carboplatin (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

lyophilized powder for reconstitution

  • 150mg

injectable solution

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

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)

General Dosing Guidelines

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

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              Serious - Use Alternative (8)

              • adenovirus types 4 and 7 live, oral

                carboplatin decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressives may diminish therapeutic effects of vaccines and increase risk of adverse effects (increased risk of infection). Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy.

              • amphotericin B deoxycholate

                amphotericin B deoxycholate and carboplatin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug.

              • bacitracin

                carboplatin and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs

              • cidofovir

                carboplatin and cidofovir both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Concomitant use of cidofovir and agents with nephrotoxic potential is contraindicated. Such agents must be discontinued at least 7 days prior to starting therapy with cidofovir.

              • influenza virus vaccine quadrivalent, adjuvanted

                carboplatin decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • influenza virus vaccine trivalent, adjuvanted

                carboplatin decreases effects of influenza virus vaccine trivalent, adjuvanted by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Immunosuppressive drugs may reduce the immune response to influenza vaccine.

              • palifermin

                palifermin increases toxicity of carboplatin by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

              • tofacitinib

                carboplatin, tofacitinib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.

              Monitor Closely (57)

              • acalabrutinib

                acalabrutinib, carboplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

              • acyclovir

                acyclovir and carboplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • adefovir

                adefovir and carboplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • amikacin

                amikacin and carboplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • belatacept

                belatacept and carboplatin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor.

              • bendamustine

                bendamustine, carboplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • busulfan

                busulfan, carboplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • capreomycin

                capreomycin and carboplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • carmustine

                carboplatin, carmustine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • chlorambucil

                carboplatin, chlorambucil. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • cholera vaccine

                carboplatin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to cholera vaccine.

              • cisplatin

                carboplatin and cisplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                carboplatin, cisplatin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • colistin

                carboplatin and colistin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • cyclophosphamide

                carboplatin, cyclophosphamide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • cyclosporine

                carboplatin and cyclosporine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • dacarbazine

                carboplatin, dacarbazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • dengue vaccine

                carboplatin decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Use Caution/Monitor. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine.

              • denosumab

                carboplatin, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

              • dichlorphenamide

                dichlorphenamide and carboplatin both decrease serum potassium. Use Caution/Monitor.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                carboplatin and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • ethotoin

                carboplatin decreases levels of ethotoin by unknown mechanism. Use Caution/Monitor.

              • fingolimod

                carboplatin increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .

              • foscarnet

                carboplatin and foscarnet both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • fosphenytoin

                carboplatin decreases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor.

              • gentamicin

                carboplatin and gentamicin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • hydroxyurea

                carboplatin, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of myelosuppression.

              • ifosfamide

                carboplatin, ifosfamide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • influenza A (H5N1) vaccine

                carboplatin decreases effects of influenza A (H5N1) vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.

              • influenza virus vaccine (H5N1), adjuvanted

                carboplatin decreases effects of influenza virus vaccine (H5N1), adjuvanted by pharmacodynamic antagonism. Use Caution/Monitor. Immunosuppressive therapies may reduce immune response to H5N1 vaccine.

              • ioversol

                carboplatin and ioversol both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

              • lomustine

                carboplatin, lomustine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • meningococcal group B vaccine

                carboplatin decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Use Caution/Monitor. Individuals with altered immunocompetence may have reduced immune responses to the vaccine.

              • methotrexate

                carboplatin and methotrexate both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • neomycin PO

                carboplatin and neomycin PO both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • ofatumumab SC

                ofatumumab SC, carboplatin. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

              • olaparib

                carboplatin and olaparib both increase pharmacodynamic synergism. Use Caution/Monitor. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity.

              • oxaliplatin

                carboplatin and oxaliplatin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • paromomycin

                carboplatin and paromomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • pentamidine

                carboplatin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • peramivir

                carboplatin increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.

              • phenytoin

                carboplatin decreases levels of phenytoin by unknown mechanism. Use Caution/Monitor.

