Carboplatin is a platinum-based therapy that inhibits DNA synthesis. It is indicated for the treatment of the following conditions:

• Advanced Ovarian cancer:
  • It is indicated for the initial treatment of advanced ovarian cancer in combination with other chemotherapy agents.
  • For the palliative treatment of recurrent ovarian cancer (after prior chemotherapy including cisplatin-based treatment)
• Off-Label Uses of Carboplatin in Adults:
  • Advanced anal cancer
  • Bladder cancer
  • Metastatic breast cancer.
  • Recurrent or metastatic cervical cancer
  • Advanced or recurrent endometrial cancer
  • Esophageal cancer
  • Gastric cancer
  • Head and neck cancer
  • Hematopoietic stem cell transplant
  • Relapsed or refractory Hodgkin lymphoma
  • Malignant pleural mesothelioma
  • Advanced or Metastatic Melanoma
  • Merkel cell carcinoma
  • Advanced, atypical, or poorly differentiated non-pulmonary Neuroendocrine tumors.
  • Relapsed or refractory Non-Hodgkin lymphomas
  • Non-small cell lung cancer
  • Small cell lung cancer
  • Testicular cancer
  • Thymic malignancies
  • Advanced anaplastic Thyroid cancer
  • Unknown primary adenocarcinoma

Carboplatin Dose in Adults

Note: Carboplatin is highly emetogenic. Administration of antiemetic drugs prior to carboplatin infusion is recommended.

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Doses are given as "Target AUC" which is put in the Calvert formula to estimate the total dose required.

Calvert formula: [Carboplatin dose = Target AUC x GFR + 25]

GFR is calculated using the Cockcroft and Gault formula: [140 - age (years)] x weight (Kgs)/ (serum creatinine x 72)

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Off-label use in the treatment of advanced Anal cancer:

• Target AUC 6 intravenous on days 1 and 22 - six-weekly for up to 4 cycles in combination with paclitaxel and fluorouracil or
• Target AUC 5 or 6 - 3-weekly in combination with paclitaxel

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Off-label use in the treatment of Bladder cancer:

• Target AUC 5 intravenous 3-weekly in combination with gemcitabine or
• Target AUC 6 intravenous 3-weekly in combination with paclitaxel

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Off label use in the treatment of metastatic Breast cancer:

• Target AUC 6 intravenous 3-weekly in combination with trastuzumab and paclitaxel or
• Target AUC 6 intravenous 3-weekly in combination with trastuzumab and docetaxel

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Off label use in the treatment of recurrent or metastatic Cervical cancer:

• Target AUC 5 intravenous 3-weekly in combination with paclitaxel or
• Target AUC 5 to 6 intravenous  4 -weekly in combination with paclitaxel or
• 400 mg/m² 4-weekly as monotherapy.

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Off-label use in the treatment of advanced or recurrent Endometrial cancer:

• Target AUC 6 intravenous 3-weekly in combination with paclitaxel for 7 cycles or
• Target AUC 5 intravenous 3-weekly in combination with paclitaxel for 6 - 9 cycles or until disease progression or unacceptable toxicity or
• Target AUC 2 intravenous on days 1, 8, and 15 four-weekly in combination with paclitaxel until disease progression or unacceptable toxicity or
• Target AUC 5 intravenous 3-weekly in combination with paclitaxel and trastuzumab for about 6 cycles, followed by trastuzumab maintenance therapy for HER2+ uterine serous cancer.

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Off label use in the treatment of Esophageal cancer:

• Target AUC 2 intravenous once weekly for 5 weeks in combination with paclitaxel and radiation therapy prior to surgery or
• Target AUC 5 intravenous 3-weekly in combination with paclitaxel.

