Carboplatin Actavis: Uses, Dosage & Side Effects
A platinum-based chemotherapy agent used to treat advanced ovarian cancer and small cell lung cancer, administered as an intravenous infusion in hospital settings
Carboplatin Actavis is a platinum-based chemotherapy medication used to treat advanced ovarian cancer and small cell lung cancer (SCLC). It belongs to a group of anticancer drugs known as platinum coordination compounds, which work by forming crosslinks within and between DNA strands, disrupting the ability of cancer cells to replicate and grow. Carboplatin is administered as an intravenous infusion in a hospital or clinic setting under the supervision of an experienced oncologist. It is generally considered less nephrotoxic and less emetogenic than the related drug cisplatin, making it a widely preferred platinum agent in many treatment protocols worldwide.
Quick Facts: Carboplatin Actavis
Key Takeaways
- Carboplatin is a platinum-based chemotherapy drug primarily used to treat advanced ovarian cancer and small cell lung cancer (SCLC), and it is also used off-label for various other malignancies including non-small cell lung cancer, head and neck cancers, and testicular cancer.
- The dose-limiting toxicity of carboplatin is myelosuppression (bone marrow suppression), particularly thrombocytopenia (low platelet count), which typically reaches its lowest point (nadir) around days 14–21 after administration and recovers by day 28.
- Dosing is commonly calculated using the Calvert formula — Dose (mg) = Target AUC × (GFR + 25) — which individualizes the dose based on the patient’s kidney function rather than body surface area alone.
- Carboplatin must not be used in patients with severe kidney impairment (creatinine clearance ≤30 ml/min), severely depressed bone marrow function, bleeding tumours, or concurrently with the yellow fever vaccine.
- Both women and men of reproductive potential must use effective contraception during treatment and for 6 months (women) or 3 months (men) after the last dose; genetic counselling is recommended if pregnancy occurs during therapy.
What Is Carboplatin Actavis and What Is It Used For?
Carboplatin Actavis contains the active substance carboplatin, a second-generation platinum coordination compound that belongs to the family of alkylating-like antineoplastic agents. Carboplatin was developed in the 1980s as an analogue of cisplatin with the goal of achieving comparable anticancer efficacy while reducing the severe dose-limiting toxicities associated with cisplatin, particularly nephrotoxicity (kidney damage), neurotoxicity, and ototoxicity (hearing damage). The development of carboplatin represented a significant advance in cancer treatment, and it has since become one of the most widely used chemotherapy agents worldwide.
The mechanism of action of carboplatin involves the formation of reactive platinum species within the cell. Once carboplatin enters the cancer cell, it undergoes aquation reactions — a process in which the leaving group (cyclobutanedicarboxylate) is displaced by water molecules, generating positively charged platinum complexes. These reactive intermediates bind to nucleophilic sites on DNA, particularly the N7 position of purine bases (guanine and adenine). The resulting DNA adducts include both intra-strand crosslinks (predominantly 1,2-d(GpG) crosslinks) and inter-strand crosslinks, which distort the DNA double helix and prevent proper unwinding and replication. This triggers recognition by the cellular DNA damage response machinery, leading to cell cycle arrest and, ultimately, apoptotic cell death. Because cancer cells typically divide more rapidly than normal cells and have impaired DNA repair mechanisms, they are generally more susceptible to platinum-induced DNA damage.
Carboplatin is approved by regulatory authorities worldwide for the treatment of the following conditions:
- Advanced ovarian carcinoma: Carboplatin is a cornerstone of first-line treatment for advanced epithelial ovarian cancer, typically administered in combination with paclitaxel. The landmark GOG-158 and AGO-OVAR3 trials established carboplatin-paclitaxel as the standard of care, demonstrating equivalent efficacy to cisplatin-paclitaxel with a more favourable toxicity profile. Carboplatin is also used in second-line and subsequent treatment settings for platinum-sensitive relapsed ovarian cancer.
- Small cell lung cancer (SCLC): Carboplatin is widely used as the platinum component in first-line treatment of both limited-stage and extensive-stage SCLC. In extensive-stage disease, the combination of carboplatin with etoposide plus an immune checkpoint inhibitor (such as atezolizumab or durvalumab) has become the new standard of care based on the IMpower133 and CASPIAN trials, improving overall survival compared with chemotherapy alone.