              • polymyxin B

                carboplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • siponimod

                siponimod and carboplatin both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • sipuleucel-T

                carboplatin decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of carboplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of carboplatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • streptomycin

                carboplatin and streptomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • streptozocin

                carboplatin and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                carboplatin, streptozocin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive myelosuppression.

              • tacrolimus

                carboplatin and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tenofovir DF

                carboplatin and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Combination may also increase tenofovir levels.

              • tobramycin

                carboplatin and tobramycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled and carboplatin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • trastuzumab

                trastuzumab, carboplatin. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • trastuzumab deruxtecan

                trastuzumab deruxtecan, carboplatin. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

              • vancomycin

                carboplatin and vancomycin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

              • voclosporin

                voclosporin, carboplatin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

              • zidovudine

                carboplatin, zidovudine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of myelosuppression.

              Minor (2)

              • vitamin A

                vitamin A, carboplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

              • vitamin E

                vitamin E, carboplatin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs.

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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

              Less nephrotoxic than cisplatin

              Avoid pregnancy

              Ototoxicity may occur

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

              Carboplatin has limited nephrotoxic potential, but concomitant treatment with aminoglycosides has resulted in increased renal and/or audiologic toxicity, and caution must be exercised when a patient receives both drugs; clinically significant hearing loss has been reported to occur in pediatric patients when carboplatin was administered at higher than recommended doses in combination with other ototoxic agents

              Therapy can induce emesis, which can be more severe in patients previously receiving emetogenic therapy; the incidence and intensity of emesis have been reduced by using premedication with antiemetics; although no conclusive efficacy data exist, lengthening the duration of single intravenous administration to 24 hours or dividing the total dose over 5 consecutive daily pulse doses has resulted in reduced emesis

              Although peripheral neurotoxicity is infrequent, its incidence is increased in patients older than 65 years and in patients previously treated with cisplatin; pre-existing cisplatin-induced neurotoxicity does not worsen in about 70% of the patients receiving carboplatin as secondary treatment

              Loss of vision, which can be complete for light and colors, has been reported after use of carboplatin with doses higher than those recommended in the package insert; vision appears to recover totally or to a significant extent within weeks of stopping these high doses

              As in the case of other platinum-coordination compounds, allergic reactions to carboplatin have been reported; these may occur within minutes of administration and should be managed with appropriate supportive therapy; there is increased risk of allergic reactions including anaphylaxis in patients previously exposed to platinum therapy

              High dosages of carboplatin (more than 4 times the recommended dose) have resulted in severe abnormalities of liver function tests

              Needles or intravenous administration sets containing aluminum parts that may come in contact with carboplatin Injection should not be used for preparation or administration of the drug; aluminum can react with carboplatin causing precipitate formation and loss of potency

              Bone marrow suppression

              • Bone marrow suppression (leukopenia, neutropenia, and thrombocytopenia) is dose-dependent and is also the dose-limiting toxicity; peripheral blood counts should be frequently monitored during treatment and, when appropriate, until recovery achieved
              • Median nadir occurs at day 21 in patients receiving single-agent carboplatin; in general, single intermittent courses should not be repeated until leukocyte, neutrophil, and platelet counts have recovered
              • Since anemia is cumulative, transfusions may be needed during treatment, particularly in patients receiving prolonged therapy; bone marrow suppression is increased in patients who have received prior therapy, especially regimens including cisplatin
              • Marrow suppression is increased in patients with impaired kidney function; initial dosages in these patients should be appropriately reduced and blood counts should be carefully monitored between courses; the use in combination with other bone marrow suppressing therapies must be carefully managed with respect to dosage and timing in order to minimize additive effects
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              Pregnancy & Lactation

              Pregnancy

              Injection may cause fetal harm when administered to a pregnant woman; the drug has been shown to be embryotoxic and teratogenic in rats; there are no adequate and well-controlled studies in pregnant women; if this drug is used during pregnancy, or if patient becomes pregnant while in therapy, the patient should be apprised of potential hazard to fetus; women of childbearing potential should be advised to avoid becoming pregnant

              Lactation

              Not known whether carboplatin is excreted in human milk; because there is possibility of toxicity in nursing infants secondary to treatment of the mother, it is recommended that breast-feeding be discontinued if the mother is treated

              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.

