The drug "Carboplatin": instructions for use, analogues and reviews

What can replace such a medicine as "Carboplatin"? Analogs of this drug will be listed below. Also in the materials of this article will be provided information on the correct use of the said means, its indications, side effects and contraindications.

Composition, description, form of medicament

In what form is the drug "Carboplatin" produced? The manufacturer claims that the product can be purchased as a white lyophilized powder for the preparation of an intravenous solution. Its active component is carboplatin, and additional - mannitol.

The injection concentrate "Carboplatin", the composition of which we presented above, is sold in vials, which are placed in cardboard packages.

Pharmacological properties

What is the drug "Carboplatin"? Instructions for use, reviews report that this is a complex compound of inorganic origin, containing a heavy metal such as platinum.

Experts suggest that the mechanism of action of this tool is due to its ability to bind to DNA. As a result, intra-helical cross-links are formed, which alter the structure of DNA and suppress its synthesis. This effect is manifested independently of the phase of the cell cycle. It should be noted that the hydration of carboplatin, during which the active form of the drug is formed, is much slower than cisplatin hydration.

Kinetic parameters of the drug

How does the distribution of the drug "Carboplatin" occur in the human body? The instruction for use states that after a single injection of this agent in the form of infusion (intravenous) for 60 minutes, the concentration in the blood of free (i.e., amenable ultrafiltration) and total platinum decreases in accordance with the 2-phase model of first-order pharmacokinetics.

The initial half-life of free platinum is approximately 2 hours, and the terminal T1 / 2 is 3-6 hours. It should also be noted that for general platinum, a similar initial half-life is typical, but it has a more prolonged half-life (about a day).

With the repeated administration of this drug for 4 consecutive days, the accumulation of platinum in the blood is not observed. One day after the application of this drug, about 85% of its active component in the plasma is in the protein-related state.

How does the drug "Carboplatin" go? The instruction states that the given drug is excreted mainly by the kidneys (approximately 30% of the administered dose goes unchanged).

In people with SC, 60 ml / min and above about 65% and 70% of the dosage used is excreted for 11 and 23 hours, respectively.

In view of the fact that the excretion of "Carboplatin" is almost completely by glomerular filtration, only a small concentration is observed in the renal tubules, which explains the low nephrotoxic potential of the drug compared to cisplatin.

Antitumor drug "Carboplatin": indications

In what cases is the use of the drug in question indicated? According to the instructions, this remedy is intended for the treatment of the following tumors:

• Ovarian cancer;
• Cervical cancer;
• Germinogenous tumors in men and women;
• Osteogenic sarcoma;
• Lung cancer;
• Medulloblastoma;
• Tumors of the neck and head.

Prohibitions for the use of an infusion solution

What are the contraindications for the drug "Carboplatin"? The use of this drug is prohibited when:

• Breast-feeding;
• Serious pathologies of the kidneys (for example, with QC less than 15 ml / min);
• Pregnancy;
• Hypersensitivity to carboplatin and other drugs, including platinum;
• Severe myelosuppression;
• Significant blood loss, including those observed in the recent past;
• In childhood.

Also with caution this medication is prescribed for:

• Recent vaccination;
• Hearing impairment;
• Disturbances in kidney function;
• Suppressed bone marrow hematopoiesis, including in conditions after radiotherapy and chemotherapy;
• Parallel use of nephrotoxic drugs (for example, "Cisplatinum");
• Acute infections of viral, fungal and bacterial origin.

Medication "Carboplatin": instructions for use

How should I use this antitumor drug? According to experts, this medication can be used both in monotherapy and in combination with other agents of a similar effect (for example, in combination with the drug "Paclitaxel").

Depending on the size and where the patient is localized tumor, doctors use different dosages of "Carboplatin." It should be administered intravenously in the form of infusion for 17-55 minutes.

How should I use the drug "Carboplatin"? The instruction indicates the following dosages of this remedy:

• 100 mg / m 2 of the body area of the patient, every day for 5 days;
• 300-400 mg / m 2 of the patient's body area, once every 4 weeks.

It should be specially noted that the interval between the administration of this drug, with a platelet ratio of 100 thousand / mm2 and neutrophils from 1,500 / mm2, should be at least 4 weeks.

After and before the application of "Carboplatin" additional fluid management, as well as conducting forced diuresis is not required.

If the patient has hematologic toxicity of severe or moderate severity, it may be necessary to reduce the dosage of the drug by 26%.

With kidney pathologies, the risk of developing toxic effects of the drug is significantly increased, and therefore its dose is reduced based on the level of QC.

In elderly people, as well as with previously conducted myelosuppressive therapy, it is necessary to reduce the dosage by 22-25%.

Before using the infusion solution, it should be monitored visually to determine if there are any abnormalities in its color or foreign inclusions.

What can be mixed with the medicinal powder "Carboplatin"? Instructions for use asserts that this medication should be diluted in solutions of 5% glucose or 9% sodium chloride. The observed concentration should be 0.5-1 mg / ml.