Beyond its approved indications, carboplatin is also used extensively in clinical practice for numerous other malignancies. These off-label uses include non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma, bladder cancer (urothelial carcinoma), endometrial cancer, cervical cancer, breast cancer (particularly triple-negative subtypes), germ cell tumours, and various paediatric solid tumours. In many of these settings, carboplatin has replaced cisplatin due to its more manageable side effect profile, particularly the lower risk of kidney damage and nerve damage.
Carboplatin is commercially available under several brand names, including Carboplatin Actavis and Carboplatin Ebewe, as well as numerous generic formulations. All contain the same active substance and are considered bioequivalent when used at the same dose. The drug is supplied as a concentrate for solution for infusion at a concentration of 10 mg/ml in various vial sizes (5 ml, 15 ml, 45 ml, and 60 ml), which is diluted before administration with 5% dextrose solution or 0.9% sodium chloride solution.
Carboplatin and cisplatin are both platinum-based chemotherapy drugs, but carboplatin has a cyclobutanedicarboxylate leaving group instead of chloride. This structural difference makes carboplatin significantly less reactive than cisplatin, resulting in reduced nephrotoxicity, neurotoxicity, ototoxicity, and emesis. However, carboplatin causes more pronounced myelosuppression (particularly thrombocytopenia) compared with cisplatin. In many clinical settings, they demonstrate comparable efficacy, and the choice between them depends on the specific tumour type, patient comorbidities, and toxicity considerations.
What Should You Know Before Taking Carboplatin Actavis?
Carboplatin is a potent chemotherapy agent that requires careful patient selection and monitoring. Before treatment begins, your oncologist will conduct a thorough assessment of your overall health status, including blood tests to evaluate kidney function, liver function, and blood cell counts. These baseline assessments are essential for determining whether carboplatin is appropriate for you and for calculating the correct dose. Understanding the contraindications, warnings, and precautions associated with carboplatin is critical for safe and effective treatment.
Contraindications
Carboplatin Actavis must not be used in the following situations:
- Allergy to carboplatin or platinum compounds: If you have a known hypersensitivity to carboplatin, any other platinum-containing compound (such as cisplatin or oxaliplatin), or any of the excipients in the formulation, you must not receive this medication. Allergic reactions to platinum compounds can be severe and potentially life-threatening.
- Severe kidney impairment: Patients with a creatinine clearance of 30 ml/min or less must not receive carboplatin. Since the drug is primarily eliminated by the kidneys, severe renal impairment leads to dangerously high drug exposure and greatly increased toxicity, particularly myelosuppression.
- Severely depressed bone marrow function: If you already have significantly reduced production of blood cells (white blood cells, red blood cells, or platelets) due to prior treatment or other causes, carboplatin may further suppress bone marrow activity to dangerous levels.
- Bleeding tumours: The presence of actively bleeding tumours is a contraindication because carboplatin-induced thrombocytopenia (low platelet count) could significantly worsen bleeding.
- Concurrent yellow fever vaccination: Live vaccines, including the yellow fever vaccine, must not be given during carboplatin treatment because the immunosuppressive effects of the drug may lead to serious or fatal infections from the live vaccine virus.
Warnings and Precautions
Your healthcare team should be informed about the following before and during carboplatin treatment:
Myelosuppression (bone marrow suppression) is the dose-limiting toxicity of carboplatin. This results in decreased production of white blood cells (increasing infection risk), red blood cells (causing anaemia and fatigue), and platelets (increasing bleeding risk). Blood counts must be monitored weekly during the first courses of treatment and before each subsequent cycle. Treatment should not be repeated until neutrophil counts are at least 2,000 cells/mm³ and platelet counts are at least 100,000 cells/mm³.
Kidney function monitoring: Carboplatin’s effect on the blood-forming system may be increased or prolonged in patients with reduced kidney function. Your doctor will monitor your kidney function more frequently if you have any degree of renal impairment. Dose adjustments are required for patients with creatinine clearance below 60 ml/min.
Hearing problems: Carboplatin can cause hearing loss, particularly at high frequencies. This is more common in children receiving carboplatin and in patients who have previously received cisplatin or other ototoxic drugs. Audiometric testing may be recommended before and during treatment, especially in paediatric patients. Report any changes in hearing, ringing in the ears (tinnitus), or difficulty hearing to your doctor immediately.