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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

              BRAND FORM. UNIT PRICE PILL IMAGE
              carboplatin intravenous
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              carboplatin intravenous
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              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              carboplatin intravenous

              CARBOPLATIN - INJECTION

              (CAR-bow-plah-tin)

              COMMON BRAND NAME(S): Paraplatin

              WARNING: Carboplatin can cause severe blood disorders (e.g., anemia, bone marrow suppression) that can result in infection and bleeding problems. Your risk of developing these problems increases with higher doses or longer treatment with carboplatin. Also, an unlikely but very serious allergic reaction to this drug may occur within minutes of receiving a dose. Tell your doctor right away if you develop any of the following symptoms: easy bruising/bleeding, signs of infection (e.g., persistent sore throat, fever), unusual tiredness, rash, itching, swelling, severe dizziness, or trouble breathing.Vomiting is a common side effect of this medication. See the Side Effects section for more information.

              USES: Carboplatin is used to treat various types of cancer. It is a chemotherapy drug that contains platinum. It is used to slow or stop cancer cell growth.

              HOW TO USE: Carboplatin is usually given by infusion into a vein (intravenously-IV) over at least 15 minutes by a healthcare professional.The dosage is based on your medical condition, body size, and response to therapy. In general, courses of carboplatin treatment should not be given more often than once every 4 weeks. Consult your doctor or pharmacist for more details.

              SIDE EFFECTS: Stomach pain, body aches/pain, diarrhea, constipation, weakness, nausea, and vomiting may occur. Nausea and vomiting can be severe in some patients but usually go away within 24 hours of treatment. Drug therapy may be needed to prevent or relieve nausea and vomiting. Not eating before your treatment may help relieve vomiting. Changes in diet such as eating several small meals or limiting activity may help lessen some of these effects. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: numbness or tingling in the hands/feet, mouth sores, yellowing eyes/skin, dark urine, unusual tiredness, signs of kidney problems (such as change in the amount of urine), pain/swelling/redness at the injection site, hearing problems (such as ringing in the ears, hearing loss), easy bruising/bleeding, blood in the urine, black/bloody stools, fast/irregular heartbeat.Rarely, temporary vision loss may occur with high doses of carboplatin. Normal vision usually returns within several weeks after the end of treatment. Consult your doctor or pharmacist for more details and report this side effect right away if it occurs.This medication can lower your body's ability to fight an infection. Notify your doctor promptly if you develop any signs of an infection such as fever, chills or persistent sore throat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using carboplatin, tell your doctor or pharmacist if you are allergic to it, or to cisplatin; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: decreased bone marrow function/blood cell disorders (such as anemia, leukopenia, thrombocytopenia), kidney problems, mineral imbalance (low blood levels of sodium, potassium, magnesium, calcium).Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine.Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised or injured.Wash your hands well to prevent the spread of infections.Older adults may be more sensitive to the side effects of this drug, especially to bleeding problems and numbness/tingling of the hands/feet.Children may be at greater risk for hearing loss when carboplatin is used at higher-than-recommended doses in combination with other medications that may affect hearing.This medication can affect sperm production in men. Men should use a reliable form of birth control during treatment and for some time afterwards. Consult your doctor for more details.This medication is not recommended for use during pregnancy. It may cause harm to an unborn baby. Women of childbearing age should use reliable form(s) of birth control during treatment and for some time afterwards. Consult your doctor for more details.It is not known whether this drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aminoglycoside antibiotics (e.g., gentamicin, neomycin), amphotericin B, certain anti-seizure medications (hydantoins such as phenytoin), certain "water pills" (loop diuretics such as furosemide, bumetanide), nalidixic acid.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Laboratory and/or medical tests (e.g., complete blood counts, kidney function tests, blood mineral levels) should be performed to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

              STORAGE: Not applicable. This medication is given in a clinic and will not be stored at home.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

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

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              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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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.