Platinum-Based Chemotherapy Pregnancy: Pregnancy Category D (US labelling). Shown to be embryotoxic and teratogenic in rats receiving the drug during organogenesis, and mutagenic in vitro and in vivo. Breast-feeding should be discontinued if the mother is treated with carboplatin.

Carboplatin

Brand names: Paraplatin

Carboplatin is a platinum-based cytotoxic chemotherapy agent used to treat a range of cancers, including urological malignancies such as urothelial carcinoma.

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: Formula (Calvert) dosing: Total Dose (mg) = (target AUC) x (GFR + 25), where GFR is in mL/min and target AUC in mg/mL.min; target AUC 4-6 mg/mL.min for single-agent carboplatin. Alternatively BSA-based: single agent 360 mg/m2 IV on day 1 every 4 weeks (recurrent ovarian carcinoma); combination with cyclophosphamide 300 mg/m2 IV on day 1 every 4 weeks for 6 cycles

Route: intravenous

Frequency: day 1 every 4 weeks

With the Calvert formula the total dose of carboplatin is calculated in mg, not mg/m2. The target AUC of 4-6 mg/mL.min using single-agent carboplatin appears to provide the most appropriate dose range in previously treated patients. Usually administered by an infusion lasting 15 minutes or longer; no pre- or post-treatment hydration or forced diuresis is required. Single intermittent courses should not be repeated until the neutrophil count is at least 2,000 and the platelet count at least 100,000. Dose adjustments from prior course based on nadir counts: platelets >100,000 and neutrophils >2,000 = 125%; platelets 50-100,000 or neutrophils 500-2,000 = no adjustment; platelets <50,000 or neutrophils <500 = 75%. Needles or IV sets containing aluminium parts must not be used (aluminium reacts with carboplatin causing precipitate and loss of potency). Geriatric: formula (GFR-based) dosing should be used because renal function is often decreased in elderly patients. NOTE: US labelling - verify vs UK SPC.

Dose adjustments

Renal

Patients with creatinine clearance below 60 mL/min are at increased risk of severe bone marrow suppression. Recommended dose on day 1: creatinine clearance 41-59 mL/min = 250 mg/m2; 16-40 mL/min = 200 mg/m2. Data for creatinine clearance below 15 mL/min are too limited to permit a treatment recommendation. These recommendations apply to the initial course; subsequent doses adjusted per tolerance/bone marrow suppression.

Dose auto-extracted from 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

History of severe allergic reactions to cisplatin or other platinum-containing compounds
Severe bone marrow depression
Significant bleeding

Side effects

Thrombocytopenia (bone marrow / haematologic)
Neutropenia
Leukopenia
Anaemia / bone marrow suppression
Nephrotoxicity risk (renal effects potentiated with nephrotoxic compounds); increased risk of severe bone marrow suppression in renal impairment

Interactions

The renal effects of nephrotoxic compounds may be potentiated by carboplatin
Needles or intravenous administration sets containing aluminium parts must not be used (aluminium reacts with carboplatin causing precipitate formation and loss of potency)

Clinical monograph

How it works

It forms platinum-DNA adducts and cross-links that disrupt DNA replication and transcription, triggering tumour cell death.

Prescribing in practice

Dose-limiting, cumulative myelosuppression (especially thrombocytopenia) is the principal toxicity and dosing is individualised to renal function rather than a fixed amount.
Hypersensitivity reactions can occur, particularly with repeated cycles, and require monitoring during infusion.
Administer only under specialist oncology supervision with full blood count and renal function review before each cycle.

Monitoring

Monitor full blood count and renal function before each cycle and watch for hypersensitivity reactions during administration.

Counselling the patient

Seek urgent advice for fever, unusual bruising or bleeding, or signs of infection.
Report any rash, flushing or breathlessness during or after infusion.

Evidence & guidelines

Carboplatin is an established platinum chemotherapy supported by extensive trial evidence and used within NICE-recognised regimens.

Reference: EAU Bladder Cancer Guidelines 2024; Calvert et al. (1989) formula; NICE NG2; 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

Drugs

Cisplatin · Platinum-Based Chemotherapy

Pathways