Details About Generic Salt ::  Carbopla

Main Medicine Class::    

(car-boe-PLATT-in)

Paraplatin

Lyophilized powder for injection

50 mg, 150 mg, or 450 mg vial

Class: Alkylating agent

 Indications

Adult

Ovarian carcinoma. Secondary treatment for palliative treatment of patients with ovarian carcinoma recurrent after prior chemotherapy,

Small cell and nonsmall cell lung, head, and neck squamous cell, and testicular cancer; Wilm tumor.

 Contraindications History of severe allergic reactions to cisplatin or other platinum compounds or mannitol; severe bone marrow depression; significant bleeding.

 Route/Dosage

Ovarian Carcinoma (Single Agent Therapy)

ADULTS: IV 360 mg/m² on day 1 q 4 wk if neutrophil count is at least 2000/mm³ and the platelet count is at least 100,000/mm³.

Ovarian Carcinoma (Combination Therapy with Cyclophosphamide)

ADULTS: IV Carboplatin 300 mg/m² plus cyclophosphamide 600 mg/m², both on day 1 q 4 wk for 6 cycles. Do not repeat intermittent courses of the combination until the neutrophil count is at least 2000/mm³ and the platelet count is at least 100,000/mm³.

Calvert Formula Dosing

ADULTS: IV Carboplatin may be dosed to achieve a target area under the curve (AUC) based on the patient’s glomerular filtration rate (GFR) using the calvert formula. The desired target AUC depends on the disease and the patient’s treatment status. The Calvert formula calculates the carboplatin dose in mg as follows: Total dose (mg) = target AUC (mg/mL/min) × (GFR [mL/min] + 25).

Dosage Adjustments Based on Lowest Post-treatment Blood Counts

ADULTS: IV If platelets above 100,000/mm³ and neutrophils above 2000/mm³, then give 125% of adjusted dose from prior course. If platelets are 50,000 to 100,000/mm³ and neutrophils are 500 to 2000/mm³, then no dosage adjustment is necessary. If platelets below 50,000/mm³ and neutrophils below 500/mm³, then give 75% of adjusted dose from prior course. Doses above 125% of the starting dose are not recommended.

Renal Function Impairment (Dosage Adjustment)

ADULTS: IV Baseline Ccr is 41 to 59 mL/min, the recommended dose on day 1 is 250 mg/m²; 16 to 40 mL/min is 200 mg/m²; no more than 15 mL/min, data too limited to permit a recommendation for treatment.

Interactions

Aminoglycosides

Concomitant use may increase risk of nephrotoxicity or ototoxicity.

Phenytoin

Serum concentrations may be decreased, resulting in a loss of therapeutic effect.

Lab Test Interferences Abnormal LFTs; alkaline phosphatase; AST; total bilirubin.

 Adverse Reactions

CNS: Parethesias. DERMATOLOGIC: Alopecia. GI: Nausea; vomiting; GI pain; constipation; diarrhea; mucositis; taste alteration; elevated LFTs. GU: Amenorrhea. HEMATOLOGIC: Bone marrow suppression; thrombocytopenia. HYPERSENSITIVITY: Anaphylactoid reaction. METABOLIC: Hyponatremia; hypokalemia; hypocalcemia; hypomagnesemia. RENAL: Decreased renal function. SPECIALSENSES: Visual disturbances; tinnitus; subclinical hearing loss.

 Precautions

Pregnancy: Category D. Lactation: Undetermined. Because of possibility of toxicity in nursing infants, discontinue breastfeeding. Children: Safety and efficacy not established. Aluminum: May react with carboplatin, causing precipitate formation and potency loss. Do not use needles or IV administration sets containing aluminum parts that may come in contact with carboplatin for the preparation or administration of the drug. Bone marrow suppression: Leukopenia, neutropenia, and thrombocytopenia is dose dependent and is the dose-limiting toxicity, which may result in infection or bleeding. Emesis: Vomiting is a frequent drug-related side effect and usually ceases within 24 hr of treatment. The incidence and intensity of emesis have been reduced by antiemetic premedication. Hypersensitivity: Anaphylactic-like reactions may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines may alleviate symptoms. Peripheral neurotoxicity: Infrequent, but its incidence is increased in patients older than 65 yr and in patients previously treated with cisplatin. Renal function impairment: Patients with impaired kidney function (Cr below 60 mL/min) are at increased risk of severe bone marrow suppression. Renal toxicity: Limited, but cotreatment with aminoglycosides has resulted in increased renal or audiologic toxicity. Exercise caution when patient receives both drugs.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

• Administer by IV over at least 1 min. Hydration is not required. Carboplatin doses also may be infused over 30 to 60 min.
• Reconstitute with Sterile Water for Injection, 0.9% Sodium Chloride, or 5% Dextrose. For dilution of carboplatin 50 mg vial, administer a diluent volume of 5 mL for a concentration of 10 mg/mL; for a 150 mg vial, administer 15 mL of diluent for a concentration of 10 mg/mL; for a 450 mg vial, administer 45 mL of diluent for a concentration of 10 mg/mL. Carboplatin can be further diluted down to 0.5 mg/mL with 0.9% Sodium Chloride or 5% Dextrose.
• Store the unopened vials at controlled room temperature. Protect from light. Solutions are stable for 8 hr at room temperature. Discard solutions 8 hr after dilution.
• Do not use needles or IV administration sets containing aluminum parts that may come in contact with carboplatin for the preparation or administration of the drug.

 Assessment/Interventions

• Anaphylactic-like reactions may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines may alleviate symptoms.
• Frequently monitor peripheral blood counts during carboplatin treatment and, when appropriate, until recovery.
• Do not repeat single intermittent courses until leukocyte, neutrophil, and platelet counts recover.
• If used in combination with other bone marrow suppressing therapies, carefully manage with respect to dosage and timing to minimize additive effects.
• Premedicate with antiemetic agents.
• Before initiating therapy, determine baseline renal function by evaluating BUN, serum creatinine, and creatinine clearance. Monitor BUN and creatinine before each course.

OVERDOSAGE: SIGNS & SYMPTOMS   Bone marrow suppression, hepatic toxicity

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient, family, or caregiver that medication will be prepared and administered by health care provider in a health care setting.
• Advise patient, family, or caregiver that medication may be used in combination with other agents to achieve maximum benefit possible.
• Review dosing schedule with patient, family, or caregiver.
• Advise patient, family, or caregiver to immediately report any of the following to the health care provider: rash; hives; difficulty breathing; fever, chills or other signs of infection; sores in mouth; unusual bleeding or bruising.
• Advise patient, family, or caregiver to report any of the following to the health care provider: persistent nausea or vomiting; persistent or worsening general body weakness; changes in hearing or ringing in the ears; dizziness or feeling of whirling motion; abnormal skin sensations; any other unexplained sensation; pain, redness, or swelling at injection site.
• Instruct patient to not take any prescription or otc medications or dietary supplements unless advised to do so by the health care provider.
• Instruct women of childbearing potential to notify the health care provider if becoming pregnant, planning on becoming pregnant, or are breastfeeding.
• Advise patient that frequent follow-up visits and laboratory tests will be required to monitor therapy, and to be sure to keep appointments.

Medicscientist Drug Facts

Drugs Class ::

Indications for Drugs ::

 Indications

Adult

Ovarian carcinoma. Secondary treatment for palliative treatment of patients with ovarian carcinoma recurrent after prior chemotherapy,

Small cell and nonsmall cell lung, head, and neck squamous cell, and testicular cancer; Wilm tumor.

Drug Dose ::

 Route/Dosage

Ovarian Carcinoma (Single Agent Therapy)

ADULTS: IV 360 mg/m² on day 1 q 4 wk if neutrophil count is at least 2000/mm³ and the platelet count is at least 100,000/mm³.

Ovarian Carcinoma (Combination Therapy with Cyclophosphamide)

ADULTS: IV Carboplatin 300 mg/m² plus cyclophosphamide 600 mg/m², both on day 1 q 4 wk for 6 cycles. Do not repeat intermittent courses of the combination until the neutrophil count is at least 2000/mm³ and the platelet count is at least 100,000/mm³.

Calvert Formula Dosing

ADULTS: IV Carboplatin may be dosed to achieve a target area under the curve (AUC) based on the patient’s glomerular filtration rate (GFR) using the calvert formula. The desired target AUC depends on the disease and the patient’s treatment status. The Calvert formula calculates the carboplatin dose in mg as follows: Total dose (mg) = target AUC (mg/mL/min) × (GFR [mL/min] + 25).

Dosage Adjustments Based on Lowest Post-treatment Blood Counts

ADULTS: IV If platelets above 100,000/mm³ and neutrophils above 2000/mm³, then give 125% of adjusted dose from prior course. If platelets are 50,000 to 100,000/mm³ and neutrophils are 500 to 2000/mm³, then no dosage adjustment is necessary. If platelets below 50,000/mm³ and neutrophils below 500/mm³, then give 75% of adjusted dose from prior course. Doses above 125% of the starting dose are not recommended.

Renal Function Impairment (Dosage Adjustment)

ADULTS: IV Baseline Ccr is 41 to 59 mL/min, the recommended dose on day 1 is 250 mg/m²; 16 to 40 mL/min is 200 mg/m²; no more than 15 mL/min, data too limited to permit a recommendation for treatment.

Contraindication ::

 Contraindications History of severe allergic reactions to cisplatin or other platinum compounds or mannitol; severe bone marrow depression; significant bleeding.

