Platinum-based alkylating agent (specialist) Pregnancy: Carboplatin can cause foetal harm when administered to a pregnant woman and has been shown to be embryotoxic and teratogenic in rats receiving the drug during organogenesis; no controlled studies in pregnant women have been conducted and safe use in pregnancy has not been established. It should not be used in pregnant women or in women of childbearing potential who might become pregnant unless the potential benefits to the mother outweigh the possible risks to the foetus. Women of childbearing potential should avoid becoming pregnant and use effective contraception during treatment and for at least 7 months after the last dose; men with female partners of childbearing potential should use effective contraception during treatment and for at least 4 months after the last dose. Breast-feeding must be stopped during carboplatin therapy and for 1 month following the last dose. Male and female fertility may be impacted, and both men and women should seek advice on fertility preservation before treatment.

Carboplatin

Brand names: Paraplatin

Carboplatin is an intravenous platinum-based cytotoxic used widely in oncology, including ovarian, lung and other solid tumours.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 400 mg/m² in previously untreated adults with normal renal function, given as a single short-term intravenous infusion over 15 to 60 minutes. Alternatively the Calvert formula may be used: Dose (mg) = target AUC (mg/ml x min) x [GFR ml/min + 25]

Route: Intravenous infusion — carboplatin injection should be used by the intravenous route only

Frequency: Therapy should not be repeated until 4 weeks after the previous carboplatin course and/or until the neutrophil count is at least 2,000 cells/mm³ and the platelet count is at least 100,000 cells/mm³

Fetched UK SPC is Carboplatin 10 mg/ml Intravenous Infusion (eMC product 3787). Calvert formula target AUC table (§4.2): 5–7 mg/ml.min for single-agent carboplatin in previously untreated patients; 4–6 mg/ml.min for single-agent carboplatin in previously treated patients; 4–6 mg/ml.min for carboplatin plus cyclophosphamide in previously untreated patients. Note that with the Calvert formula the total dose of carboplatin is calculated in mg, not mg/m². Initial dosage should be reduced by 20–25% in patients with risk factors such as previous myelosuppressive therapy and/or poor performance status (ECOG-Zubrod 2–4 or Karnofsky below 80). Determination of the haematologic nadir by weekly blood counts during initial courses is recommended for future dosage adjustment and scheduling. All of the stated dosing recommendations apply to the initial course of treatment; subsequent dosages should be adjusted according to the patient's tolerance and to the acceptable level of myelosuppression. Combination therapy: optimal use of carboplatin with other myelosuppressive agents requires dosage adjustments according to the regimen and schedule adopted. Elderly: in patients of more than 65 years of age, adjustment of the carboplatin dose to the general condition is necessary during the first and the subsequent therapeutic courses. Paediatric population: there is insufficient information to support a dosage recommendation in the paediatric population — verify any under-18 use against a children's formulary. Preparation and administration: needles or intravenous sets containing aluminium parts that may come into contact with carboplatin injection should not be used, because aluminium reacts with carboplatin causing precipitate formation and/or loss of potency; the safety measures for dangerous substances must be complied with, and preparation must be carried out by personnel trained in safe use while wearing protective gloves, face mask and protective clothes. The fetched §4.4 text was truncated at the source-fetch limit before §4.5, so the UK interaction section was not retrieved; the interactions listed below are drawn from §4.3 and §4.4 only.

Dose adjustments

Renal

In patients with impaired renal function the dosage of carboplatin should be reduced (refer to the Calvert formula) and haematological nadirs and renal function monitored; patients with creatinine clearance values below 60 ml/min are at increased risk of severe myelosuppression. Initial dose (Day 1) by baseline creatinine clearance: 41–59 ml/min — 250 mg/m² IV; 16–40 ml/min — 200 mg/m² IV. Insufficient data exist on the use of carboplatin injection in patients with creatinine clearance of 15 ml/min or less to permit a recommendation for treatment. Renal function parameters should be assessed prior to, during and after carboplatin therapy.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
Patients with severe myelosuppression
Patients with pre-existing severe renal impairment (creatinine clearance < 30 ml per minute) unless, in the judgment of the physician and patient, the possible benefits of treatment outweigh the risks
Patients with bleeding tumours
Concomitant use with yellow fever vaccine
Patients with a history of severe allergic reaction to carboplatin or other platinum-containing compounds

Side effects

Thrombocytopenia, neutropenia, leukopenia and anaemia — very common
Vomiting, nausea and abdominal pain — very common
Peripheral neuropathy, paraesthesia, decrease of osteotendinous reflexes, sensory disturbance and dysgeusia — common
Ototoxicity — common
Hypersensitivity and anaphylactoid-type reaction — common (cross-reactions, sometimes fatal, reported with all platinum compounds; hypersensitivity has progressed to Kounis syndrome)
Visual disturbance including rare cases of loss of vision — common
Creatinine renal clearance decreased, blood urea increased, alkaline phosphatase / AST increased, abnormal liver function tests and decreased sodium, potassium, calcium and magnesium — very common laboratory findings

Interactions

Yellow fever vaccine — concomitant use is contraindicated (§4.3, cross-referring to §4.5, which was not retrieved)
Nephrotoxic drugs — in patients receiving concomitant nephrotoxic therapy, myelosuppression, especially thrombocytopenia, may be more severe and prolonged (§4.4)
Other myelosuppressive drugs — combination therapy may require modification of dosage/timing of schedules in order to minimise additive effects (§4.4)
Aluminium (administration-set compatibility, not a pharmacological interaction) — aluminium reacts with carboplatin injection causing precipitate formation and/or loss of potency; do not use needles or IV sets containing aluminium parts (§4.2)

Clinical monograph

How it works

It forms platinum-DNA cross-links that disrupt DNA replication and transcription, triggering apoptosis; dosing is individualised using renal function via the Calvert formula.

Prescribing in practice

Myelosuppression — particularly thrombocytopenia — is dose-limiting, so dosing is calculated from renal function and blood counts and adjusted accordingly.
Hypersensitivity reactions become more likely with repeated cycles and require vigilance.
It is markedly less nephrotoxic and neurotoxic than cisplatin but still warrants renal monitoring and antiemetic cover.

Monitoring

Monitor the full blood count (especially platelets), renal function and electrolytes before each cycle.

Counselling the patient

Report bruising, bleeding, fever or signs of infection promptly.
Report any rash, flushing or breathlessness during or after the infusion, as allergy can develop with later cycles.

Evidence & guidelines

Use is long established within standard chemotherapy regimens supported by clinical trials and oncology guidelines.

Reference: multiple NICE TAs; ESMO; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways