Carboplatin

Adults: Needles or intravenous sets with aluminium parts that may touch Carboplatin injection must not be used to prepare or give the drug. Aluminium reacts with Carboplatin, which can form a precipitate and/or reduce its potency. Proper procedures for handling and disposing of anti-cancer drugs should be followed. Several guidelines on this topic have been published, but there is no general agreement that every procedure they recommend is necessary or appropriate. After dilution, Carboplatin should be given by the intravenous route only. For previously untreated adult patients with normal kidney function, the recommended dose of Carboplatin is 400 mg/m2 as a single I.V. dose, infused over 15 to 60 minutes. Treatment should not be repeated until four weeks after the previous Carboplatin course and/or until the neutrophil count is at least 2000 cells/mm3 and the platelet count is at least 100,000 cells/mm3. A 20-25% reduction of the initial dose (i.e. 300-320 mg/m2) is recommended for patients with risk factors such as prior myelosuppressive treatment or low performance status (ECOG-Zubrod 2-4 or Karnofsky below 80). For patients aged 65 and over, dose adjustment, either at the start or later, may be needed depending on the patient's physical condition. Determination of the hematologic nadir through weekly blood counts during the initial courses of Carboplatin treatment is recommended to guide dose adjustment in later courses.