What can replace a medication such as carboplatin? Analogs of this drug will be listed below. Also, the materials of this article will provide information on the correct use of the said funds, its indications, side effects and contraindications.
Composition, description, form of medication
In what form is the preparation “carboplatin” produced? The manufacturer claims that this tool can be purchased in the form of a white lyophilized powder, intended for the preparation of an intravenous solution. Its active component is carboplatin, and mannitol is an additional component.
“Carboplatin” injection concentrate, the composition of which we presented above, goes on sale in bottles that are placed in cardboard packages.
Pharmacological properties
What is the carboplatin medication? Instructions for use, reviews report that this is a complex compound of inorganic origin containing such a heavy metal as platinum.
Experts suggest that the mechanism of action of this drug is due to its ability to bind to DNA. As a result of this, intraviral cross-linking is formed, altering the structure of DNA and inhibiting its synthesis. A similar effect is manifested regardless of the phase of the cell cycle. It should be noted that the hydration of carboplatin, during which the active form of the drug is formed, is much slower than the hydration of cisplatin.
Kinetic indicators of the drug
How is the distribution of the carboplatin drug in the human body? The instruction for use states that after a single administration of this agent in the form of an infusion (intravenous) of 60 minutes, the concentration in the blood of free (i.e., ultrafiltered) and total platinum decreases in accordance with the 2-phase first-order pharmacokinetics model.
The initial half-life of free platinum is approximately 2 hours, and the terminal T1 / 2 is 3-6 hours. It should also be noted that common platinum is characterized by a similar initial half-life, but in terminal it is longer (about a day).
With the repeated administration of this drug for 4 consecutive days, the accumulation of platinum in the blood is not observed. A day after the use of this drug, about 85% of its active component in plasma is in a protein-bound state.
How is the withdrawal of the carboplatin medication? The instruction states that this drug is excreted mainly by the kidneys (approximately 30% of the administered dose leaves unchanged).
In people with CC 60 ml / min and above, approximately 65% and 70% of the dosage used is excreted within 11 and 23 hours, respectively.
Due to the fact that the elimination of “carboplatin” occurs almost completely by glomerular filtration, only a small concentration is observed in the renal tubules, which explains the low nephrotoxic potential of the drug compared to cisplatin.
Anticancer drug "Carboplatin": indications
In what cases is the use of the medication in question indicated? According to the instructions, this tool is intended for the treatment of the following tumors:
- ovarian cancer;
- cervical cancer;
- germ cell tumors in men and women;
- osteogenic sarcoma;
- lung cancer
- medulloblastomas;
- tumors of the neck and head.
Bans for the use of infusion solution
What contraindications does the carboplatin drug have? The use of this drug is prohibited with:
- breastfeeding;
- serious kidney pathologies (for example, with QC less than 15 ml / min);
- pregnancy
- hypersensitivity to carboplatin and other drugs, including platinum;
- severe myelosuppression;
- significant blood loss, including observed in the recent past;
- in childhood.
Also, with caution, this medication is prescribed for:
- recent vaccination;
- hearing impairment;
- impaired kidney function;
- suppressed bone marrow hematopoiesis, including in conditions after radiation therapy and chemotherapy;
- concurrent use of nephrotoxic drugs (for example, "Cisplatin");
- acute infections of viral, fungal and bacterial origin.
Medication "Carboplatin": instructions for use
How should I use the antitumor drug in question ? According to experts, this medication can be used both in monotherapy and in combination with other drugs of similar action (for example, in combination with the drug "Paclitaxel").
Depending on the size and where the tumor is localized in the patient, doctors use different dosages of carboplatin. It should be administered intravenously as an infusion over a period of 17-55 minutes.
How should I use the carboplatin medication? The instruction indicates the following dosages of this remedy:
- 100 mg / sq.m of the patient’s body area, every day for 5 days;
- 300-400 mg / sq.m of the patient’s body area, once every 4 weeks.
It should be especially noted that the interval between injections of this drug, with a proportion of platelets from 100 thousand / sq. Mm and neutrophils from 1.5 thousand / sq. Mm, should be at least 4 weeks.
After and before the use of Carboplatin, additional fluid management and forced diuresis are not required.
If the patient has severe or moderate hematologic toxicity, a dosage reduction of 26% may be required.
With kidney pathologies, the risk of developing a toxic effect of the drug significantly increases, and therefore its dose is reduced based on the level of QC.
In elderly people, as well as with previously conducted myelosuppressive therapy, it is necessary to reduce the dosage by 22-25%.
Before applying the infusion solution, it should be visually checked to determine if there are any irregularities in its color or foreign inclusions.
What can mix carboplatin medicinal powder be mixed with? Instructions for use states that this medication should be diluted in solutions of 5% glucose or 9% sodium chloride. In this case, the observed concentration should be 0.5-1 mg / ml.
