Aricarb Infusion

Aricarb Infusion is used for: Ovarian carcinoma, Lung cancer

Intravenous Small cell lung cancer; Advanced ovarian carcinoma Adult: IV As single agent in treatment-naive patients: 400 mg/m2; As single agent in previously treated patients: 360 mg/m2; W/ cyclophosphamide in treatment-naive patients: 300 mg/m2. Doses to be given not more frequently than every 4 wk. Adjust subsequent doses based on nadir of WBC and platelet counts.

Solid tumor 300-600 mg/m² IV q4Weeks Sarcoma (bone/soft tissue) 400 mg/m²/day for 2 days every 21 days Brain tumor 175 mg/m² qWeek x 4 weeks with a 2 weeks recovery period between courses Bone marrow transplant preparative regimen 500 mg/m²/day x 3 days Retinoblastoma 1-2 mL subconjunctival injection of 10 mg/mL solution per dose

Renal Impairment CrCl 41-59 mL/min: 250 mg/m² IV on day 1 CrCl 16-40 mL/min: 200 mg/m² IV on day 1 CrCl <15 mL/min: Not recommended

IV Preparation Single-dose lyophilized powder (reconstitution require) Reconstitute powder with sterile water for injection, D5W, or 0.9% NaCl to yield a final concentration of 10 mg/mL Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl Multidose premixed injectable solution Available as a 10 mg/mL aqueous solution Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl IV Administration Administer IV over 15 min or continuous IV infusion over 24 hr May also be administered intraperitoneally When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression and to enhance efficacy Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can cause precipitate formation and loss of potency)

Severe hypersensitivity to carboplatin, other platinum compounds, mannitol Severe myelosuppression, significant bleeding Severe renal dysfunction Pregnancy/lactation

The drug should be administered under the supervision of an experienced cancer chemotherapy physician. Increased risk of allergic reactions in patients previously exposed to platinum. The allergic reaction may occur within minutes of carboplatin administration Bone marrow suppression, which may be severe and may result in infection or bleeding, is dose related. Reduce dosage in patients with bone marrow suppression and impaired renal function. Anemia is cumulative Vomiting is a frequent adverse effect and is dose related Pediatric patients, elderly, renal impairment, hearing impairment, neuropathy, neuromuscular disease, prior cisplatin treatment, concomitant neurotoxic agents, concomitant ototoxic agents Less nephrotoxic than cisplatin Avoid pregnancy Ototoxicity may occur Caution in patients with renal impairment; patients with renal failure are at increased risk for bone marrow suppression Carboplatin has limited nephrotoxic potential, but concomitant treatment with aminoglycosides has resulted in increased renal and/or audiologic toxicity, and caution must be exercised when a patient receives both drugs; clinically significant hearing loss has been reported to occur in pediatric patients when carboplatin was administered at higher than recommended doses in combination with other ototoxic agents Therapy can induce emesis, which can be more severe in patients previously receiving emetogenic therapy; the incidence and intensity of emesis have been reduced by using premedication with antiemetics; although no conclusive efficacy data exist, lengthening the duration of single intravenous administration to 24 hours or dividing the total dose over 5 consecutive daily pulse doses has resulted in reduced emesis Although peripheral neurotoxicity is infrequent, its incidence is increased in patients older than 65 years and in patients previously treated with cisplatin; pre-existing cisplatin-induced neurotoxicity does not worsen in about 70% of the patients receiving carboplatin as secondary treatment Loss of vision, which can be complete for light and colors, has been reported after use of carboplatin with doses higher than those recommended in the package insert; vision appears to recover totally or to a significant extent within weeks of stopping these high doses As in the case of 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; there is increased risk of allergic reactions including anaphylaxis in patients previously exposed to platinum therapy High dosages of carboplatin (more than 4 times the recommended dose) have resulted in severe abnormalities of liver function tests Needles or intravenous administration sets containing aluminum parts that may come in contact with carboplatin Injection should not be used for preparation or administration of the drug; aluminum can react with carboplatin causing precipitate formation and loss of potency Bone marrow suppression Bone marrow suppression (leukopenia, neutropenia, and thrombocytopenia) is dose-dependent and is also the dose-limiting toxicity; peripheral blood counts should be frequently monitored during treatment and, when appropriate, until recovery achieved Marrow suppression is increased in patients with impaired kidney function; initial dosages in these patients should be appropriately reduced and blood counts should be carefully monitored between courses; the use in combination with other bone marrow suppressing therapies must be carefully managed with respect to dosage and timing in order to minimize additive effects

Pregnancy Injection may cause fetal harm when administered to a pregnant woman; the drug has been shown to be embryotoxic and teratogenic in rats; there are no adequate and well-controlled studies in pregnant women; if this drug is used during pregnancy, or if patient becomes pregnant while in therapy, the patient should be apprised of potential hazard to fetus; women of childbearing potential should be advised to avoid becoming pregnant Lactation Not known whether carboplatin is excreted in human milk; because there is possibility of toxicity in nursing infants secondary to treatment of the mother, it is recommended that breast-feeding be discontinued if the mother is treated

Increased risk of ototoxicity when used with aminoglycosides. Contraindicated (0) Serious (16) adenovirus types 4 and 7 live, oral amphotericin B deoxycholate axicabtagene ciloleucel bacitracin brexucabtagene autoleucel cidofovir ciltacabtagene autoleucel etrasimod idecabtagene vicleucel influenza virus vaccine quadrivalent, adjuvanted influenza virus vaccine trivalent, adjuvanted lisocabtagene maraleucel palifermin ropeginterferon alfa 2b tisagenlecleucel tofacitinib

Side effects of Carboplatin : >10% Leukopenia (26-97%),Neutropenia (21-96%),Nausea (81-93%),Vomiting (81-93%),Anemia (14-90%),Magnesium loss (43-61%),Thrombocytopenia (33-66%),Alopecia (2-49%),Asthenia (11-41%),Elevated alkaline phosphatase (29-37%),Central neurotoxicity (5-26%),Elevated AST (19-20%),Peripheral neuropathy (6-15%) 1-10% Immune hypersensitivity reaction (2-9.2%),Elevated bilirubin (5%) Frequency Not Defined Visual disturbance (rare) Potentially Fatal: Bone marrow suppression and anaphylactic reactions.

Carboplatin is an alkylating agent which binds covalently to DNA. It modifies the cell cycle by interfering with DNA structure and function.

Aricarb 10 mg/ml Infusion manufactured by Aristopharma Limited. Its generic name is Carboplatin. Aricarb is availble in Bangladesh. Farmaco BD drug index information on Aricarb Infusion is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.