CLARIBOP 450 mg/45 ml

Indications

• Advanced ovarian cancer
• Testicular cancer
• Small cell lung cancer
• Cervical cancer
• Bladder cancer
• Head and neck cancers

Dosage

Children: Paediatric dosing for carboplatin is determined on a case-by-case basis and should be referenced in the BNF for Children. Individualized treatment plans are essential, especially in the context of dosing adjustments for renal function.

Adults: The specific dosage of carboplatin varies based on the treatment regimen and the specific type of malignancy being treated. Consult product literature for recommended dosing schedules and adjustments.

Mechanism of action

Carboplatin exerts its cytotoxic effects by forming DNA cross-links, which impede DNA replication and transcription. This action leads to the induction of apoptosis in rapidly dividing tumor cells. The drug is activated in cells to produce reactive species that bind to DNA, predominantly at the N7 position of guanine bases, causing the formation of interstrand cross-links.

Pharmacodynamics

The pharmacodynamic profile of carboplatin involves dose-dependent cytotoxicity, with its effectiveness being influenced by the rate of DNA cross-linking and the cancer cell's ability to repair this damage. The drug's antitumor activity is typically enhanced in combination with other chemotherapeutic agents. The therapeutic window is narrow, necessitating careful dosing to balance efficacy and toxicity.

Pharmacokinetics

Carboplatin is administered intravenously and has a distribution volume of approximately 10-20 L/m2. It exhibits a biphasic elimination profile, with a rapid distribution phase followed by a slower elimination phase. The drug is primarily excreted unchanged in the urine, with renal function being a significant determinant of clearance. The half-life ranges from 1 to 6 hours depending on the dosage and patient-specific factors. Dose adjustments are necessary in patients with renal impairment.

Contra-indications

• Hypersensitivity to carboplatin or any of its components
• Severe myelosuppression
• Pregnancy

Adverse effects

• Nausea
• Vomiting
• Alopecia
• Anemia
• Leukopenia
• Thrombocytopenia
• Hypersensitivity reactions
• Renal toxicity
• Neurotoxicity

Interactions

• Other nephrotoxic agents (increased risk of renal impairment)
• Live vaccines (risk of infection due to immunosuppression)
• Anticoagulants (increased risk of bleeding)

Precautions

• Monitor renal function prior to and during treatment
• Hydration is essential to prevent nephrotoxicity
• Caution in patients with existing hematological disorders
• Monitor for signs of infection due to potential leukopenia

Pregnancy

Avoid use during pregnancy as carboplatin is teratogenic and carcinogenic in animal studies. Specialist advice should always be sought for pregnant women requiring chemotherapy.

Breast-feeding

Discontinue breastfeeding during treatment due to potential exposure of the infant to the drug.

Storage

Store in a refrigerator (2°C to 8°C). Protect from light. Do not use after the expiry date printed on the label.

Formulations

• Carboplatin 10 mg per 1 ml solution for infusion
• Carboplatin 50 mg/5 ml concentrate for solution for infusion
• Carboplatin 150 mg/15 ml concentrate for solution for infusion
• Carboplatin 450 mg/45 ml concentrate for solution for infusion