The drug solution must be prepared right before use, since the maximum shelf life of the mixed preparation is one day.

Side effects

What are the negative reactions caused by the drug "Carboplatin"? Reviews about this tool claim that it can provoke the development of the following undesirable effects:

• Gastrointestinal organs: within 11-12 hours after using the drug, the patient may experience a feeling of nausea, as well as vomiting. The risk of emetic reactions is reduced by preliminary administration of antiemetics, as well as fractional administration of the drug for 5 days or its continuous intravenous infusion throughout the day. Also, in some patients, adverse reactions were observed, such as diarrhea, abdominal pain, inflammation of the oral mucosa and constipation.
• The system of hematopoiesis: the use of elevated doses of "carboplatinum" can suppress the function of bone marrow hematopoiesis. Also, a large number of patients manifest symptoms of anemia, the intensity of which depends on the dosage of the drug used. Often there were also clinical complications, such as infectious diseases, fever, bleeding and septic shock.
• Peripheral HC and CNS: there is a high probability of peripheral neuropathy development, as well as a decrease in deep tendon reflexes, especially in people older than 65 years. In addition, there may be signs of disruption of the CNS. Long-term treatment with medication can cause cumulative neurotoxicity.
• Organs of vision: in the process of using the means under consideration, there is a high probability of temporary deterioration or complete loss of vision, as well as a loss of the ability to see light and distinguish colors. The recovery of vision and its improvement usually occurs within a few weeks after the drug is withdrawn. People with impaired renal function who were treated with high doses of the drug had cortical blindness.
• Hearing organs: with the introduction of "Carboplatinum", some patients experience ototoxicity, which manifests itself in the form of deterioration of hearing and noise in the ears.
• Allergy: fever, erythematous rash, itching, anaphylactic reactions, urticaria, arterial hypotension and bronchospasm. The listed effects may appear several minutes after the administration of the drug. In rare cases, exfoliative dermatitis may also occur in patients .
• Renal system: with the introduction of "Carboplatinum" in some patients, a temporary and easy increase in the concentrations of the drug and urea in the blood is observed. In this acute lesions of the kidneys were very rare. The risk of developing nephrotoxicity against the background of the use of this drug increases with an increase in its dose, as well as in people previously treated with cisplatin.
• Electrolyte balance: hypocalcemia, hypokalemia, hypomagnesemia and hyponatremia.
• Liver: There may be a temporary increase in the concentrations of bilirubin, ACT and alkaline phosphatase in the blood. In people who have been treated with high doses of the drug with autologous bone marrow transplantation, there have been abnormalities in the functioning of the liver.
• Other reactions: hemolytic-uremic syndrome, asthenia, alopecia, heart failure, influenza-like symptoms, myalgia / arthralgia, allergic reactions, cerebrovascular disorders.

Special Information

What should patients know before using the drug "Carboplatin"? Instructions, reviews argue that the infusion of this drug can be carried out only under the constant supervision of medical personnel who specialize in cytotoxic treatment. It is necessary to monitor possible toxic effects, especially when using high doses of the drug.

In the process of therapy with this drug and for the next three months, patients need to use reliable contraceptives.

For the preparation, as well as the subsequent administration of the drug solution, it is necessary to use medical supplies that do not contain aluminum. This is due to the fact that when it interacts with the drug, a precipitate forms and a decrease in the effectiveness of the drug is noted.

During the treatment with "Carboplatinum" periodic neurological examinations are required, including those of the elderly and people who have previously received cisplatin.

The use of this drug can lead to the development of ototoxic effects, and therefore, before the start of therapy should be audiometric tests.

When observing clinically significant disorders on the part of the hearing organs, it may be necessary to adjust the dose of "Carboplatin" or to completely abolish it.

If the product gets on the skin or eyes, immediately flush with a large volume of water. If swallowed, seek medical assistance.

Similar medicines

What analogs can replace the drug "Carboplatin"? The instructions for use do not contain any information on this matter. Behind it you have to turn to an experienced doctor. As a rule, experts recommend using the following analogues of "Carboplatin": "Cytoplatin", "Texalkus", "Displanor", "Oxiplate", "Oxaliplatin", "Platinol", "Cisplatinum", "Eloxatin", "Platikad", "Plaksat "," Oxitane "," Oxtera "," Exorum ".

Reviews about the antitumor drug

Now you know why a drug such as Carboplatin (Carboplatin Teva) is needed. Instructions for the use of this drug have also been described above.

The patient's assessment of the toxicity and effectiveness of the drug "Carboplatin" is quite contradictory. Some patients speak about excellent results of therapy of various oncological diseases, while others very often mention the toxic effect of the drug on different organs and systems of man, as well as other negative phenomena. Experts argue that this is due to the individual patient's tolerability of the active substance of the drug and its general condition. In any case, cancer requires mandatory chemotherapy. If the medicine "Carboplatin" is not suitable for the patient for one reason or another, then it is replaced by analogues. This replacement of the antitumor drug helps in 90% of cases.