Severe Myelosuppression:
Dose-limiting toxicity — causes neutropenia, thrombocytopenia, and anaemia.
→ Monitor FBC weekly during early cycles and before each dose; delay next cycle until recovery (neutrophils ≥2 ×10⁹/L, platelets ≥100 ×10⁹/L).
Renal Impairment:
Clearance directly related to renal function.
→ Check renal function (creatinine clearance) before each dose; reduce dose if CrCl <60 mL/min.
→ Contraindicated if CrCl ≤20 mL/min.
Hypersensitivity Reactions:
Risk of anaphylaxis (may occur within minutes), especially in patients previously exposed to platinum drugs.
→ Stop infusion immediately and manage with supportive therapy (antihistamines, corticosteroids, adrenaline if severe).
Ototoxicity and Neurotoxicity:
Risk increased with prior platinum exposure or in elderly patients.
→ Monitor hearing and neurological function, especially in those with prior cisplatin therapy.
Avoid Aluminium Equipment:
Reacts with aluminium → black precipitate and potency loss.
→ Do not use aluminium-containing IV sets, needles, or syringes.
Generic name: Carboplatin
Brand name: Carbosin
Drug class: Platinum coordination complex (cytostatic agent)
Formulation: Solution for injection (50 mg, 150 mg, 450 mg, 600 mg vials; 10 mg/mL)
Mechanism of action:
Forms DNA inter- and intrastrand crosslinks → inhibits DNA replication and transcription → tumour cell death.
Use in these indications should be based on clinical judgement and individual patient factors.
Advanced ovarian carcinoma of epithelial origin:
First-line therapy
Second-line therapy in patients whose disease has progressed or recurred after prior treatment
There is limited clinical evidence supporting the use of carboplatin in the following conditions:
Small cell carcinoma of the lung
Squamous cell carcinoma of the head and neck
Route: Intravenous infusion (15–60 minutes)
Typical adult dose (normal renal function): 400 mg/m² IV every 4 weeks.
Renal dose adjustment:
CrCl 41–59 mL/min → 250 mg/m²
CrCl 16–40 mL/min → 200 mg/m²
CrCl ≤15 mL/min → insufficient data (avoid use).
Cycle frequency: Repeat every 4 weeks only if FBC has recovered.
Elderly: May require dose reduction based on performance status.
Hypersensitivity to carboplatin or other platinum compounds.
Severe renal impairment (CrCl ≤20 mL/min).
Severe myelosuppression or active bleeding.
Pregnancy or lactation.
Administer only under supervision of an experienced oncology team.
FBC, renal, and hepatic function must be monitored regularly.
Avoid combination with other nephrotoxic or ototoxic agents (e.g. aminoglycosides, furosemide).
Dose reduction in elderly, renally impaired, or previously treated patients.
Use contraception — teratogenic and mutagenic.
Haematologic:
Neutropenia, thrombocytopenia, anaemia (dose-limiting, cumulative).
GI:
Nausea, vomiting (within 24 h; use prophylactic antiemetics).
Hepatic:
↑ Alkaline phosphatase, ALT, AST, bilirubin (usually mild).
Renal:
↑ Serum creatinine and urea (less nephrotoxic than cisplatin).
Others:
Fatigue, alopecia, pain, electrolyte imbalances (↓ Na⁺, K⁺, Mg²⁺, Ca²⁺).
Rare / Serious:
Hypersensitivity, hearing loss, vision loss (high-dose), ILD, haemolytic uraemic syndrome.
Elderly: Increased risk of myelosuppression — start lower dose.
Renal impairment: Adjust dose per CrCl.
Hepatic impairment: Monitor LFTs closely.
Pregnancy/Lactation: Contraindicated.
Paediatrics: Safety and efficacy not established.
Continue until maximum benefit or disease progression.
Delay or reduce dose for severe myelosuppression, renal impairment, or cumulative toxicity.
Stop permanently if:
Persistent Grade ≥3 myelosuppression or bleeding.
Severe hypersensitivity or anaphylaxis.
Irreversible renal or hepatic dysfunction.
Switch therapy: If disease progresses, consider alternate platinum-based combination or non-platinum agent depending on prior exposure/tolerance.
| Trade Name | Carbosin |
|---|---|
| Drug Class | Alkylating Agents |
| Cost | |
| Company | |
|---|---|
| Drug Rep | Admin |
| Indications | Lung Cancer, Ovarian Cancer |
| Dosage |