Drug Precautions ::

 Precautions

Pregnancy: Category D. Lactation: Undetermined. Because of possibility of toxicity in nursing infants, discontinue breastfeeding. Children: Safety and efficacy not established. Aluminum: May react with carboplatin, causing precipitate formation and potency loss. Do not use needles or IV administration sets containing aluminum parts that may come in contact with carboplatin for the preparation or administration of the drug. Bone marrow suppression: Leukopenia, neutropenia, and thrombocytopenia is dose dependent and is the dose-limiting toxicity, which may result in infection or bleeding. Emesis: Vomiting is a frequent drug-related side effect and usually ceases within 24 hr of treatment. The incidence and intensity of emesis have been reduced by antiemetic premedication. Hypersensitivity: Anaphylactic-like reactions may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines may alleviate symptoms. Peripheral neurotoxicity: Infrequent, but its incidence is increased in patients older than 65 yr and in patients previously treated with cisplatin. Renal function impairment: Patients with impaired kidney function (Cr below 60 mL/min) are at increased risk of severe bone marrow suppression. Renal toxicity: Limited, but cotreatment with aminoglycosides has resulted in increased renal or audiologic toxicity. Exercise caution when patient receives both drugs.

Drug Side Effects ::

 Adverse Reactions

CNS: Parethesias. DERMATOLOGIC: Alopecia. GI: Nausea; vomiting; GI pain; constipation; diarrhea; mucositis; taste alteration; elevated LFTs. GU: Amenorrhea. HEMATOLOGIC: Bone marrow suppression; thrombocytopenia. HYPERSENSITIVITY: Anaphylactoid reaction. METABOLIC: Hyponatremia; hypokalemia; hypocalcemia; hypomagnesemia. RENAL: Decreased renal function. SPECIALSENSES: Visual disturbances; tinnitus; subclinical hearing loss.

Drug Mode of Action ::  

Drug Interactions ::

Interactions

Aminoglycosides

Concomitant use may increase risk of nephrotoxicity or ototoxicity.

Phenytoin

Serum concentrations may be decreased, resulting in a loss of therapeutic effect.

Drug Assesment ::

 Assessment/Interventions

• Anaphylactic-like reactions may occur within minutes of administration. Epinephrine, corticosteroids, and antihistamines may alleviate symptoms.
• Frequently monitor peripheral blood counts during carboplatin treatment and, when appropriate, until recovery.
• Do not repeat single intermittent courses until leukocyte, neutrophil, and platelet counts recover.
• If used in combination with other bone marrow suppressing therapies, carefully manage with respect to dosage and timing to minimize additive effects.
• Premedicate with antiemetic agents.
• Before initiating therapy, determine baseline renal function by evaluating BUN, serum creatinine, and creatinine clearance. Monitor BUN and creatinine before each course.

Drug Storage/Management ::

 Administration/Storage

• Administer by IV over at least 1 min. Hydration is not required. Carboplatin doses also may be infused over 30 to 60 min.
• Reconstitute with Sterile Water for Injection, 0.9% Sodium Chloride, or 5% Dextrose. For dilution of carboplatin 50 mg vial, administer a diluent volume of 5 mL for a concentration of 10 mg/mL; for a 150 mg vial, administer 15 mL of diluent for a concentration of 10 mg/mL; for a 450 mg vial, administer 45 mL of diluent for a concentration of 10 mg/mL. Carboplatin can be further diluted down to 0.5 mg/mL with 0.9% Sodium Chloride or 5% Dextrose.
• Store the unopened vials at controlled room temperature. Protect from light. Solutions are stable for 8 hr at room temperature. Discard solutions 8 hr after dilution.
• Do not use needles or IV administration sets containing aluminum parts that may come in contact with carboplatin for the preparation or administration of the drug.

Drug Notes ::

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Advise patient, family, or caregiver that medication will be prepared and administered by health care provider in a health care setting.
• Advise patient, family, or caregiver that medication may be used in combination with other agents to achieve maximum benefit possible.
• Review dosing schedule with patient, family, or caregiver.
• Advise patient, family, or caregiver to immediately report any of the following to the health care provider: rash; hives; difficulty breathing; fever, chills or other signs of infection; sores in mouth; unusual bleeding or bruising.
• Advise patient, family, or caregiver to report any of the following to the health care provider: persistent nausea or vomiting; persistent or worsening general body weakness; changes in hearing or ringing in the ears; dizziness or feeling of whirling motion; abnormal skin sensations; any other unexplained sensation; pain, redness, or swelling at injection site.
• Instruct patient to not take any prescription or otc medications or dietary supplements unless advised to do so by the health care provider.
• Instruct women of childbearing potential to notify the health care provider if becoming pregnant, planning on becoming pregnant, or are breastfeeding.
• Advise patient that frequent follow-up visits and laboratory tests will be required to monitor therapy, and to be sure to keep appointments.

Medicscientist Drug Facts

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.