Neurological effects: Peripheral neuropathy (numbness, tingling, or pain in hands and feet) may occur during carboplatin treatment, although it is less common and generally milder than with cisplatin. In rare cases, more serious neurological complications may develop, including posterior reversible encephalopathy syndrome (PRES), which presents with headache, altered mental function, seizures, and visual disturbances ranging from blurring to vision loss. Seek immediate medical attention if you experience these symptoms.
Tumour lysis syndrome: In patients with rapidly growing tumours, the breakdown of dying cancer cells may release large quantities of intracellular contents into the bloodstream, causing a potentially life-threatening condition known as tumour lysis syndrome (TLS). This manifests as muscle cramps, weakness, confusion, visual disturbances, irregular heartbeat, and kidney failure. Preventive measures, including adequate hydration and medications to lower uric acid levels, are typically administered before and during chemotherapy.
Infection risk: If you develop a fever of 38°C (100.4°F) or higher, or chills, contact your healthcare team immediately. These may be signs of an infection, and patients undergoing chemotherapy are at increased risk of developing serious infections, including bloodstream infections (sepsis), due to their suppressed immune system.
Haemolytic uraemic syndrome (HUS): In rare cases, carboplatin may cause haemolytic uraemic syndrome, a serious condition characterised by the destruction of red blood cells (microangiopathic haemolytic anaemia), low platelet count, and acute kidney failure. Report extreme fatigue, shortness of breath, unusual bruising, or markedly decreased urine output to your doctor immediately.
Pregnancy and Breastfeeding
Carboplatin may cause harm to an unborn baby. Animal studies have demonstrated embryotoxic and teratogenic effects. Women of childbearing potential must use effective contraception during treatment and for 6 months after the last dose. Men should use effective contraception during treatment and for 3 months after the last dose. Men should consider sperm banking before treatment due to the risk of permanent infertility. Genetic counselling is recommended for patients who become pregnant during treatment or wish to have children afterwards.
Pregnancy: Carboplatin should not be administered during pregnancy unless the clinical benefit to the mother clearly outweighs the potential risk to the foetus. If treatment is absolutely necessary during pregnancy, the patient should be fully informed about the potential risks to the unborn child. Because carboplatin can damage genetic material (DNA), genetic counselling is advised if pregnancy occurs during treatment.
Breastfeeding: It is not known whether carboplatin is excreted in human breast milk. Due to the potential for serious adverse effects in the nursing infant, breastfeeding must be discontinued during carboplatin treatment and should not be resumed until your doctor advises that it is safe.
Fertility: Carboplatin may impair fertility in both men and women. Men are advised to seek advice about sperm cryopreservation (freezing) before starting treatment, as there is a risk of irreversible infertility. Women should discuss fertility preservation options (such as egg or embryo freezing) with their oncology team before beginning chemotherapy.
Driving and Operating Machinery
Carboplatin itself does not directly impair your ability to drive or use machines. However, you should exercise particular caution after your first infusion, especially if you experience dizziness, visual disturbances, nausea, or fatigue. Many patients receiving chemotherapy also take antiemetic medications that may cause drowsiness. You are responsible for assessing your own fitness to drive or perform tasks requiring concentration during treatment.
How Does Carboplatin Actavis Interact with Other Drugs?
Drug interactions are an important consideration during carboplatin chemotherapy because many of the side effects of carboplatin — particularly kidney toxicity, hearing damage, and bone marrow suppression — can be amplified by concurrent medications that cause similar effects. Additionally, some drugs may alter the way carboplatin is processed or eliminated by the body, potentially affecting its efficacy or toxicity. Inform your oncologist about all medications you are currently taking, including prescription drugs, over-the-counter medicines, and herbal supplements.
