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Carboplatin

Carboplatin is one of the most important chemotherapy medicines commonly used by oncologists in the fight against cancer. Recognising the importance of this platinum-based drug, the World Health Organisation included it in their List of Essential Medicines in 2023. Doctors developed it as a milder alternative to cisplatin.

Patients with advanced ovarian cancer that has spread receive carboplatin as their primary treatment. The drug proves effective against lung, bladder, breast, and endometrial cancers. Doctors also prescribe it to treat head and neck cancer, cervical and testicular cancers, and specific brain tumours.

Carboplatin's major advantage lies in its safety profile. Standard doses rarely cause nerve damage compared to other platinum treatments. This makes carboplatin the preferred choice for many oncologists' chemotherapy plans. The drug's elimination process remains gradual with a half-life of approximately 5 days. This article explains carboplatin's nature, its cancer-fighting mechanisms, dosing guidelines, side effects, and precautions. 

What is Carboplatin?

Carboplatin is a chemotherapy drug from the platinum-containing alkylating agents family. This medication binds to DNA and damages it. The process stops cancer cells from multiplying and leads to their death.

Carboplatin Uses

Doctors most often prescribe carboplatin to treat advanced ovarian cancer that hasn't responded to other treatments. Doctors also use it to treat several other types of cancers, such as

How and When to Use Carboplatin 

Medical staff give carboplatin through an intravenous infusion that lasts 15-60 minutes. Patients receive treatment once every four weeks. The dosage depends on body size, kidney function, and cancer type.

Carboplatin Side Effects 

Patients might experience these common reactions:

  • Low blood cell counts that increase infection risk, anaemia and bleeding
  • Nausea and vomiting that start 6-12 hours after treatment
  • Changes in kidney function that need fluid intake monitoring
  • Nerve problems that affect patients over 65 or those with previous cisplatin treatment

Serious side effects:

Precautions

Let your doctor know about any kidney problems, hearing issues, or previous platinum therapy before starting treatment. Patients should avoid immunisations during treatment. The drug can harm developing babies, so pregnant women must not use carboplatin. Doctors avoid giving carboplatin to people with blood disorders or who have active bleeding.

How Carboplatin Works

Carboplatin binds to DNA strands inside cancer cells and creates cross-links that stop them from dividing normally. This drug blocks the production of RNA, DNA, and proteins - key elements that cells need to divide. So cancer cells can't multiply and eventually die off.

This drug differs from cisplatin because it has a bidentate dicarboxylate structure rather than chloride ligands. Its unique design makes it more stable and binds to DNA more slowly, which gives it a longer retention half-life of about 30 hours.

Can I Take Carboplatin with Other Medicines?

Carboplatin can interact with many medications. You should be careful with:

  • Aminoglycoside antibiotic
  • Amphotericin B
  • Blood thinners like warfarin
  • Diuretics
  • Immunosuppressive medicines
  • Live vaccines
  • NSAIDs
  • Other chemotherapy drugs
  • Phenytoin

You must tell your doctor about all medications and supplements you take. Even grapefruit juice could increase the side effects.

Carboplatin Dosage Information

Your doctor will give you carboplatin through an IV that takes 15-60 minutes every four weeks. They use the Calvert formula to calculate your exact dose based on your kidney function: Total Dose (mg) = (target AUC) × (GFR + 25). An AUC of 4-6 mg/mL/min usually provides the right dose. You will need a lower dose if your creatinine clearance is low.

Conclusion

Carboplatin is essential in fighting many types of cancer, especially when treating advanced ovarian cancer. This platinum-based medication has significant advantages over other drugs. Doctors prefer this gentler option because it has a lower risk of nerve damage at standard doses when creating treatment plans.

Carboplatin works more slowly than cisplatin but ended up creating similar reaction products. Patients get this medication through intravenous infusion every four weeks. Doctors calculate dosages carefully based on the patient's kidney function, body size, and cancer type. 

Carboplatin is a valuable tool in modern cancer treatment. The medication strikes a balance between effectiveness and manageable side effects compared to other options. This balance helps countless patients face their cancer journey with a better quality of life while getting powerful treatment for their disease.

FAQs

1. Is carboplatin a high-risk medicine?

Yes, doctors call it a highly toxic drug with a narrow therapeutic index. The drug suppresses bone marrow, which can lead to infection or bleeding. Patients may experience severe allergic reactions within minutes after receiving the drug. More serious side effects include potential vision loss, particularly in patients who have kidney problems.

2. How long does carboplatin take to work?

The treatment follows a cycle pattern. Patients receive doses every 3 to 4 weeks. Blood counts reach their lowest point around day 21 after administration. Therefore, doctors track blood counts throughout the treatment period to measure its effectiveness.

3. What happens if I miss a dose?

Missing your carboplatin injection appointment requires immediate contact with your doctor to get instructions. Your doctor will adjust your treatment schedule appropriately.

4. What happens if I overdose?

Carboplatin overdose has no known antidote. Patients may experience severe bone marrow suppression and liver toxicity. The treatment focuses on supportive care, and doctors may use hemodialysis if they can perform it within three hours of administration.

5. What not to take with carboplatin?

Carboplatin can interact with many different medications. You should not take:

  • Yellow fever vaccine and live vaccines
  • Aminoglycoside antibiotics like gentamicin
  • Loop diuretics such as furosemide
  • NSAIDs, including aspirin, ibuprofen and naproxen
  • Phenytoin and fosphenytoin

6. Who cannot take carboplatin?

The medication isn't suitable if you have:

  • A history of severe allergic reactions to platinum compounds
  • Severe bone marrow depression
  • Heavy bleeding
  • Severe kidney problems
  • Pregnancy or breastfeeding

7. When should I take carboplatin?

Doctors give carboplatin through an IV that runs for at least 15 minutes. Your specific cancer type and overall health determine the treatment schedule.

8. How many days to take carboplatin?

The standard treatment happens once every 3-4 weeks. Your cancer type, response to treatment and doctor's assessment determine the total duration.

9. When to stop carboplatin?

Your doctor will stop the treatment based on:

  • Your response to the therapy
  • Blood count recovery
  • Side effect severity
  • Overall treatment goals

10. Is it safe to take carboplatin daily?

Daily use of carboplatin is not safe. Your healthcare team must determine proper intervals between doses. Taking it daily could lead to dangerous bone marrow suppression.

11. What is the best time to take carboplatin?

You will receive carboplatin during scheduled visits to medical facilities. The time between doses matters more than the specific time of day.

12. What to avoid when taking carboplatin?

During your treatment, stay away from:

  • People who are sick
  • Grapefruit juice
  • Regular razors (electric razors are safe)
  • Contact sports
  • Live vaccines
  • Getting pregnant