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Off label use in the treatment of Gastric cancer:

• Target AUC 2 intravenous once weekly for 5 weeks in combination with paclitaxel and concurrent radiation prior to surgery or
• Target AUC 5 to 6 intravenous 3-weekly in combination with paclitaxel

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Off label use in the treatment of Head and neck cancer:

• Target AUC 5 intravenous 3-weekly in combination with cetuximab or
• Target AUC 5 intravenous 3-weekly in combination with cetuximab and fluorouracil or
• 300 mg/m² intravenous every 4 weeks in combination with fluorouracil or
• Target AUC 6 intravenous 3-weekly in combination with paclitaxel or
• Target AUC 1.5 intravenous weekly for 7 weeks in combination with radiation, following 3 cycles of docetaxel, cisplatin, and fluorouracil [TPF] induction therapy [begin carboplatin & radiation therapy three to eight weeks after the start of TPF cycle 3])

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Use in treatment of Hematopoietic stem cell transplant (HSCT) for metastatic germ cell tumors:

• 700 mg/m² /day intravenous for 3 days beginning 5 days prior to peripheral stem cell infusion in combination with etoposide for 2 cycles.

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Off-label use in the treatment of relapsed or refractory of Hodgkin lymphoma:

• Target AUC 5 to a maximum dose of 800 mg intravenous for 2 cycles in combination with ifosfamide and etoposide.

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Off label use in the treatment of Malignant pleural mesothelioma:

• Target AUC 5 intravenous 3-weekly in combination with pemetrexed

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Off label use in the treatment of advanced or metastatic Melanoma:

• Target AUC 2 intravenous days on 1, 8, and 15 four-weekly in combination with paclitaxel.

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Off label use in the treatment of Merkel cell carcinoma:

• Target AUC 4.5 intravenous on day 1 of weeks 1, 4, 7, and 10 in combination with etoposide and synchronous radiation therapy or
• Target AUC 2 intravenous on day 1 weekly for up to 5 doses administered concurrently with radiation, followed 3 weeks after radiation therapy by carboplatin with a target AUC of 4.5 on day 1 in combination with etoposide 3-weekly for 3 cycles

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Off label use in the treatment of advanced, atypical, or poorly differentiated non-pulmonary Neuroendocrine tumors

• Target AUC 6 intravenous 3-weekly in combination with etoposide for 4 to 6 cycles.

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Off label use in the treatment of relapsed or refractory of Non-Hodgkin lymphomas:

• Target AUC 5 to a maximum dose of 800 mg intravenous per cycle for 3 cycles in combination with rituximab, ifosfamide, and etoposide

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Off label use in the treatment of Non-small cell lung cancer:

• Target AUC 6 intravenous 3 or 4 weekly in combination with paclitaxel or
• Target AUC 6 intravenous 3-weekly in combination with bevacizumab and paclitaxel or
• Target AUC 5 intravenous 3-weekly in combination with pemetrexed or
• Target AUC 6 intravenous 3-weekly in combination with pemetrexed and bevacizumab for up to 4 cycles followed by maintenance therapy or
• Target AUC 5 intravenous 3-weekly in combination with pemetrexed and pembrolizumab for 4 cycles followed by pembrolizumab/pemetrexed maintenance therapy  or
• Target AUC 6 intravenous 3-weekly for 4 cycles in combination with pembrolizumab and either paclitaxel or paclitaxel [protein bound]) followed by pembrolizumab maintenance therapy or
• Target AUC 6 intravenous 3-weekly for 4 to 6 cycles in combination with atezolizumab, bevacizumab, and paclitaxel followed by atezolizumab/bevacizumab maintenance therapy or  in combination with radiation therapy and paclitaxel
• Target AUC 6 intravenous 3-weekly for 2 cycles or
• Target AUC 6 intravenous 3-weekly for 2 cycles, then target AUC 2 weekly for 7 weeks or
• Target AUC 2 intravenous every week for 7 weeks, then target AUC 6 3-weekly for 2 cycles

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Use in treatment of advanced Ovarian cancer:

• Off-label dosing in Advanced ovarian cancer:
  • Target AUC 5 to 7.5 intravenous 3-weekly in combination with paclitaxel or
  • Target AUC 2 once weekly in combination with weekly paclitaxel for 18 consecutive weeks or
  • Target AUC 5 3-weekly in combination with docetaxel or
  • Target AUC 6 on day 1 3-weekly in combination with bevacizumab [delayed until cycle 2] and paclitaxel) for up to 6 cycles, followed by bevacizumab monotherapy for a total of up to 22 cycles or until disease progression whichever occurs earlier.
• Off-label dosing in malignant germ cell tumor:
  • 400 mg/m² on day 1 in combination with etoposide every four weekly for 3 cycles
• Manufacturer's labeling:
  • 360 mg/m² every 4 weeks as monotherapy or
  • 300 mg/m² every 4 weeks in combination with cyclophosphamide for 6 cycles or
  • Target AUC 4 to 6 as monotherapy in previously treated patients

