you are pregnant or could become pregnant during treatment. Discuss with your doctor the appropriate use of birth control during treatment with carboplatin if necessary. It is not known whether carboplatin passes into breast milk. Breast-feeding should be avoided during treatment with carboplatin.

How should I use carboplatin?

Carboplatin should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Your doctor will determine the correct amount and frequency of treatment with carboplatin depending upon the type of cancer being treated and other factors. Talk to your doctor if you have any questions or concerns regarding the treatment schedule.

Adequate hydration is important during treatment with carboplatin. Your doctor may prescribe the administration of intravenous fluids and/or recommend additional fluid intake by mouth during treatment.

Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with carboplatin to monitor progress and side effects.

Your healthcare provider will store carboplatin as directed by the manufacturer. If you are storing carboplatin at home, follow the directions provided by your healthcare provider.

What happens if I miss a dose?

Contact your doctor if you miss a dose of carboplatin.

What happens if I overdose?

If for any reason an overdose of carboplatin is suspected, seek emergency medical attention or contact your healthcare provider immediately.

Symptoms of a carboplatin overdose tend to be similar to side effects caused by the medication, although often more severe.

What should I avoid while using carboplatin?

Carboplatin can lower the activity of your immune system making you susceptible to infections. Avoid contact with people who have colds, the flu, or other contagious illnesses and do not receive vaccines that contain live strains of a virus (e.g., live oral polio vaccine) during treatment with carboplatin. In addition, avoid contact with individuals who have recently been vaccinated with a live vaccine. There is a chance that the virus can be passed on to you.

Carboplatin side effects

If you experience any of the following serious side effects from carboplatin, contact your doctor immediately or seek emergency medical attention:

an allergic reaction (including difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
kidney damage (little or no urine production, blood in the urine);
decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; or fever, chills, or signs of infection);
severe nausea, vomiting, and loss of appetite; or
blurred vision, altered color perception, temporary blindness, and other visual problems.

Other, less serious side effects may be more likely to occur. Continue taking carboplatin and talk to your doctor if you experience:

hearing loss or ringing in the ears;
numbness or tingling;
weakness;
mild to moderate nausea, vomiting, or loss of appetite; or
hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Carboplatin Dosing 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.

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:

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.

What other drugs will affect carboplatin?

Do not receive "live" vaccines during treatment with carboplatin. Administration of a live vaccine may be dangerous during treatment with carboplatin.

Other medications may interact with carboplatin. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, during treatment with carboplatin.

Where can I get more information?

Your healthcare provider may have additional information about carboplatin that you may read.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.