Adult Dosing
Advanced ovarian carcinoma
Monotherapy
- 360 mg/m2 IV on day 1 q4 wks, alt: Calvert formula [Total dose (mg) = (target AUC) × (GFR + 25)]; do not repeat intermittent courses of carboplatin until the neutrophil count is at least 2,000 and the platelet count is at least 100,000
Combination therapy with cyclophosphamide
- Carboplatin 300 mg/m2 plus cyclophosphamide 600 mg/m2 IV on day 1 q4 wks x 6 cycles, alt: Calvert formula [Total dose (mg) = (target AUC) × (GFR + 25)]; do not repeat intermittent courses of the combination until the neutrophil count is at least 2,000 and the platelet count is at least 100,000
Note:
- Dosage adjustments based on lowest post-treatment blood counts
- Platelets >100,000 and neutrophils >2,000: Give 125% of adjusted dose from prior course
- Platelets 50,000-100,000 and neutrophils 500-2,000: No dose adjustments
- Platelets <50,000 and neutrophils <500/mm3 : Give 75% of adjusted dose from prior course
- Max: 125% of adjusted dose from prior course
- Aluminum reacts with carboplatin causing precipitate formation and loss of potency; therefore, needles or intravenous sets containing aluminum parts that may come in contact with the drug must not be used for the preparation or administration of carboplatin injection
- Use Calvert formula dosing in elderly patients
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Renal Dose Adjustment (Based on CrCl)
- 41-59 mL/min: 250 mg/m2 on day 1 q4 wks
- 16-40 mL/min: 200 mg/m2 on day 1 q4 wks
- <15 mL/min: Dose adjustments not defined
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Myelosuppression is dose related and may be severe, resulting in infection and/or bleeding [US Black Box Warning]
- Ensure that carboplatin dose is adjusted based on lowest post-treatment platelet or neutrophil value following manufacturer's guidelines. Ensure that the CBC with differential and platelet counts are monitored frequently during treatment and when appropriate, until recovery is achieved
- Concomitant treatment with aminoglycosides has resulted in increased renal and/or audiologic toxicity. Exercise caution when patient receives both drugs
- Emesis can occur and may be severe in patients receiving emetogenic therapy; this can be reduced by using pre-medication with antiemetics
- Peripheral neurotoxicity is infrequent, but its incidence is increased in patients older than 65 yrs of age and in patients previously treated with cisplatin
- Loss of vision, which can be complete for light and colors, have occurred with the use of carboplatin with doses higher than recommended; vision may recover on discontinuation of therapy
- Contraindicated in patients with a history of severe allergic reactions to platinum-coordination compounds
- Higher doses, more than four times the recommended, may result in severe abnormalities of LFTs
- Carboplatin can cause fetal harm when administered to a pregnant woman. If the drug is used during pregnancy, apprise the patient about the potential hazard to the fetus
- Needles or intravenous administration sets containing aluminum parts that may come in contact with carboplatin injection should not be used for the preparation or administration of the drug. Aluminum can react with carboplatin causing precipitate formation and loss of potency
Cautions: Use cautiously in
- Concurrent neurotoxic agents
- Concurrent ototoxic agents
- Neuromuscular disease
Pregnancy Category:D
Breastfeeding: Unsafe. Because of the possibility of toxicity in breastfed infants, manufacturer recommends breastfeeding to be discontinued if the mother is treated with carboplatin.
