In the U.S.— Paraplatin

In Canada— Paraplatin  Paraplatin-AQ

Carboplatin ( KAR-boe-pla-tin) belongs to the group of medicines known as alkylating agents. It is used to treat cancer of the ovaries. It may also be used to treat other kinds of cancer, as determined by your doctor.

Carboplatin interferes with the growth of cancer cells, which eventually are destroyed. Since the growth of normal body cells may also be affected by carboplatin, other effects also will occur. Some of these may be serious and must be reported to your doctor. Other effects may not be serious but may cause concern. Some effects may not occur until months or years after the medicine is used.

Before you begin treatment with carboplatin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Carboplatin is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral -Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carboplatin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to carboplatin, cisplatin, or any other platinum-containing substance.

Pregnancy—There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Carboplatin causes toxic or harmful effects and birth defects in rats. In addition, many cancer medicines may cause sterility that could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed these possible effects with your doctor before receiving this medicine. Before receiving carboplatin, make sure your doctor knows if you are pregnant or if you may become pregnant. It is best to use some kind of birth control while you are receiving carboplatin. Tell your doctor right away if you think you have become pregnant while receiving carboplatin.

Breast-feeding—Because carboplatin may cause serious side effects, breast-feeding generally is not recommended while you are receiving this medicine.

Children—Studies on this medicine have been done only in adult patients and there is no specific information comparing use of carboplatin in children with use in other age groups.

Older adults—Some side effects of carboplatin (especially blood problems or numbness or tingling in fingers or toes) may be more likely to occur in the elderly.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When receiving carboplatin it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir)
• If you have ever been treated with radiation or cancer medicines—Carboplatin may increase the effects of these medicines or radiation therapy on the blood

Other medical problems—The presence of other medical problems may affect the use of carboplatin. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Hearing problems—May be worsened by carboplatin

• Infection—Carboplatin decreases your body's ability to fight infection

• Kidney disease—Effects may be increased because of slower removal from the body

This medicine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

This medicine usually causes nausea and vomiting that sometimes may be severe. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects, especially if they are severe.

Dosing—

The dose of carboplatin will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are receiving carboplatin at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of carboplatin, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with carboplatin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Carboplatin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Carboplatin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your health care professional before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Pain at place of injection 

  Less common

  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness, accompanied by fever or chills;  fever or chills;  lower back or side pain, accompanied by fever or chills;  numbness or tingling in fingers or toes;  painful or difficult urination, accompanied by fever or chills;  pinpoint red spots on skin;  skin rash or itching ;  unusual bleeding or bruising;  unusual tiredness or weakness 

• Rare
  • Blurred vision;  ringing in ears;  sores in mouth and on lips;  wheezing  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Nausea and vomiting;  unusual tiredness or weakness 

• Less common
  • Constipation or diarrhea;  loss of appetite  

This medicine may cause a temporary loss of hair in some people. After treatment with carboplatin has ended, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, carboplatin is used in certain patients with the following medical conditions:

• Cancer of the bladder
• Cancer of the breast
• Cancer of the esophagus, including the junction between the esophagus and stomach
• Cancer of the fallopian tube or lining of the abdomen (spreading from the ovary)
• Cancers of the head and neck
• Cancer of the testicles (including seminoma)
• Cancers of the lymph system
• Cancer of the lung
• Cancer of the endometrium (the lining of the uterus)
• Cancer of unknown origin (primary site)
• Malignant melanoma (a certain type of skin cancer)
• Retinoblastoma (a certain type of eye cancer)
• Tumors in the brain

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

Developed: 09/02/1999        Revised: 04/23/2004