| Interacting Drug/Class | Type of Interaction | Clinical Significance |
|---|---|---|
| Aminoglycoside antibiotics (gentamicin, tobramycin, amikacin) | Increased nephrotoxicity and ototoxicity | Monitor kidney function and hearing closely; avoid combination if possible |
| Immunosuppressants (ciclosporin, tacrolimus, sirolimus) | Additive immunosuppression | Increased risk of serious infections; close monitoring required |
| Phenytoin / Fosphenytoin | Reduced phenytoin absorption and efficacy | Monitor phenytoin serum levels; dose adjustment may be needed |
| Loop diuretics (furosemide) | Increased ototoxicity and nephrotoxicity | Monitor hearing and kidney function; use with caution |
| Anticoagulants (warfarin, heparin) | Altered anticoagulant effect | Monitor INR/coagulation parameters more frequently |
| Chelating agents | Bind to carboplatin, reducing its efficacy | Avoid concurrent use; chelating agents neutralise the platinum compound |
| Live vaccines (yellow fever, MMR, varicella) | Risk of disseminated vaccine infection | Contraindicated during treatment and for a period after completion |
| Other myelosuppressive agents | Additive bone marrow suppression | Dose adjustments may be required; monitor blood counts closely |
Major Interactions
Nephrotoxic drugs: The concurrent use of carboplatin with other nephrotoxic agents, particularly aminoglycoside antibiotics (such as gentamicin, tobramycin, and amikacin), significantly increases the risk of kidney damage. These antibiotics are known to cause direct tubular damage, and when combined with the renal effects of carboplatin, the risk of acute kidney injury is substantially elevated. If aminoglycoside use is unavoidable, kidney function should be monitored very closely, and dose adjustments may be necessary for both drugs.
Ototoxic drugs: Aminoglycoside antibiotics and loop diuretics (such as furosemide) can cause damage to the hearing and balance organs of the inner ear. When used alongside carboplatin, which also has ototoxic potential, the cumulative risk of hearing loss — particularly at high frequencies — is increased. Baseline and periodic audiometric evaluations should be considered, especially in paediatric patients and those receiving high cumulative doses.
Live vaccines: All live attenuated vaccines are contraindicated during carboplatin treatment. The profound immunosuppression caused by chemotherapy may allow live vaccine organisms to replicate uncontrollably, potentially causing serious or fatal disseminated infections. This restriction specifically includes the yellow fever vaccine, measles-mumps-rubella (MMR), varicella, oral polio, and live influenza vaccines. Inactivated vaccines may be administered but may produce a reduced immune response.
Minor Interactions
Alcohol: There is no known direct pharmacological interaction between carboplatin and alcohol. However, because carboplatin can affect liver function (as evidenced by elevated liver enzymes in some patients), it is advisable to discuss alcohol consumption with your doctor. Most oncologists recommend limiting or avoiding alcohol during chemotherapy, as it may exacerbate nausea, dehydration, and hepatotoxicity.
Food: As carboplatin is administered intravenously, food does not affect its absorption. However, maintaining adequate hydration and nutrition during treatment is important for supporting kidney function and overall recovery between chemotherapy cycles.
Needles, syringes, catheters, or intravenous sets containing aluminium parts that may come into contact with carboplatin must not be used for preparation or administration. Carboplatin reacts with aluminium, forming a black precipitate that may reduce the drug’s effectiveness and could potentially cause harm. Only aluminium-free equipment should be used.
What Is the Correct Dosage of Carboplatin Actavis?
Carboplatin is always administered in a hospital or specialist clinic setting by healthcare professionals experienced in the use of anticancer drugs. The dose is carefully calculated for each individual patient based on several factors, including body size, kidney function, blood cell counts, and previous treatment history. Your oncologist will determine the most appropriate dose and schedule for your specific situation.
The infusion is given into a vein (intravenously) and typically takes between 15 and 60 minutes. Before infusion, the concentrate is diluted with 5% dextrose (glucose) solution or 0.9% sodium chloride (normal saline) solution to concentrations as low as 0.5 mg/ml. Anti-nausea medications are usually given before the infusion to reduce the severity of nausea and vomiting.
Adults
Standard Body Surface Area Dosing
The recommended dose for previously untreated adults with normal kidney function (creatinine clearance >60 ml/min) is 400 mg/m² body surface area, administered as a single intravenous dose over 15–60 minutes. Treatment cycles are repeated every 4 weeks.
