Carboplat

Indications

Carboplatin is an anticancer (chemotherapy) medicine. It is mainly used for ovarian cancer and lung cancer (both small cell and non-small cell), and a cancer specialist may also use it for other cancers such as head and neck, bladder, cervical, testicular and some childhood cancers. It is often given together with other medicines such as Paclitaxel, Gemcitabine or Etoposide.

How It Works

Carboplatin is a platinum compound. It attaches to the DNA (genetic material) inside cells and links its strands together, so the cells cannot copy their DNA or divide. Fast-dividing cells such as cancer cells are affected most, but some healthy cells, such as those in the bone marrow, are also affected.

Dosage and Administration

Carboplatin is given only in hospital or a cancer centre, by a doctor or trained nurse, as a drip (infusion) into a vein, usually over 15 to 60 minutes. The dose is worked out by the cancer specialist for each person, mainly from kidney function and blood counts, and is given as prescribed. Treatment is usually repeated every 3 to 4 weeks. Blood tests are done before each cycle, and the dose may be delayed or reduced if blood counts are low. Medicines to prevent sickness are usually given before the infusion.

Interactions

Tell your cancer team about every medicine, herbal product and vaccine. Aminoglycoside antibiotics (such as Gentamicin or Amikacin), Vancomycin and loop diuretics (such as Furosemide) can increase the risk of kidney and hearing damage. Other cancer medicines and radiotherapy add to the effect on the bone marrow. Carboplatin can lower Phenytoin levels and change the effect of Warfarin. Live vaccines must be avoided during treatment.

Contraindications

• Severe allergy to carboplatin or other platinum medicines (such as Cisplatin).
• Severe bone marrow suppression (very low blood counts).
• Severe kidney problems.
• Heavy bleeding.
• Pregnancy and breastfeeding.

Side Effects

Common: low blood counts (raising the risk of infection, bleeding and tiredness from anaemia), nausea and vomiting, loss of appetite, tiredness, hair thinning, taste changes, tingling in hands and feet, ringing in the ears or hearing changes, and low magnesium, potassium or sodium in the blood. Allergic reactions can happen during the infusion, especially after several cycles.

Get urgent medical help, or contact your cancer team straight away, if you have a temperature of 38°C or higher, chills or other signs of infection, unusual bleeding or bruising, black stools or blood in urine, rash, swelling, chest tightness or difficulty breathing during or after the infusion, vomiting that stops you keeping fluids down, or very little urine.

Pregnancy and Lactation

Carboplatin can harm an unborn baby. Women should not become pregnant, and men should not father a child, during treatment and for some months afterwards; use reliable contraception as advised by the cancer team. Do not breastfeed during treatment.

Precautions and Warnings

Regular blood tests, kidney tests and checks of blood salts are needed. Older people and those who have had previous chemotherapy are more likely to have low blood counts. Tell the team about any kidney problems, hearing problems or past reactions to platinum medicines. Avoid people with infections where possible, wash hands often and do not have live vaccines. Tell any dentist or other doctor that you are receiving chemotherapy.

Overdose

Because it is given in hospital, overdose is rare. Too much can cause severe bone marrow suppression and damage to the kidneys, liver and hearing. There is no specific antidote; the hospital team gives supportive treatment and monitors blood counts closely.

Therapeutic Class

Antineoplastic (anticancer medicine), platinum compound.

Storage

Vials are stored by the hospital pharmacy below 25°C, protected from light, in the original carton, or as the product leaflet says. Do not refrigerate unless the leaflet says so. Keep out of the reach of children.