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Off label use in the treatment of Ewing sarcoma and osteosarcoma:

• 400 mg/m² /day intravenous for 2 days 3-weekly in combination with ifosfamide and etoposide

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Off label use in the treatment of Small cell lung cancer:

• Extensive stage disease:
  • Target AUC 5 intravenous 3-weekly in combination with irinotecan or
  • Target AUC 5 intravenous 4-weekly in combination with irinotecan or
  • Target AUC 5 intravenous on day 1 3-weekly in combination with etoposide and atezolizumab for 4 induction cycles, followed by atezolizumab maintenance therapy.
• Limited stage disease:
  • Target AUC 6 intravenous 3-weekly in combination with etoposide

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Off label use in the treatment of Testicular cancer:

• Target AUC 7 intravenous as a one-time dose or
• 700 mg/m² /day intravenous for 3 days beginning 5 days prior to peripheral stem cell infusion in combination with etoposide for 2 cycles.

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Off label use in the treatment of Thymic malignancies:

• Target AUC 5 intravenous 3-weekly in combination with paclitaxel

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Use in the treatment of advanced anaplastic Thyroid cancer:

 

• Target AUC 6 intravenous on day 1 3-weekly in combination with paclitaxel for 6 cycles or
• Target AUC 2 intravenous once weekly in combination with weekly paclitaxel

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Off label use in the treatment of Unknown primary adenocarcinoma:

• Target AUC 6 intravenous 3-weekly in combination with paclitaxel or
• Target AUC 6 intravenous 3-weekly in combination with docetaxel or
• Target AUC 6 intravenous 3-weekly in combination with paclitaxel and etoposide

Carboplatin Dose in Childrens

Note: Carboplatin is highly emetogenic. Administration of antiemetic drugs prior to carboplatin infusion is recommended.

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Doses are given as "Target AUC" which is put in the Calvert formula to estimate the total dose required.

Calvert formula: [Carboplatin dose = Target AUC x GFR + 25]

GFR is calculated using the Cockcroft and Gault formula: [140 - age (years)] x weight (Kgs)/ (serum creatinine x 72)

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Use in the treatment of Hematopoietic stem cell transplant (HSCT):

• Consolidation with myeloablative chemotherapy:
  • Infants older than 6 months and Children less than 3 years of age:
    • 17 mg/kg intravenous over two hours on days 0 and 1 of a 21-day cycle in combination with thiotepa for 3 cycles.
• Myeloablative:
  • Children and Adolescents:
    • 500 mg/m² intravenous over four hours for 3 doses on days 5 to 3

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Consolidation after reinduction chemo in patients with a relapsed Wilms Tumor:

• Children less than12 years:
  • 200 mg/m² intravenous for 4 doses on days 6 to 3 in combination with melphalan and etoposide

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Use in the treatment of Glioma: 

• Infants older than 3 months, Children, and Adolescents:
  • Induction:
    • 175 mg/m² intravenous once a week for 4 weeks 6 weekly (2-week recovery period between courses) in combination with vincristine for 2 cycles
  • Maintenance:
    • 175 mg/m² intravenous once a week for 4 weeks, with a 3-week recovery period between courses in combination with vincristine for less than 12 cycles

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Use in treatment of localized and unresectable Neuroblastoma:​​​​​​​

• Infants:
  • 6.6 mg/kg intravenous on days 1, 2, and 3 in combinations with etoposide for 2 cycles (CE regimen), followed by cyclophosphamide, doxorubicin, and vincristine (CAdO regimen)
• Children less than10 kgs:
  • 100 to 140 mg/m² /day intravenous on days 1, 2, and 3 every 3 weeks in combination with etoposide for 2 cycles (CE regimen), followed by cyclophosphamide, doxorubicin, and vincristine (CAdO regimen)
• Children more than 10 kgs and Adolescents:
  • 200 mg/m² /day intravenous on days 1, 2, and 3 every 3 weeks in combination with etoposide for 2 cycles (CE regimen), followed by cyclophosphamide, doxorubicin, and vincristine (CAdO regimen)

