carboplatin (CDBCA, Paraplatin)
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Introduction
Tradename: Paraplatin.
Indications
- ovarian carcinoma
- cervical carcinoma
- endometrial cancer
- small cell lung carcinoma
- non-small cell carcinoma
- esophageal cancer
- testicular cancer
- prostate cancer
- bladder cancer
- mesothelioma
- pediatric brain tumors
- head & neck cancer
- breast cancer
- diffuse large B-cell lymphoma
- acute myeloid leukemia
- osteosarcoma
- Ewing sarcoma
Dosage
- 300-450 mg/m2 every 4 weeks
- in renal failure (4-8 mg/mL/min x (GFR* + 25))
* glomerular filtration rate in mg/mL/min
Lyophilized powder for injection: 50 mg, 150 mg, 450 mg.
Pharmacokinetics
- most of the drug is not metabolized
- 1/2 life 1-3 hours
elimination via kidney
1/2life = 1-3 hours
Adverse effects
- common (> 10%)
- asthenia
- pain at site of injection
- abnormal liver function tests
- myelosuppression
- neutropenia
- leukopenia
- thrombocytopenia (platelet count reaches nadir 14-21 days)
- anemia
- electrolyte abnormalities
- less common (1-10%)
- uncommon (< 1%)
- blurred vision, nephrotoxicity, neurotoxicity in patients previously treated with cisplatin
- other
- delayed nausea/vomiting may occur after 2-5 days
- report loss of hearing, numbness or paresthesias
* carboplatin associated with favorable toxicity profile vs cisplatin[4]
Drug interactions
- vancomycin & gentamicin should not be used within 3 days of carboplatin because of increased risk of nephrotoxicity & ototoxicity
Test interactions
increases serum K+
Mechanism of action
- platinum complexes bind to & crosslink of DNA, which triggers apoptosis
More general terms
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 529
- ↑ 4.0 4.1 Azar I, Yazdanpanah Y, Jang H et al Comparison of Carboplatin With Cisplatin in Small Cell Lung Cancer in US Veterans. JAMA Netw Open. 2022;5(10):e2237699. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36264573 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797497