Carbotinol Special Precautions

Hematologic tests and renal function tests should be monitored closely. Blood counts should be performed prior to commencement of Carboplatin therapy, and at weekly intervals thereafter. Neurological evaluation and an assessment of hearing should also be performed on a regular basis. Long-term therapy may cause severe adverse reactions and become chronic, therefore it should be cautioned.
Carboplatin myelosuppression is closely related to its renal clearance: patients with abnormal kidney function or receiving concomitant therapy with other drugs with nephrotoxic potential are likely to experience more severe and prolonged myelotoxicity. Renal function parameters should, therefore, be carefully assessed before and during therapy. Carboplatin courses should not be repeated more frequently than monthly under normal circumstances. Thrombocytopenia, leucopenia and anemia occur after administration of carboplatin. Frequent monitoring of peripheral blood counts is recommended throughout and following therapy with carboplatin. Carboplatin combination therapy with other myelosuppressive compounds must be planned very carefully with respect to dosages and timing in order to minimize additive effects. Supportive transfusional therapy may be required in patients who suffer severe myelosuppression.
Carboplatin should only be administered under the supervision of a qualified physician who is experienced in the use of chemotherapeutic agents. Diagnostic and treatment facilities should be readily available for management of therapy and possible complications.
Carboplatin can cause nausea and vomiting. Premedication with antiemetics has been reported to be useful in reducing the incidence and intensity of these effects.
Renal function impairment may be encountered with carboplatin. Although no clinical evidence on compounding nephrotoxicity has been accumulated, it is recommended not to combine carboplatin with aminoglycosides or other nephrotoxic compounds.
As for other platinum coordination compounds, allergic reactions to carboplatin have been reported. These may occur within minutes of administration and should be managed with appropriate supportive therapy.
Manifestation or exacerbation of infections, bleeding tendency should be taken with caution.
Use in children or patients of childbearing potential should be taken with caution.
Others: In cases where the efficacy of cisplatin administration has not been acceptable, the efficacy of carboplatin may also be unacceptable.
Carboplatin has shown mutagenicity in bacteria and lymphocyte cell of human. It also has shown clastogenicity in hamsters.
In chronic toxicity (i.v.) tests in rats, adenocarcinoma of glandula parotis and glandula mammaria, premalignant lesion of prostate has been reported to occur.
Cardiac infarction, cerebral infarction have been reported to occur during concomitant administration with other antineoplastic agents.
Use in children: The recommended dosage for children has not been established.
Use in pregnancy & lactation: The safe use of carboplatin during pregnancy has not been established; carboplatin has been shown to be an embryotoxin and mutagen in several experimental systems. Carboplatin has been shown to be embryotoxic and teratogenic in rats.
Carboplatin has been reported to be distributed in human milk; therefore, the administration should be avoided in nursing mothers.