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Use in the treatment of Retinoblastoma: ​​​​​​​

• Infants and Children:
  • GFR 50 mL/minute/m² or more:
    • 560 mg/m² intravenous in combination with vincristine every 3 weeks for 8 cycles
  • GFR less than 50 mL/minute/m²:
    • Dosing utilized modified Calvert formula with a target AUC=6.5 in a combination regimen with vincristine intravenous 3-weekly for 8 cycles OR
• Infants and Children less than 3 years:
  • • 18.6 mg/kg intravenous on day 0 every four weeks in combination with etoposide and vincristine for 6 cycles (VEC regimen)
• Children older than 3 years:
  • • 560 mg/m² intravenous on day 0 every four weeks in combination with etoposide and vincristine for 6 cycles (VEC regimen)

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Use in treatment of Ewings and Osteosarcomas:​​​​​​​

• Children and Adolescents:
  • 400 mg/m² /day intravenous for 2 days every three weeks in combination with ifosfamide and etoposide (ICE regimen)

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Use in treatment of relapsed or refractory Wilms tumor:​​​​​​​

• Children and Adolescents:
  • 400 mg/m² /day intravenous for 2 days

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Reinduction prior to autologous stem cell rescue:​​​​​​​

• Children less than 12 years of age:
  • 600 mg/m² intravenous for 1 dose in combination with ifosfamide and etoposide

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Dosing adjustment for toxicity: ​​​​​​​

• Specific recommendations for pediatric patients are not available. Dose adjustment as per adult guidelines may be followed.
• Administer 75% of dose if platelets less than 50,000 cells/mm³ or ANC less than 500 cells/mm³

Pregnancy Risk Factor D

• Carboplatin can have serious side effects on the fetus. Before starting therapy, women of childbearing years should observe strict contraception.
• Women of childbearing years should have a baseline pregnancy test.

Carboplatin can be used duringBreastfeeding:

• It is unknown if carboplatin can be excreted into breastmilk. Manufacturers recommend that breastfeeding should be stopped during carboplatin therapy.

 

Carboplatin Dose in Renal Disease:

For single-agent therapy, the manufacturer’s labeling recommends the following dosage adjustments in patients with renal impairment. After initiating therapy, subsequent doses should be adjusted based on bone marrow toxicity.

• Baseline CrCl of 41 - 59 mL/minute:
  • Initiate the dose at 250 mg/m².
• Baseline CrCl 16 - 40 mL/minute:
  • Initiate the dose at 200 mg/m².
• Baseline CrCl of 15 mL/minute or less:
  • Dose adjustment not provided by the manufacturer (see alternate dosing)

Alternate Dosing (for dosing based on mg/m²):​​​​​​​

• GFR of more than 50 mL/minute: No adjustment in the dose is required.
• GFR 10 - 50 mL/minute: Administer half the usual dose.
• GFR of less than 10 mL/minute: Administer a quarter of the usual dose.
• Hemodialysis: Administer half the usual dose.
• Continuous ambulatory peritoneal dialysis (CAPD): Administer a quarter of the usual dose.
• Continuous renal replacement therapy (CRRT): 200 mg/m²

Carboplatin Dose in Liver Disease:

No dose adjustment is required since it is minimally metabolized by the liver as per manufacturer's labeling.

Common Side Effects Of Carboplatin include:

• Central nervous system:
  • Pain
• Endocrine & metabolic:
  • Hyponatremia
  • Hypomagnesemia
  • Hypocalcemia
  • Hypokalemia
• Gastrointestinal:
  • Vomiting
  • Abdominal pain
  • Nausea

• Hematologic & oncologic:
  • Bone marrow depression
  • Anemia
  • Leukopenia
  • Neutropenia
  • Thrombocytopenia
• Hepatic:
  • Increased serum alkaline phosphatase
  • Increased serum AST
• Hypersensitivity:
  • Hypersensitivity
• Neuromuscular & skeletal:
  • Weakness
• Renal:
  • Decreased creatinine clearance
  • Increased blood urea nitrogen

Less Common Side Effects Of Carboplatin include:

• Central nervous system:
  • Peripheral neuropathy
  • Neurotoxicity
• Dermatologic:
  • Alopecia
• Gastrointestinal:
  • Constipation
  • Diarrhea
  • Dysgeusia
  • Mucositis
  • Stomatitis
• Hematologic & oncologic:
  • Bleeding complications
  • Hemorrhage
• Hepatic:
  • Increased serum bilirubin
• Infection:
  • Infection
• Ophthalmic:
  • Visual disturbance
• Otic:
  • Ototoxicity
• Renal:
  • Increased serum creatinine

Contraindication to Carboplatin include:

• Allergy to carboplatin or cisplatin or platinum-containing formulations or mannitol or any component of the formulation
• Patients with severe bone marrow depression or marked cytopenia (severe bone-marrow deficiency) should not use it.

Warnings and Precautions

• Suppression of bone marrow [US Boxed Warning]
  • It can lead to severe bone marrow suppression, manifested as peripheral cytopenias.
  • This can lead to recurrent infections, bleeding due to low platelets count, and anemia that could require a blood transfusion.
  • The dose should be decreased if bone marrow suppression is observed. Also, it is important to delay the cycle until WBC and platelet counts are normal.
  • Patients taking concomitant myelosuppressive medications and patients with renal dysfunction are at greater risk of bone marrow suppression.

• Gastrointestinal toxicities: [US Boxed Warning]
  • It is extremely emetogenic, and antiemetics should not be used prior to infusion or during therapy.

• Hypersensitivity and anaphylactic reactions: [US Boxed Warning]
  • Carboplatin has been linked to severe allergic reactions, including anaphylactic-like reactions.
  • Within minutes of administering the medication, an allergic reaction may occur.
  • The appropriate treatment should include epinephrine and corticosteroids.

• Abnormalities in liver function:
  • Hepatotoxicity can occur in patients who are exposed to higher doses of medication.

• Neurotoxicity:
  • Peripheral neuropathy is more common in older patients, who are over 65.

• Ototoxicity
  • Ototoxicity is a possibility in patients who are taking concomitant aminoglycosides and carboplatin therapy.
  • Pediatric patients are a high-risk group. During carboplatin treatment, it is important to conduct a baseline and periodic audiometric assessment.

• Toxicity in the renal system:
  • Patients who are on concomitant carboplatin therapy with aminoglycosides may develop nephrotoxicity. These patients should not take it.
  • Patients who have impaired renal function at baseline are at increased risk for bone marrow suppression.

• Vision loss
  • A permmanent vision loss has been observed in patients who received higher doses of the drug.

Carboplatin: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Risk Factor C (Monitor therapy).
Aminoglycosides	CARBOplatin may increase the ototoxic effects. Particularly when you take higher amounts of carboplatin.
Systemic Bexarotene	CARBOplatin could increase the serum concentrations of Bexarotene.
Chloramphenicol Ophthalmic	May increase the toxic/adverse effects of Myelosuppressive Agents.
CloZAPine	CloZAPine's toxic/adverse effects may be exacerbated by myelosuppressive agents. Particularly, there may be an increase in the risk of neutropenia.
Coccidioides immitis skin test	Coccidioides immitis Skin Test may be affected by immunosuppressants.
Denosumab	Might increase the toxic/adverse effects of Immunosuppressants. In particular, there may be an increase in the risk of serious infections.
Fosphenytoin - Phenytoin	The serum concentration of Fosphenytoin -Phenytoin may be decreased by Platinum Derivatives
Ocrelizumab	May increase the immunosuppressive effects of Immunosuppressants.
Pidotimod	Pidotimod's therapeutic effects may be diminished by immunosuppressants.
Promazine	May increase the myelosuppressive effects of Myelosuppressive Drugs.
Siponimod	Siponimod's immunosuppressive effects may be enhanced by taking immunosuppressants.
Sipuleucel - T	Sipuleucel T's therapeutic effects may be diminished by immunosuppressants
Tertomotide	Tertomotide's therapeutic effects may be diminished by immunosuppressants.
Trastuzumab	May increase the neutropenic effects of Immunosuppressants.
Risk Factor D (Consider therapy modifications)
Baricitinib	Baricitinib's immunosuppressive effects may be enhanced by immunosuppressants. Management: Baricitinib should not be used in combination with immunosuppressants like azathioprine and cyclosporine. It is permissible to use antirheumatic doses of methotrexate and nonbiologic disease modifying antirheumatic drug (DMARDs) together.
Echinacea	Might decrease the therapeutic effects of Immunosuppressants.
Fingolimod	Fingolimod may be immunosuppressed by immunosuppressants. When possible, avoid the use of fingolimod with other immunosuppressants. Patients should be closely monitored for any additive immunosuppressant effects, such as infections, if they are used together.
Leflunomide	Leflunomide's toxic/adverse effects may be exacerbated by immunosuppressants. The risk of hematologic toxicities such as pancytopenia and agranulocytosis may increase. Patients on immunosuppressants should not be given a leflunomide loading dosage. Patients who are receiving leflunomide or another immunosuppressant must be checked for bone marrow suppression at minimum monthly.
Lenograstim	Antineoplastic Agents can reduce the therapeutic effects of Lenograstim. Management: Lenograstim should be avoided 24 hours prior to and 24 hours following the completion of myelosuppressive, cytotoxic chemotherapy.
Lipegfilgrastim	Antineoplastic agents may reduce the therapeutic effects of Lipegfilgrastim. Management: It is important to avoid the simultaneous use of lipegfilgrastim with myelosuppressive, cytotoxic chemotherapy. After myelosuppressive chemotherapy has been completed, lipegfilgrastim must be given at least 24 hours.
Nivolumab	Nivolumab's therapeutic effects may be diminished by immunosuppressants.
Palifermin	Can increase the toxic/adverse effects of Antineoplastic Agents. In particular, oral mucositis can be more severe and prolonged. Management: Avoid palifermin administration within the first 24 hours of infusion or 24 hours following myelotoxic chemotherapy.
Roflumilast	May increase the immunosuppressive effects of Immunosuppressants.
Taxane Derivatives	The myelosuppressive effects of Taxane derivatives may be enhanced by platinum derivatives. To limit toxicities, administer Taxane derivative prior to Platinum derivative if given in sequential infusions.
Tofacitinib	Tofacitinib's immunosuppressive effects may be enhanced by immunosuppressants. Management: It is permissible to use methotrexate (or nonbiologic disease-modifying antirheumatic drug (DMARDs), concurrently with antirheumatic doses. This warning appears to be particularly targeted at more potent immunosuppressants.
Topotecan	Topotecan's toxic/adverse effects may be exacerbated by Platinum Derivatives.
Vaccines (Inactivated).	Immunosuppressants can reduce the therapeutic effects of Vaccines (Inactivated). Management: The effectiveness of vaccines may be decreased. All age-appropriate vaccines must be completed at least two weeks before you start an immunosuppressant. Re-vaccinate anyone who was vaccinated while on immunosuppressant therapy.
Risk Factor X (Avoid Combination)
BCG (Intravesical).	The therapeutic effects of BCG (Intravesical) may be diminished by immunosuppressants
BCG (Intravesical).	Myelosuppressive agents may reduce the therapeutic effects of BCG (Intravesical).
Cladribine	May increase the immunosuppressive effects of Immunosuppressants.
Cladribine	May increase the myelosuppressive effects of Myelosuppressive Drugs.
Deferiprone	Deferiprone may have a neutropenic effect that myelosuppressive agents can increase.
Dipyrone	May increase the toxic/adverse effects of Myelosuppressive Agents. In particular, there may be an increase in the risk of pancytopenia and agranulocytosis.
Natalizumab	Natalizumab's toxic/adverse effects may be exacerbated by immunosuppressants. Particularly, concurrent infections may increase.
Pimecrolimus	May increase the toxic/adverse effects of Immunosuppressants
SORAfenib	CARBOplatin may have an adverse/toxic effect. Patients with squamous-cell lung cancer should not be given sorafenib and paclitaxel at the same time. Although not explicitly contraindicated, it is recommended to use in other settings.
Tacrolimus - Topical	May increase the toxic/adverse effects of Immunosuppressants
Vaccines (Live).	Immunosuppressants can increase the toxic/adverse effects of Vaccines (Live). Immunosuppressants can decrease the therapeutic effects of Vaccines. Management: Live-attenuated vaccines should be avoided for at least three months following immunosuppressants.

