20 to 50     : Dose as in normal renal function. See ‘Other Information’
10 to 20     : Dose as in normal renal function. See ‘Other Information’
<10           : Dose as in normal renal function. See ‘Other Information’
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
HD                     :Dialysed. Dose as in GFR
<10           : mL/min
HDF/high flux   :Dialysed. Dose as in GFR
<10           : mL/min
CAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Aminoglycosides: increased risk of nephrotoxicity and possibly ototoxicity with aminoglycosides, capreomycin, polymyxins or vancomycin
Antipsychotics: avoid concomitant use with clozapine, increased risk of agranulocytosis
ADMINISTRATION
Reconstition
–
Route
IV
Rate of Administration
IV infusion
over 15–60 minutes
Comments
Therapy should not be repeated until 4 weeks after the previous carboplatin course
May be diluted with glucose 5%, or sodium chloride 0.9% to concentrations as low as 0.5 mg/mL
OTHER INFORMATION
Patients with abnormal kidney function or receiving concomitant therapy with nephrotoxic drugs are likely to experience more severe and prolonged myelotoxicity
Blood counts and renal function should be monitored closely
Some units still use a dose in normal renal function of 400 mg/m2. In this instance, the dose should be reduced to 50% of normal for a GFR of 10 to 20 mL/min, and to 25% of normal for a GFR <10 mL/min
There is little, if any, true metabolism of carboplatin. Excretion is primarily by glomerular filtration in the urine, with most of the drug excreted in the first 6 hours. Approximately 32% of the dose is excreted unchanged.
Platinum from carboplatin slowly becomes protein bound, and is subsequently excreted with a terminal half-life of 5 days or more.