Carboplatin Pharmachemie Special Precautions

Peripheral blood counts and renal function should be monitored closely. Blood counts should be performed prior to commencement of carboplatin therapy and weekly to assess hematologic nadir, for subsequent dose adjustments. Lowest levels in white cells and platelets are seen between days 14 and 28, and days 14 and 21 respectively, after initial therapy. A greater reduction in platelets is seen in patients who have received extensive myelosuppressive chemotherapy than in untreated patients. White blood cell counts less than 2,000 cells/mm³ or platelets less than 50,000 cells/mm³ may necessitate postponement of carboplatin therapy until bone marrow recovery is evident, usually within 5 to 6 weeks.
Renal toxicity is not usually dose-limiting. Pretreatment and post-treatment hydration is not necessary. However, about a quarter of patients show decreases in creatinine clearance below 60 ml/min. and, less frequently, rises in serum creatinine and blood urea nitrogen may be seen in patients who have previously experienced nephrotoxicity as a result of cisplatin therapy.