Calvert Formula (AUC-Based Dosing)
The Calvert formula is widely regarded as the preferred method for calculating carboplatin doses because it accounts for the patient’s individual kidney function:
Dose (mg) = Target AUC (mg/ml × min) × [GFR (ml/min) + 25]
Note: The Calvert formula calculates the dose in milligrams (mg), not mg/m². GFR (glomerular filtration rate) should be measured using an accurate method such as &sup51;Cr-EDTA clearance or calculated using validated equations.
| Target AUC | Planned Chemotherapy | Patient Treatment Status |
|---|---|---|
| 5–7 mg/ml × min | Carboplatin monotherapy | Previously untreated |
| 4–6 mg/ml × min | Carboplatin monotherapy | Previously treated |
| 4–6 mg/ml × min | Carboplatin + cyclophosphamide | Previously untreated |
The Calvert formula should not be used for patients who have received extensive prior therapy, defined as previous treatment with mitomycin C, nitrosoureas, combination therapy with doxorubicin/cyclophosphamide/cisplatin, combination therapy with 5 or more drugs, or radiation therapy covering 4,500 rad or more over an area of 20 × 20 cm or larger.
It is recommended that the initial dose be reduced by 20–25% in patients with risk factors such as prior myelosuppressive treatment and low performance status (ECOG-Zubrod 2–4 or Karnofsky below 80).
Renal Impairment
Dose Adjustments for Kidney Function
Patients with creatinine clearance below 60 ml/min are at higher risk of developing myelosuppression and require dose reduction. The Calvert formula automatically accounts for reduced kidney function when GFR is accurately measured. There is insufficient data to recommend treatment in patients with creatinine clearance of 15 ml/min or below. Kidney function and complete blood counts should be monitored frequently in all patients with renal impairment.
Children
There is insufficient clinical data to provide specific dosage recommendations for children and adolescents. However, carboplatin is used in paediatric oncology for various solid tumours under specialist supervision, and dosing is determined by the treating paediatric oncologist based on institutional protocols and clinical guidelines. Hearing monitoring is particularly important in children, as hearing impairment is more common in the paediatric population receiving carboplatin.
Elderly
The standard adult dose may be used in patients over 65 years of age, although the dose should be adjusted according to the patient’s general condition and kidney function at both the first and subsequent treatments. Age-related decline in kidney function is common, and since carboplatin dosing is heavily dependent on renal clearance, careful assessment of GFR is essential in elderly patients.
Missed Dose
Since carboplatin is administered by healthcare professionals in a hospital setting on a fixed schedule, it is very unlikely that a dose will be missed. If you believe you may have missed a scheduled treatment, contact your oncology team. Do not attempt to take a double dose.
Overdose
Carboplatin overdose is unlikely to occur in clinical practice because the drug is administered under strict medical supervision. However, if an overdose were to occur, the expected effects would include severe myelosuppression, kidney impairment, liver damage, and hearing and vision problems. There is no specific antidote for carboplatin overdose. Treatment would be supportive, including management of bone marrow suppression, monitoring of organ function, and potential haemodialysis, though the effectiveness of dialysis in removing carboplatin is limited once it is protein-bound.
What Are the Side Effects of Carboplatin Actavis?
Like all chemotherapy drugs, carboplatin can cause side effects, although not everyone will experience them. The type and severity of side effects depend on the dose administered, the number of treatment cycles received, your overall health status, and whether carboplatin is given alone or in combination with other chemotherapy drugs. Most side effects are predictable and manageable with appropriate supportive care.
Your healthcare team will monitor you closely during and after each treatment cycle. It is important to report any new or worsening symptoms promptly, as some side effects require immediate medical intervention. The following is a comprehensive list of known side effects, organised by their frequency of occurrence:
Unusual bruising, bleeding, or signs of infection (sore throat, fever); severe allergic reactions (skin rash, swelling of face, lips, tongue or throat, difficulty breathing); chest pain; or symptoms of posterior reversible encephalopathy syndrome (headache, altered mental function, seizures, visual disturbances).
