CARBOPLAT (CARBOPLATIN) 450MG INJECTION

Carboplat contains carboplatin, a platinum-based chemotherapy medicine that fights cancer by interfering with the DNA inside cancer cells, preventing them from multiplying. It is administered exclusively by intravenous infusion in hospital oncology centres under specialist supervision.

Carboplatin was developed as a less toxic alternative to cisplatin, offering similar anti-tumour activity with significantly reduced kidney damage and nerve toxicity, though it causes more bone marrow suppression than cisplatin.

Approved Uses

•     Advanced ovarian carcinoma — first-line treatment in combination with paclitaxel or cyclophosphamide

•     Recurrent ovarian cancer — palliative treatment after prior chemotherapy

•     Also widely used (off-label) in: non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), breast cancer, bladder cancer, endometrial cancer, cervical cancer, testicular cancer, head and neck cancer, brain tumours, and paediatric solid tumours

Dosing is ALWAYS individualised by the oncologist using the Calvert formula, which takes into account the patient's kidney function (GFR) and the target drug exposure (AUC), where Total dose (mg) = Target AUC × (GFR + 25). There is no universal standard dose.

Typical Doses

•     Single agent (recurrent ovarian cancer): Approximately 360 mg/m² IV on Day 1 of each 4-week cycle

•     Combination therapy (first-line ovarian cancer with paclitaxel): Approximately 300 mg/m² IV on Day 1, every 4 weeks for 6 cycles

•     Alternative AUC-based dosing: AUC 5–7 for combination therapy; AUC 4–6 for single-agent use

Administration Rules

•     Infused IV over at least 15–60 minutes (longer if tolerated, to reduce infusion reactions)

•     CRITICAL: Do NOT use needles or IV sets containing aluminium — aluminium reacts with carboplatin, causing loss of potency

•     A new cycle must NOT begin until: neutrophil count ≥2,000/mm³ AND platelets ≥100,000/mm³

•     Dose reductions are required for renal impairment — recalculate using GFR

Common (may affect more than 1 in 10 patients)

•     Myelosuppression: Low platelets (thrombocytopenia), low neutrophils (neutropenia), anaemia — the most significant side effect

•     Nausea and vomiting — antiemetic pre-treatment is standard

•     Fatigue and weakness

•     Peripheral neuropathy (numbness/tingling in hands and feet) — less common than cisplatin

•     Hair loss (alopecia)

•     Elevated liver enzymes

Serious — Tell Your Oncology Team Immediately

•     Severe bone marrow suppression: life-threatening infection or bleeding — requires regular blood count monitoring

•     Anaphylaxis / severe allergic reactions: can occur within minutes of starting the infusion — epinephrine and corticosteroids must be available

•     Acute kidney injury: less nephrotoxic than cisplatin but kidney function monitoring is still required

•     Hearing changes (ototoxicity): less common than with cisplatin but monitor for changes in hearing

•     Secondary leukaemia: very rare long-term risk with platinum agents

•     Known hypersensitivity to carboplatin, cisplatin, or other platinum compounds

•     Severe myelosuppression (very low blood cell counts) at baseline

•     Severe renal impairment

•     Pregnancy — can cause serious harm to the developing fetus

•     Breastfeeding

Pregnancy

CONTRAINDICATED. Carboplatin is known to cause fetal harm. Effective contraception is required during treatment and for at least 6 months after the last dose (females) or 3 months (males).

Breastfeeding

CONTRAINDICATED. Do not breastfeed during treatment or for at least 2 weeks after the final dose.

Blood Count Monitoring

Complete blood counts must be performed before every cycle. Dose delays or reductions are necessary if counts are too low.

•     Nephrotoxic drugs (aminoglycosides, amphotericin B): Additive kidney toxicity — avoid or monitor very closely

•     Ototoxic drugs (aminoglycosides, loop diuretics): Additive hearing damage

•     Live vaccines: CONTRAINDICATED during chemotherapy — risk of serious or fatal vaccine-related infection

•     Warfarin and anticoagulants: May alter INR — monitor closely

•     Phenytoin: Carboplatin may reduce phenytoin blood levels — increased risk of seizures; monitor

•     Store at room temperature (15–30°C), protected from light. Do not refrigerate or freeze.

•     Once opened: stable for up to 14 days at 25°C

•     Prepared infusion solutions: discard within 8 hours of preparation

•     NEVER use aluminium-containing IV equipment — causes degradation

POM — Prescription Only Medicine. Specialist oncologist or haematologist prescription required. Administration in a certified oncology unit only.

•     Attend all blood count checks before each cycle — your dose depends on your results

•     Use effective contraception during treatment and for 6 months after your last dose

•     Avoid live vaccines during treatment

•     Tell all other healthcare providers that you are receiving carboplatin chemotherapy

•     Calvert formula: Dose (mg) = Target AUC × (GFR + 25) — GFR should be measured (eGFR or 24-hr urine CrCl), not estimated

•     Maximum GFR cap: Many centres cap GFR at 125 mL/min in the Calvert formula to avoid overdosing

•     Nadir: Thrombocytopenia and neutropenia nadir occur at days 14–21 post-infusion — plan monitoring accordingly

•     Hypersensitivity reactions: More common after 6+ cycles or in platinum-sensitive patients — have an anaphylaxis kit at bedside

•     Aluminium incompatibility: Strictly enforce — aluminium needles/tubing cause carboplatin degradation and potentially enhance toxicity

•     No glass containers required: carboplatin is stable in PVC bags/tubing (unlike cisplatin)

Q: Why does my dose look different from another patient's with the same cancer?

A: Carboplatin is dosed based on your individual kidney function and body measurements using a precise mathematical formula (the Calvert formula). Every patient receives a personalised dose — this is deliberate, not an error.

Q: What should I watch for between my chemotherapy cycles?

A: Contact your oncology team immediately if you develop: fever above 38°C (sign of dangerous infection), unusual bleeding or bruising, black or tarry stools, persistent vomiting, significantly reduced urine output, or any other concerning symptoms.

Q: Is carboplatin the same as cisplatin?

A: Both are platinum-based chemotherapy drugs, but they are not the same. Carboplatin generally causes less nausea, less kidney damage, and less nerve damage than cisplatin, but tends to cause more bone marrow suppression (lower blood counts).