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Carboplatin is a chemotherapy drug used to treat certain types of cancer. However, Carboplatin also brings unwanted side effects that affect other body functions such as kidney, liver, hearing, heart.
1. What is Carboplatin?
Carboplatin (also known as Paraplatin) is a chemical used in the treatment of some cancers such as: brain cancer, lung cancer, ovarian cancer, head and neck cancer, testicular cancer, bladder cancer, advanced and recurrent retinoblastoma in children
Drugs used to treat various types of cancer. This is a chemotherapy drug that contains the platinum ingredient Platinum. Used in combination with other drugs to prevent the spread and growth of cancer cells.
2. Dosage and Administration of Carboplatin
2.1. Administration of Carboplatin Carboplatin is used for intravenous or peritoneal infusion. Mixing method:
Need a solution of 10 mg/m2, it is necessary to add 45ml of distilled water, 0.9% sodium chloride solution or 5% glucose into the bottles of 50mg, 150mg, 450mg to get a solution of 10 mg/ml. Need a solution of 0.5 mg/m2 just dilute with 5% glucose solution or 0.9% sodium chloride solution. Before use, the drug should be checked for turbidity or color change, if there is a change, the drug should not be used.
Note: supporting tools such as needles, catheters, infusion devices must not contain aluminum or the medicine will be damaged. In the process of drug preparation and manipulation, care should be taken to avoid getting the drug on the skin of the hands or splashing into the eyes, because Carboplatin can cause blindness and damage the skin of the hands.
2.2. Dosage of Carboplatin The dose of carboplatin prescribed will depend on tolerability, toxicity, clinical response, and adverse drug reactions. Initial doses will be based on body surface area, and renal function. The indicated dose ranges from 300 to 450 mg/m^2. Specifically, it will be calculated based on the following formula:
Total dose (mg) = target AUC (mg/ml/min) x Cl carboplatin (ml/min).
In which:
The common target AUC is 5-7 mg/ml/min. This figure will depend on prior treatment and concomitant medications.
The glomerular filtration rate is calculated by the formula:
For men:
Cl carboplatin (ml/min) = (0.134 x p) + 218 x P (1 – 0.00457 x T) : Cr
Where: P is the weight (kg), T is the age of the patient (years), Cr is the serum concentration (liters)
For women: Cl carboplatin (ml/min) = (0.134 x P) + 0.686 (218 x P) x (1 – 0.00457 x T): Cr
For people with ovarian cancer:
Advanced ovarian cancer (in stages III and IV): The starting dose for adults is 300 mg/m2. The following doses will be calculated based on the decrease in platelet count of the previous dose and kidney function The following dose will be administered after 4 weeks if the hematologic toxicity is slow to recover For recurrent ovarian cancer, the dose Initial dose is 360 mg/m2. Dosage for treatment of other cancers is similar to that used for patients with ovarian cancer For patients with renal failure: Dosage depends on creatinine clearance: Degree of Creatinine clearance is 41-59 ml/min, initial dose will be 250 mg/m2. Clearance is 16-40. ml/min, the starting dose is 200 mg/m2.
3. Overdose and treatment
When used in excess, the patient will have symptoms such as marrow failure, liver, kidney function, hearing and digestion are reduced.
Currently there is no specific antidote, so when we know we have overdosed, first we need to stop using the drug and treat the symptoms. Specifically, if the patient reacts and has symptoms such as: facial edema, bronchospasm, tachycardia, low blood pressure, it should be treated by intravenous injection with antihistamines or epinephrine, corticosteroids.
To fight bone marrow failure, patients need to receive blood transfusions or transfusions of platelets, red blood cells or use drugs that stimulate white blood cell flow.
4. Possible interactions of the drug Carboplatin
When carboplatin is used in combination with other drugs, careful monitoring is required, because carboplatin alone or in combination has the potential to cause myelosuppression and increase blood toxicity. Dosage and duration of use need to be adjusted to minimize the toxicity that the drug causes. For patients who have taken anti-cancer drugs before, the toxicity in the blood will also be more severe.
When used with cyclophosphamide will cause interactions affecting gastrointestinal function, hearing and vision
Carboplatin is nephrotoxic but only mildly, but when combined with carboplatin and aminoglycosides, increased nephrotoxicity and ototoxicity. Therefore, care must be taken when taking these two drugs together.
When used in combination with drugs that affect hearing such as aminoglycosides, furosemide, ifosfamide will increase toxicity on hearing, if used in too high concentrations, it may lead to hearing loss.
5. Carboplatin side effects
Carboplatin often causes quite serious complications, typically bone marrow failure, one of the most common complications in patients who have used previous anti-cancer drugs or radiation therapy. In addition to bone marrow failure, there are other complications related to digestion, eyes, ears and kidneys. The side effects will usually depend on the dose of the drug and the medication used and the location of the person using the drug. specifically like:
5.1. Common side effects Gastrointestinal: Vomiting, nausea, constipation, abdominal pain, peptic ulcer. Neurological: Loss of taste, convulsions, cramps, muscle weakness, peripheral neurotoxicity, body pain and weakness. Blood: Bone marrow failure: leukopenia, thrombocytopenia, anemia. Kidneys: Increased creatinine in the blood At: Hearing loss, tinnitus Cardiovascular: Causes cerebrovascular disease, heart failure, embolism Allergy: Causes itching, urticaria, skin rash Hair loss: Often occurs with use combined with cyclophosphamide. Pain and swelling at the injection site, if injected outside the vessel, can cause necrosis.
6. Cases needing caution when using Carboplatin
For the elderly (over 65 years old), when using carboplatin, it is more likely to cause neurotoxicity, causing peripheral neuropathy, marrow failure, kidney failure than younger people.
For children, side effects are similar to adults, so special care should be taken.
For pregnant women: According to research, Carboplatin has the potential to cause fetal harm. Therefore, doctors recommend not to use Carboplatin for pregnant women. However, if the pregnant woman has a serious problem and needs to take medicine to treat it, the doctor will still prescribe it for use.
During the use of Carboplatin, the patient needs to have contraception.
Lactation: There are currently no studies to prove whether the drug can be passed into breast milk, but because the drug has the potential to be toxic to the baby, the doctor will recommend that when the mother takes the drug, she must stop. Breastfeeding.
With the above sharing, it is hoped that the drug treatment process in patients will be effective and safe. In particular, minimizing the risk of adverse health effects.
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