Carboplatin may enhance the toxicity of other myelosuppressive agents. Caution is advised when administered with nephrotoxic or ototoxic drugs.

Carboplatin is administered by an infusion lasting 15 minutes or longer. No pre- or post-treatment hydration or forced diuresis is required.

Patients with Impaired Kidney Function: Patients with creatinine clearance values below 60 ml/min are at increased risk of severe bone marrow suppression. In renally-impaired patients who received single-agent carboplatin therapy, the incidence of severe leukopenia, neutropenia, or thrombocytopenia has been about 25% when the dosage modifications listed below have been used.

Creatinine Clearance 41–59 ml/min → 250 mg/m²

Creatinine Clearance 16–40 ml/min → 200 mg/m²

The data available for patients with severely impaired kidney function (creatinine clearance below 15 ml/min) are too limited to permit a recommendation for treatment. These dosing recommendations apply to the initial course of treatment. Subsequent dosages should be adjusted according to the patient’s tolerance based on the degree of bone marrow suppression.

Formula Dosing (Calvert Formula): Total Dose (mg) = Target AUC × (GFR + 25) With the Calvert formula, the total dose of carboplatin is calculated in mg, not mg/m².

Target AUC of 4–6 mg/ml•min using single-agent carboplatin provides the most appropriate dose range in previously treated patients.

This method allows compensation for variations in pretreatment renal function that might otherwise result in underdosing or overdosing.

Geriatric Dosing: Because renal function is often decreased in elderly patients, formula dosing of carboplatin based on estimates of GFR should be used to provide predictable plasma carboplatin AUCs and minimize the risk of toxicity.

Preparation of Intravenous Solutions: Carboplatin Injection is a premixed aqueous solution of 10 mg/ml carboplatin. It can be further diluted to concentrations as low as 0.5 mg/ml with 5% Dextrose in Water (D5W) or 0.9% Sodium Chloride Injection, USP. When prepared as directed, carboplatin aqueous solutions are stable for 8 hours at room temperature (25°C). Since no antibacterial preservative is contained in the formulation, it is recommended that carboplatin aqueous solutions be discarded 8 hours after dilution.

Carboplatin is contraindicated in patients with severe bone marrow suppression, severe bleeding, or hypersensitivity to carboplatin or other platinum-containing compounds.

The most common adverse effects are bone marrow suppression (thrombocytopenia, leukopenia, neutropenia), nausea, vomiting, anemia, and electrolyte disturbances.

Observed Toxicity Rates in Previously Treated Patients:
AUC 4–5 → Thrombocytopenia 16%, Leukopenia 13%
AUC 6–7 → Thrombocytopenia 33%, Leukopenia 34%

Carboplatin can cause fetal harm when administered to a pregnant woman. It is not known whether carboplatin is excreted in human milk. Breastfeeding should be discontinued during treatment.

Monitor blood counts and renal function regularly.

Use formula dosing in patients with impaired renal function and elderly patients.

Monitor for signs of myelosuppression and infection.

There is no known antidote for carboplatin overdose. Expected complications include bone marrow suppression and renal and hepatic impairment. Supportive care should be provided.

Store at a temperature not exceeding 25°C in a dry place. Protect from light. Do not freeze.

Medicine: Keep out of reach of children.