Carboplatin is excreted mainly by the kidneys, and about 30% of the administered dose is excreted unchanged. In patients with a creatinine clearance of 60 ml / min or more, about 65% and 70% of the administered dose was excreted respectively for 12 and 24 hours after administration. Since carboplatin appears almost entirely by glomerular filtration rate, only a very small concentration of carboplatin is present in the renal tubules, which may explain the small nephrotoxic potential of the drug as compared to halotestin buy cisplatin.
Dosage and administration
Carboplatin can be used both as a monotherapy and in combination with other anticancer drugs. The drug is administered intravenously in a dose following modes:
– 300 – 400 mg / m 2 by intravenous infusion over 15-60 minutes or as a 24 hour infusion;
– 100 mg / m 2 by intravenous infusion over 15-60 minutes every day for 5 days
carboplatin Introduction repeated at intervals of at least 4 weeks at rates of at least 100,000 platelet cells / mm and the blood neutrophil count is not less than 1,500 cells / mm of blood.
liquid prior to or after Introduction of carboplatin and forced diuresis is required.
From hemopoiesis system: The main toxic factor limiting the dose of carboplatin is the suppression of the function of bone marrow hematopoiesis. Myelosuppression is dose-dependent. The maximum low platelet count and leukocyte / granulocyte typically achieved after two – three weeks after the start of dosing, and the more common thrombocytopenia. Adequate recovery to a level that allows for your next dose of carboplatin, usually takes at least four weeks. At a sufficiently large number of patients may also show symptoms of anemia (hemoglobin less than 11 g / dL), the intensity of which depends on the total dose. There may be a need for transfusion therapy, particularly in patients undergoing long-term treatment (for example, more than six cycles of dosing). There is also the possibility of clinical complications such as fever, infections, sepsis / septic shock and haemorrhage.
From the gastrointestinal tract: for 6 – 12 hours after administration of the drug is likely occurrence of nausea and / or vomiting (.till from mild to moderate), continuing up to 24 hours or longer. The risk of emetic effects can be reduced by pre-treatment antiemetics, continuous I / carboplatin infusion for 24 hours halotestin buy or fractional dose for 5 consecutive days. It is also observed in some cases and other adverse effects on the gastrointestinal tract, such as inflammation of the oral mucosa, diarrhea, constipation and abdominal pain.
From the central and peripheral nervous system: There is the risk of peripheral neuropathy in osnovnom- in the form of paresthesia and reduction of deep tendon reflexes, which is more likely in patients older than 65 years with long-term or prior treatment with cisplatin. Perhaps the emergence of CNS dysfunction symptoms. Long-term therapy the drug can result in cumulative neurotoxicity.
From the hearing: ototoxicity manifested as tinnitus and hearing loss.
From the side of view: There is a possibility of temporary degradation or complete loss of vision (possible loss of the ability to distinguish color and visible light), and other disorders of the visual function.Improvement and / or total recovery of vision usually occurs within a few weeks after the drug is discontinued. In patients with impaired renal function who were treated with high doses of carboplatin, cortical blindness was observed.
Kidneys: There may be a slight and transient increase in serum creatinine and urea concentrations. Acute kidney injury were observed infrequently. The risk of nephrotoxicity in patients receiving carboplatin (decreased creatinine clearance) increases with increasing dose of carboplatin, as well as in patients who have previously been treated with cisplatin.
Liver: It can be observed easily and, generally, a temporary increase in ACT concentrations of bilirubin and alkaline phosphatase in serum. Patients being treated with high doses of carboplatin with autologous bone marrow transplantation, there were significant liver function abnormalities.
From the electrolyte balance: Possible hypokalemia, hypocalcemia, hyponatremia and / or hypomagnesemia.
Allergic reactions: erythematous rash, fever, pruritus, urticaria, bronchospasm, hypotension and anaphylactic reactions. These reactions may occur within a few minutes after the administration of carboplatin.In rare cases, halotestin buy it may also be observed exfoliative dermatitis.
Other side effects include
alopecia, asthenia, flu-like symptoms, hemolytic uremic syndrome, myalgia / arthralgia, heart failure, cerebrovascular disorders and allergic reactions directly to the site of administration.