Monitor:

• Complete blood counts with differential and platelet count
• Serum electrolytes
• Serum creatinine
• BUN
• Creatinine clearance
• Liver function tests
• Audiology evaluations in children less than 6 months of age
• Clinical features of hypersensitivity reactions

How to administer Carboplatin?

• Carboplatin can be highly emetogenic. Antiemetic drugs are recommended to be taken before and during the administration of carboplatin.

Administration intravenous:

• Allow the drug to infuse for between 15 and 60 minutes. 
• If you are administering chemotherapeutic drugs as combination therapy, consult the prescribing information as the sequence of infusions may differ.
• Carboplatin may react with aluminum to form a precipitate. This can cause drug efficacy loss. 
• Avoid intravenous sets and needles that are made of aluminum.

Mechanism of action of Carboplatin:

Carboplatin

• Interstrand DNA cross-links are produced which inhibit DNA synthesis. 
• It is a platinum compound that binds covalently with DNA. It is not specific to a cell cycle.

It isdistributedIn body tissues such as the liver, kidneys, skin, and tumour cells, it is found extensively Carboplatin doesn't bindProteins. On the other hand, platinum binds irreversibly with plasma proteins The liver can only minimally metabolize it to hydroxylated substances. Half-life of carboplatin is reduced in patients who have a CrCl greater than 60 ml/min. It takes 2.6 to 5.9 hours for platinum to be eliminated, while that of carboplatin takes more than 5 days. Within 24 hours, 70% of the drug is eliminated via urine as carboplatin.

International Brands of Carboplatin:

• Actoplatin
• Adcarb
• B-Platin
• Bagotanilo
• Balidon
• Biocarb
• Biovinate
• Biplatinex
• Blastocarb
• Blastocarb RU
• Bobei
• Bopacatin
• Boplatex
• Carbol
• Carbopa
• Carboplatin
• Carboplatin
• Carboplatin Abic
• Carboplatin DBL
• Carboplatin dbl
• Carboplatin “Delta West”
• Carboplatin-David Bull
• Carboplatin-Medac
• Carboplatin-Teva
• Carboplatino
• Carbosin
• Carbosin Lundbeck
• Carbotec
• Carbotin
• Carbotinol
• Carcan
• Carplan
• Cobalmin
• Cytocarb
• Delta West Carboplatin
• Kemocarb
• Megaplatin
• Naprolat
• Naproplat
• Neoplatin
• Nuvaplast
• Omilipis
• Oncocarb
• Oncocarbin
• P&U Carboplatin
• Pharmaplatin
• Unicarb
• Vancel
• Womaplat
• Womastin

Carboplatin Brands in Pakistan:

Carboplatin [Inj 50 mg]
CARBOPLATIN	BIO PHARMA
CARBOTINOL	AL-HABIB PHARMACEUTICALS.
CARPSOL	PFIZER LABORATORIES LTD.
CYCLOPLATIN	UMAIR ASSOCIATES

Carboplatin [Inj 150 mg]
CARBOPLATIN	ATCO LABORATORIES LIMITED
CARBOPLATIN	BIO PHARMA
CARBOTINOL	AL-HABIB PHARMACEUTICALS.
CARPSOL	PFIZER LABORATORIES LTD.
CYTOCARB	A. J. MIRZA PHARMA (PVT) LTD
KEMOCARB	ATCO LABORATORIES LIMITED
TOXIPLATIN	CONSOLIDATED CHEMICAL LABORATORIES (PVT) LTD.

Carboplatin [Inj 200 mg]
CYCLOPLATIN	UMAIR ASSOCIATES
PHARMAPLATIN	PHARMEDIC (PVT) LTD.

Carboplatin [Inj 450 mg]
CARBOPLATIN	ATCO LABORATORIES LIMITED
CARBOPLATIN	BIO PHARMA
CARBOTINOL	AL-HABIB PHARMACEUTICALS.
CYTOCARB	A. J. MIRZA PHARMA (PVT) LTD
KEMOCARB	ATCO LABORATORIES LIMITED
NEOPLATINE	NEO MEDIX
TOXIPLATIN	CONSOLIDATED CHEMICAL LABORATORIES (PVT) LTD.