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carboplatin (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

lyophilized powder for reconstitution

  • 150mg

injectable solution

  • 10mg/mL (in vials of 50, 150, 450, and 600 mg)
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Advanced Ovarian Carcinoma

Single agent: 360 mg/m² IV q4Weeks 

Combination treatment: 300 mg/m² IV (plus cyclophosphamide 600 mg/m² IV) q4Weeks

Dose Modifications

For SI units: Count in US units x 10^6/L

Give full dose if

  • Platelets 50-100,000
  • Neutrophils 500-2000

Give 125% if

  • Platelets >100000
  • Neutrophils >2000

Give 75% if

  • Platelets <50000
  • Neutrophils <500

Renal Impairment

CrCl 41-59 mL/min: 250 mg/m² IV on day 1

CrCl 16-40 mL/min: 200 mg/m² IV on day 1

CrCl <15 mL/min: Not recommended

Hepatic Impairment

Dose adjustment may not be necessary; not studied

Administration

Do not repeat dose until ANC >2000 AND platelets >100000

Infuse over >15 minutes

Monitor: CBC weekly

Other Indications & Uses

Off-label: testicular cancer, head and neck cancer, cervix cancer, small cell lung cancer, progressive diffuse large B-cell lymphoma

Dosage Forms & Strengths

lyophilized powder for reconstitution

  • 150mg

injectable solution

  • 10mg/mL (in vials of 50, 150, 450, and 600 mg)
more...

General Dosing Guidlines

Solid tumor

  • 300-600 mg/m² IV q4Weeks 

Sarcoma (bone/soft tissue)

  • 400 mg/m²/day for 2 days every 21 days

Brain tumor

  • 175 mg/m² qWeek x 4 weeks with a 2 weeks recovery period between courses

Bone marrow transplant preparative regimen

  • 500 mg/m²/day x 3 days

Retinoblastoma

  • 1-2 mL subconjunctival injection of 10 mg/mL solution per dose

Calvert formula should be used to calculate dosing

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Interactions

Interaction Checker

carboplatin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Leukopenia (26-97%)

            Neutropenia (21-96%)

            Nausea (81-93%)

            Vomiting (81-93%)

            Anemia (14-90%)

            Magnesium loss (43-61%)

            Thrombocytopenia (33-66%)

            Alopecia (2-49%)

            Asthenia (11-41%)

            Elevated alkaline phosphatase (29-37%)

            Central neurotoxicity (5-26%)

            Elevated AST (19-20%)

            Peripheral neuropathy (6-15%)

            1-10%

            Immune hypersensitivity reaction (2-9.2%)

            Elevated bilirubin (5%)

            Frequency Not Defined

            Visual disturbance (rare)

            Postmarketing Reports

            Dehydration

            Stomatitis

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            Warnings

            Black Box Warnings

            The drug should be administered under the supervision of an experienced cancer chemotherapy physician. Increased risk of allergic reactions in patients previously exposed to platinum. The allergic reaction may occur within minutes of carboplatin administration

            Bone marrow suppression, which may be severe and may result in infection or bleeding, is dose related. Reduce dosage in patients with bone marrow suppression and impaired renal function. Anemia is cumulative

            Vomiting is a frequent adverse effect and is dose related

            Contraindications

            Severe hypersensitivity to carboplatin, other platinum compounds, mannitol

            Severe myelosuppression, significant bleeding

            Severe renal dysfunction

            Pregnancy/lactation

            Cautions

            Pediatric patients, elderly, renal impairment, hearing impairment, neuropathy, neuromuscular disease, prior cisplatin treatment, concomitant neurotoxic agents, concomitant ototoxic agents

            Avoid aluminum needles/intravenous sets for preparation/administration

            Less nephrotoxic than cisplatin

            Avoid pregnancy

            Abnormal liver function tests reported with high doses

            Risk of neuropathy increases in patients >65 years and patients treated previously with the drug

            Ototoxicity may occur

            Caution in patients with renal impairment; patients with renal failure are at increased risk for bone marrow suppression

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            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: not known if excreted in breast milk; do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Platinum coordination compound; covalently binds to DNA; cross-links strands of DNA

            Not a true alkylating agent

            Absorption

            Peak plasma time: 2-4 hr

            Distribution

            Protein bound: 87% (platinum)

            Vd: 16 L

            Elimination

            Clearance: 4.4 L/hr

            Excretion: Urine (70% as carboplatin)

            Half-life

            • Carboplatin: 3-6 hr
            • Free ultrafilterable platinum: 6 hr
            • Total plasma platinum: 4-6 days
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            Administration

            IV Incompatibilities

            Solution: Na Bicarb 200 mM

            Additive: fluorouracil, mesna

            Y-site: amphotericin B cholesteryl-SO4

            IV Compatibilities

            Solution: D5W, D5W in NS, NS

            Additive: cisplatin, etoposide, floxuridine, ifosfamide, ifosfamide with etoposide, paclitaxel

            Y-site (partial list): allopurinol, etoposide PO4, filgrastim, gemcitabine, granisetron, linezolid, ondansetron, paclitaxel, piperacillin-tazobactam, propofol

            IV Preparation

            Single-dose lyophilized powder (reconstitution require)

            • Reconstitute powder with sterile water for injection, D5W, or 0.9% NaCl to yield a final concentration of 10 mg/mL
            • Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl

            Multidose premixed injectable solution

            • Available as a 10 mg/mL aqueous solution
            • Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl

            IV Administration

            Administer IV over 15 min or continuous IV infusion over 24 hr

            May also be administered intraperitoneally

            When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression and to enhance efficacy

            Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can cause precipitate formation and loss of potency)

            Storage

            Single-dose lyophilized powder (reconstitution required)

            • Unreconstituted vials: Stable at controlled room temperature (20-25°C [68-77°F]); protect from light
            • Reconstituted vials and diluted solutions: Stable for 8 hr at room temperature (25°C [77°C]); since no antibacterial preservative is contained in the formulation, discard 8 hr after dilution

            Multidose premixed injectable solution

            • Unopened multidose vials: Stable to the date indicated on the package when stored at 20-25°C (68-77°F) and protected from light
            • Multidose vials maintain microbial, chemical, and physical stability for up to 14 days at 25°C following multiple needle entries
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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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