Parenteral Manual

CARBOplatin

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
PARAPLATIN®, CBDCA, JM
Classification: 
Antineoplastic, alkylator - CYTOTOXIC
Original Date: 
June 2015
Indications: 
  • Ovarian carcinoma
  • Under investigation for use in other malignancies (e.g., relapsed or high risk solid tumors in children)

THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.

Reconstitution and Stability: 
  • 10 mg/mL solution, no reconstitution required
  • Stable in vial for 7 days at room temperature
  • DO NOT expose to bright light for extended periods of time
  • Use only IV sets and needles which do not contain aluminum
  • Stable for 21 days when diluted to 0.5-4 mg/mL in D5W at room temperature or in the fridge
  • Stable for 28 days when diluted to 0.1 mg/mL in D5W at room temperature or in the fridge
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: ondansetron, filgrastim, potassium, TPN

- Incompatible: DO NOT MIX with any other drug

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Push

NO

IV Intermittant Infusion YES
Usual dilution: dilute in 50-100 mL
Infusion time: 30-60 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • 400-600 mg/m2 IV Q 3-4 weeks
  • Lower dosage when used to potentiate radiotherapy
  • Use mg/kg dosing for children <3 years of age or <12 kg
  • Dosing based on target AUC- use modified Calvert formula (refer to protocol for details)

** dosage may differ according to protocol

Dose adjustment in renal failure:

  • Dosage should be reduced in renal failure (use Calvert formula)
  • If GFR is <60 mL/minute/1.73 m2 consider discontinuing drug
Potential hazards of parenteral administration: 

Immediate (within a few minutes to hours):

  • Nausea and vomiting (moderate) - starting approximately 6 hours after treatment and lasting 12-24 hours
  • Allergic reaction: rare
  • Metallic taste
  • If extravasation occurs, click HERE for treatment guidelines.

Delayed (within a few weeks to months):

  • Myelosuppression, particularly thrombocytopenia - nadir 21 days (dose limiting toxicity)
  • nephrotoxicity - not usually dose limiting, transient increases in serum creatinine may occur; some patients have decreases in creatinine clearance
  • Hypomagnesemia, hypokalemia in some patients
  • Infrequent:  neurotoxicity, ototoxicity, alopecia, skin rash
  • Increase in liver function test
  • Non-vesicant

- Treatment for unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy

Notes: 
  • Monitor renal function, hematologic status, serum electrolytes
  • Audiogram as per protocol for monitoring high frequency hearing loss
  • An analogue of cisplatin
  • Less nephrotoxic, ototoxic, neurotoxic than cisplatin
  • High volume hydration is not necessary to prevent nephrotoxicity (as with cisplatin), however, patients should be adequately hydrated
  • Myelosuppression may be enhanced in patients with preexisting renal impairment or myelosuppression - reduce dose or withhold treatment in these patients
  • Contraindicated in patients with history of severe allergic reaction to platinum containing compounds
  • Modified Calvert formula uses uncorrected GFR in mL/min, and the result is the total dose, not the dosage in mg/m2

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