৳ 4,400/unit
Pack: ৳ 4,400
৳ 4,400/unit
Pack: ৳ 4,400
At a glance
Carboplatin is an alkylating agent chemotherapy used in the treatment of advanced ovarian carcinoma and small cell lung cancer. It covalently binds to DNA, interfering with DNA structure and function, thereby modifying the cell cycle.
Indications
- Advanced ovarian carcinoma (epithelial) - initial treatment
- Recurrent ovarian carcinoma - palliative treatment
- Small cell lung cancer
Pharmacology
Carboplatin is an alkylating agent that covalently binds to DNA. It modifies the cell cycle by interfering with DNA structure and function, leading to inhibition of cancer cell division and growth.
Dosage
Adults (previously untreated, normal renal function): 400 mg/m² IV infusion (15-60 min), not more frequently than every 4 weeks.
Previously treated patients (single agent): 360 mg/m² IV.
With cyclophosphamide (previously untreated): 300 mg/m² IV.
Renal impairment (CrCl):
CrCl >40 mL/min: 400 mg/m²
CrCl 20-39 mL/min: 250 mg/m²
Risk factors (prior myelosuppressive treatment, low performance status): Initial dose reduced by 20-25% (300-320 mg/m²).
Elderly (≥65 years): Dose adjustment may be necessary based on physical condition.
Children (Solid tumor): 300-600 mg/m² IV every 4 weeks.
Children (Sarcoma): 400 mg/m²/day for 2 days every 21 days.
Children (Brain tumor): 175 mg/m² weekly x 4 weeks with 2 weeks recovery.
Hematologic nadir: Repeat when WBC ≥2000/mm³ and platelets ≥100,000/mm³.
Hepatic impairment: Dose adjustment may not be necessary (not studied).
Side effects
Hematologic (dose-limiting): Thrombocytopenia (platelets <50,000/mm³ - 25%), neutropenia (granulocytes <1,000/mm³ - 18%), leukopenia (WBC <2,000/mm³ - 14%), anemia (Hb <11 g/dL - 71%). Nadir: Days 14-21; recovery within 35-42 days.
Nephrotoxicity: Elevated serum creatinine (6%), BUN (14%), uric acid (5%); electrolyte decreases (Na 29%, K 20%, Ca 22%, Mg 29%).
Gastrointestinal: Vomiting (65%, 1/3 severe), nausea (15%), abdominal pain (17%), diarrhea (6%), constipation (6%), anorexia.
Allergic (<2%): Erythematous rash, fever, pruritus, urticaria; rarely bronchospasm, hypotension.
Hepatic: Elevated total bilirubin (5%), SGOT (15%), alkaline phosphatase (24%) - generally mild and reversible.
Neurotoxicity: Peripheral neuropathy (4%), paresthesias, decreased deep tendon reflexes (more in cisplatin-pretreated patients).
Other: Fatigue, stomatitis, peripheral neuropathy (tingling and numbness of hands and feet).
Infectious (4%) and hemorrhagic (5%) complications reported.
Use in pregnancy
Unsafe during pregnancy (Category D). Definite evidence of risk to the developing baby. May be used in life-threatening situations if benefits outweigh risks. Use effective contraception during treatment.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Carboplatin should be administered under the supervision of a qualified physician experienced in cancer chemotherapy.
- Monitor peripheral blood counts, renal and hepatic function tests regularly.
- Weekly CBC recommended to assess hematologic nadir for subsequent dose adjustment.
- Perform neurologic evaluations regularly.
- Discontinue if abnormal bone marrow depression, renal or hepatic function occurs.
- Carboplatin myelosuppression is related to renal clearance; carefully assess renal function.
- Carboplatin courses should not be repeated more frequently than monthly.
- Avoid combination with aminoglycosides or other nephrotoxic compounds.
- Allergic reactions (within 5 minutes of administration) should be managed with supportive therapy.
- Do not use during pregnancy and lactation (Category D).
Overdose effects
Overdose may cause severe myelosuppression, nephrotoxicity, ototoxicity, and gastrointestinal toxicity. Supportive care and blood transfusions may be required.
Storage conditions
Store below 25°C in a dry place. Do not refrigerate. Keep out of reach of children.