A drug solution must be prepared right before its use, since the maximum shelf life of a mixed preparation is one day.
Side effects
What negative reactions does “carboplatin" cause? Reviews about this tool claim that it can provoke the development of the following undesirable effects:
- Gastrointestinal organs: within 11-12 hours after using the drug, the patient may experience a feeling of nausea, as well as vomiting. The risk of vomiting is reduced by prior administration of antiemetics, as well as fractional administration of the drug for 5 days or continuous intravenous infusion over the course of a day. Also, some patients experienced adverse reactions such as diarrhea, abdominal pain, inflammation of the oral mucosa, and constipation.
- Hematopoietic system: the use of high doses of "carboplatin" can suppress the function of bone marrow hematopoiesis. Also, a large number of patients show symptoms of anemia, the intensity of which depends on the dosage of the drug used. Often, clinical complications such as infectious diseases, fever, bleeding, and septic shock occurred.
- Peripheral NS and CNS: there is a high probability of developing peripheral neuropathies, as well as a decrease in deep tendon reflexes, especially in people over 65 years of age. In addition, signs of a malfunction of the central nervous system may occur. Long-term medication treatment may cause cumulative neurotoxicity.
- Organs of vision: in the process of using the agent in question, there is a high probability of temporary deterioration or complete loss of vision, as well as a loss of the ability to see light and distinguish colors. Vision restoration and improvement usually occurs within a few weeks after drug withdrawal. In people with impaired renal function, who were treated with high doses of the drug, cortical blindness was noted.
- Hearing organs: with the introduction of "carboplatin" in some patients there is ototoxicity, which manifests itself in the form of impaired hearing and tinnitus.
- Allergy: fever, erythematous rash, pruritus, anaphylactic reactions, urticaria, arterial hypotension and bronchospasm. The listed effects may occur several minutes after the administration of the drug. Also in rare cases, patients may experience exfoliative dermatitis.
- Renal system: with the introduction of "carboplatin" in some patients there is a temporary and slight increase in the concentration of the drug and urea in the blood. In this case, acute kidney damage was observed very rarely. The risk of nephrotoxicity associated with the use of this drug increases with an increase in its dose, as well as in people who have previously been treated with cisplatin.
- Electrolyte balance: hypocalcemia, hypokalemia, hypomagnesemia and hyponatremia.
- Liver: a temporary increase in blood concentrations of bilirubin, ACT, and alkaline phosphatase may be observed. People who were treated with high doses of the drug with autologous bone marrow transplantation showed abnormalities in the liver.
- Other reactions: hemolytic-uremic syndrome, asthenia, alopecia, heart failure, flu-like symptoms, myalgia / arthralgia, allergic reactions, cerebrovascular disorders.
Special information
What should patients be aware of before using the carboplatin medication? Instructions, reviews claim that infusions with this drug can only be carried out under the constant supervision of medical personnel who specialize in the treatment of cytotoxic drugs. At the same time, monitoring of possible toxic phenomena is mandatory, especially when using high doses of the drug.
In the course of therapy with this drug and over the next three months, patients need to use reliable contraceptives.
For the preparation, as well as the subsequent administration of the medicinal solution, it is necessary to use medical items that do not contain aluminum. This is due to the fact that when it interacts with the drug, a precipitate forms and a decrease in the effectiveness of the drug is noted.
During treatment with carboplatin, periodic neurological examinations are required, including the elderly and people previously treated with cisplatin.
The use of this medication can lead to the development of ototoxic effects, and therefore audiometric tests should be performed before starting therapy.
When observing clinically significant hearing impairment, a dose adjustment of carboplatin may be necessary or its complete withdrawal.
In case of contact with skin or eyes, rinse immediately with plenty of water. If swallowed, seek professional help.
Similar drugs
What analogues can replace the carboplatin medication? The instruction for use does not contain any information in this regard. You will have to consult an experienced doctor for it. As a rule, experts recommend the use of the following Carboplatin analogues: Cytoplatin, Texaloc, Displanor, Oxyplat, Oxaliplatin, Platinol, Cisplatin, Eloxatin, Platikad, Plaksat ”,“ Occitan ”,“ Oxatera ”,“ Exorum ”.
Antitumor drug reviews
Now you know why such a medicine as “Carboplatin” (“Carboplatin Teva”) is needed. Instructions for use of this drug have also been described above.
Patients' assessment of the toxicity and effectiveness of the carboplatin medication is quite controversial. Some patients talk about the excellent results of the treatment of various oncological diseases, while others very often mention the toxic effects of the drug on different organs and systems of the person, as well as other negative phenomena. Experts say that this is due to the individual tolerance of the patient to the active substance of the drug and its general condition. In any case, cancers require mandatory chemotherapy. If the carboplatin medication is not suitable for the patient for one reason or another, then it is replaced with analogues. This replacement of the antitumor drug helps in 90% of cases.