ANTINEOPLASTIC DRUGS›PLATINUM
COMPOUNDSCarboplatin 10-Jun-2016
lINDICATIONS AND DOSE
Stage 4 neuroblastoma|Germ cell tumours|Low-grade
gliomas (including astrocytomas)|Neuroectodermal
tumours (including medulloblastoma)|
Rhabdomyosarcoma (metastatic and non-metastatic
disease)|Soft-tissue sarcomas|Retinoblastoma|High
risk Wilms’tumour|Some liver tumours
▶BY INTRAVENOUS INFUSION
▶Child:(consult local protocol)lUNLICENSED USENot licensed for use in children.
lINTERACTIONS→Appendix 1 : platinum compounds
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.alopecia.
anaemia.asthenia.cardiovascular disorder.constipation.
diarrhoea.haemorrhage.hypersensitivity.increased risk
of infection.leucopenia.mucosal abnormalities.
musculoskeletal disorder.nausea.neutropenia.
ototoxicity.peripheral neuropathy.reflexes decreased.
respiratory disorders.sensation abnormal.skin reactions.
taste altered.thrombocytopenia.urogenital disorder.
vision disorders.vomiting
▶Rare or very rareCardiac discomfort.dyspnoea
▶Frequency not knownAbdominal cramps.appetite
decreased.bone marrow failure.chills.dehydration.
embolism.encephalopathy.fever.haemolytic uraemic
syndrome.heart failure.hypertension.hyponatraemia.
hypotension.malaise.pancreatitis.stomatitis.stroke.
treatment related secondary malignancy
lCONCEPTION AND CONTRACEPTIONContraceptive advice
required, seePregnancy and reproductive functionin
Cytotoxic drugs p. 531.
lPREGNANCYAvoid (teratogenic and embryotoxic inanimal
studies). See alsoPregnancy and reproductive functionin
Cytotoxic drugs p. 531.
lBREAST FEEDINGDiscontinue breast-feeding.
lRENAL IMPAIRMENTAvoid if creatinine clearance less than
20 mL/minute/ 1. 73 m^2.
Dose adjustmentsReduce dose.
MonitoringMonitor haematological parameters in renal
impairment. Monitor renal function in renal impairment.
lMONITORING REQUIREMENTS
▶Consider therapeutic drug monitoring.
lPRESCRIBING AND DISPENSING INFORMATIONCarboplatin
can be given in an outpatient setting.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for infusion
▶Carboplatin (Non-proprietary)
Carboplatin 10 mg per 1 mlCarboplatin 50 mg/ 5 ml concentrate for
solution for infusion vials| 1 vialP£ 22. 04 (Hospital only)|
1 vialP£ 20. 00 – £ 20. 20
Carboplatin 150 mg/ 15 ml concentrate for solution for infusion vials|
1 vialP£ 56. 92 (Hospital only)| 1 vialP£ 50. 00 – £ 60. 59
Carboplatin 600 mg/ 60 ml concentrate for solution for infusion vials|
1 vialP£ 232. 64 – £ 260. 00
Carboplatin 600 mg/ 60 ml solution for infusion vials| 1 vialP
£ 260. 00 (Hospital only)
Carboplatin 450 mg/ 45 ml concentrate for solution for infusion vials|
1 vialP£ 168. 85 (Hospital only)| 1 vialP£ 160. 00 – £ 181. 77
Carboplatin 450 mg/ 45 ml solution for infusion vials| 1 vialP
£ 197. 48 (Hospital only)
Carboplatin 150 mg/ 15 ml solution for infusion vials| 1 vialP
£ 65. 83 (Hospital only)
Carboplatin 50 mg/ 5 ml solution for infusion vials| 1 vialP£ 22. 86
(Hospital only)Cisplatin
lINDICATIONS AND DOSE
Osteogenic sarcoma|Stage 4 neuroblastoma|Some liver
tumours|Infant brain tumours|Intra-cranial germ-cell
tumours
▶BY INTRAVENOUS INFUSION
▶Child:(consult local protocol)lUNLICENSED USENot licensed for use in children.
lCAUTIONS
CAUTIONS, FURTHER INFORMATION
▶HydrationCisplatin requires intensive intravenous
hydration; routine use of intravenousfluids containing
potassium or magnesium may also be required to help
control hypokalaemia and hypomagnesaemia. Treatment
may be complicated by severe nausea and vomiting;
delayed vomiting may occur and is difficult to control.
lINTERACTIONS→Appendix 1 : platinum compounds
lSIDE-EFFECTS
▶Common or very commonAnaemia.arrhythmias.bone
marrow failure.electrolyte imbalance.fever.leucopenia.
nephrotoxicity (dose-related and potentially cumulative).
sepsis.thrombocytopenia
▶UncommonAnaphylactoid reaction.ototoxicity (dose-
related and potentially cumulative).spermatogenesis
abnormal
▶Rare or very rareAcute leukaemia.cardiac arrest.
encephalopathy.myocardial infarction.nerve disorders.
seizure.stomatitis
▶Frequency not knownAlopecia.appetite decreased.
asthenia.autonomic dysfunction.cardiac disorder.
cerebrovascular insufficiency.dehydration.diarrhoea.
haemolytic anaemia.hearing impairment.hiccups.
hyperuricaemia.infection.Lhermitte’s sign.malaise.
muscle spasms.myelopathy.nausea.papilloedema.
pulmonary embolism.rash.Raynaud’s phenomenon.
renal impairment.renal tubular disorder.retinal
discolouration.SIADH.taste loss.tetany.thrombotic
microangiopathy.vision disorders.vomiting
lCONCEPTION AND CONTRACEPTIONManufacturer advises
effective contraception during and for at least 6 months
after treatment in men or women.
lPREGNANCYAvoid (teratogenic and toxic inanimal
studies. See alsoPregnancy and reproductive functionin
Cytotoxic drugs p. 531.
lBREAST FEEDINGDiscontinue breast-feeding.
lRENAL IMPAIRMENTAvoid if possible—nephrotoxic.
MonitoringBaseline testing of renal function is required;
for children with pre-existing renal impairment,
consideration should be given to withholding treatment or
using another drug.
lMONITORING REQUIREMENTS
▶Monitor full blood count.
▶Monitor audiology.
▶Monitor plasma electrolytes.
▶Baseline testing of hearing is required; for children with
pre-existing hearing impairment, consideration should be
given to withholding treatment or using another drug.
▶For children with pre-existing marked bone-marrow
suppression, consideration should be given to withholding
treatment or using another drug.
▶Monitor renal function.548 Cytotoxic responsive malignancy BNFC 2018 – 2019
Immune system and malignant disease8