NAME OF DRUG
carboplatin

CLASSIFICATION

Cytotoxic agent - non-vesicant

ALTERNATE NAME

PARAPLATIN, PARAPLATIN-AQ

 INDICATIONS

• treatment of advanced ovarian carcinoma of epithelial origin
• relapsed acute myelogenous leukemia (AML)

• "second generation" platinum compound structurally related to cisplatin
• binds to DNA and causes interstrand and intrastrand DNA crosslinks which results in disruption and unwinding of the DNA double helix
• approximately 70% of the total platinum dose is renally excreted in the first 24 hours
• plasma concentrations increase proportionally with the dose

RECONSTITUTION AND STABILITY

• ALL cytotoxic agents are prepared in pharmacy and will be sent to the ward with a label indicating storage conditions and the expiry date. All cytotoxic waste including bags, sets, tubing, gloves, etc. must be properly disposed of in the cytotoxic waste containers on the nursing unit.

COMPATIBILITY

• dilution with solutions containing CHLORIDE is NOT RECOMMENDED because of possible conversion to cisplatin
• compatible in D5W ONLY
• DO NOT USE ANY ALUMINUM-CONTAINING APPARATUS FOR PREPARING OR ADMINISTERING AS A BLACK PRECIPITATE WILL FORM.

ROUTES OF ADMINISTRATION

• IV intermittent - in 100-250mL of compatible IV solution over 15-60 minutes
• IV infusion

VH & HSC ADMINISTRATION POLICY

A Parenteral Chemotherapy/Immunotherapy pre-printed order form (PPO # 45) must be used for prescribing if this cytotoxic agent
is not already on an existing PPO.

A - Not to be administered by the direct IV route.
G - Cytotoxic Agents - See Drug Table G for specific administration guidelines.
H - The IV infusion rate MUST be controlled by an automated infusion control device.

DOSAGE

Dose and schedule depend on protocol and patient response.

Advanced Ovarian Carcinoma:

• doses range up to 400mg/m² as a single dose, repeated every four weeks as required

Acute Myelogenous Leukemia (AML):

• continuous infusion of 200 mg/m² to 350 mg/m² daily x 4 days

A reduced dosage is recommended in impaired renal function, elderly and patients who have received previous chemotherapy

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• hypersensitivity reaction - wheezing, tachycardia, hypotension
• extravasation (see Appendix VII for extravasation protocol of non-vesicants)

IMPORTANT IMPLICATIONS

• dose-limiting toxicity of carboplatin is myelosuppression, predominantly thrombocytopenia; leukopenia and anemia also occur with relatively high frequency; factors possibly causing increased risk of myelosuppression include increased age, renal impairment and concurrent or previous chemotherapy.
• dose-related nausea or vomiting occurs commonly, usually starting 6-12 hours after administration and seldom lasting longer than 24 hours (usually manageable with standard antiemetics)

VGH Site only:
Notify security -84 immediately upon accidental spillage.
DO NOT ATTEMPT CLEAN-UP

• See also Appendix VI

Rev. May 2006