Very Common
May affect more than 1 in 10 patients
- Bone marrow suppression causing low white blood cell counts (leukopenia, neutropenia) — increases infection risk
- Low platelet count (thrombocytopenia) — increases risk of bruising and bleeding
- Anaemia (low red blood cell count) — causes tiredness and shortness of breath
- Elevated uric acid levels in the blood (hyperuricaemia)
- Mild hearing loss at high frequencies
- Nausea and vomiting
- Abdominal pain and cramps
- Unusual tiredness or weakness (asthenia)
- Abnormal liver function tests (elevated transaminases, alkaline phosphatase)
- Decreased kidney function (reduced creatinine clearance, elevated blood urea)
- Low blood levels of sodium, potassium, calcium, and magnesium
Common
May affect up to 1 in 10 patients
- Infections
- Bleeding complications
- Allergic reactions (rash, hives, redness, itching, fever)
- Peripheral neuropathy (weakness, tingling, numbness)
- Tingling and prickling sensations (paraesthesia)
- Decreased deep tendon reflexes
- Sensory disturbances
- Taste changes (dysgeusia)
- Fatigue and malaise
- Visual disturbances, including temporary vision loss
- Ringing in the ears (tinnitus) and hearing loss
- Cardiovascular disorders
- Respiratory disorders, interstitial lung disease (scarring and thickening of the lungs with breathing difficulty, sometimes fatal)
- Diarrhoea, constipation
- Mucous membrane disorders (mouth sores)
- Hair loss (alopecia)
- Skin disorders, urticaria, pruritus, erythematous rash
- Musculoskeletal disorders (pain in muscles, joints, tendons)
- Urogenital disorders
- Flu-like symptoms
- Elevated creatinine, bilirubin, and uric acid levels
Uncommon
May affect up to 1 in 100 patients
- Secondary cancers (treatment-related malignancies)
- Fever and chills without signs of infection
- Injection site reactions (redness, swelling, pain, or tissue damage)
Rare
May affect up to 1 in 1,000 patients
- Febrile neutropenia (fever with dangerously low white blood cell count)
- Severe allergic/anaphylactic reactions (sudden wheezing, chest tightness, facial swelling, rapid heartbeat, low blood pressure, difficulty breathing, anaphylactic shock)
- Low sodium levels in the blood (hyponatraemia)
- Loss of appetite (anorexia)
- Optic neuritis (inflammation of the optic nerve causing visual loss)
- Severe liver dysfunction and hepatocellular damage
Very Rare
May affect up to 1 in 10,000 patients
- Cerebrovascular events (brain haemorrhage causing stroke or loss of consciousness)
- Heart failure
- Embolism (sudden blockage of a blood vessel), high blood pressure, low blood pressure
Not Known
Frequency cannot be estimated from available data
- Haemolytic uraemic syndrome (HUS) — acute kidney failure with anaemia and low platelets
- Dehydration
- Stomatitis (mouth sores)
- Posterior reversible encephalopathy syndrome (PRES) — headache, confusion, seizures, visual disturbances
- Pancreatitis
- Lung infection (pneumonia)
- Acute promyelocytic leukaemia (treatment-related blood cancer)
- Tumour lysis syndrome (muscle cramps, weakness, confusion, irregular heartbeat, kidney failure)
- Kounis syndrome (allergic chest pain resembling a heart attack)
Your oncology team is experienced in managing chemotherapy side effects and will provide supportive care including anti-nausea medications, growth factors for low blood counts, antibiotics for infections, blood transfusions if needed, and electrolyte replacement. If you experience any unexpected symptoms or if existing symptoms worsen, do not hesitate to contact your healthcare team.
Reporting suspected side effects after a medicine has been approved is important for ongoing safety monitoring. Healthcare professionals and patients can report adverse reactions to their national pharmacovigilance authority (for example, the MHRA in the United Kingdom, the FDA MedWatch programme in the United States, or the EMA in the European Union). This helps maintain an up-to-date understanding of the benefit-risk balance of the medicine.
How Should You Store Carboplatin Actavis?
Carboplatin Actavis is a hospital-administered medication, and in most cases, patients will not need to store this drug at home. The storage and handling of carboplatin are managed by trained pharmacy and nursing staff in the hospital or clinic. However, the following storage information is provided for completeness:
- Unopened vials: Store at or below 25°C (77°F). Keep the vial in the original outer carton to protect from light. Carboplatin is light-sensitive and may degrade if exposed to direct light for extended periods.
- After dilution: Chemical and physical stability of the diluted solution has been demonstrated for up to 8 hours at 25°C. From a microbiological safety standpoint, the diluted product should be used immediately unless the dilution method precludes the risk of microbial contamination. If not used immediately, in-use storage times and conditions are the responsibility of the user.
- Single use only: Carboplatin Actavis vials are intended for single use. Any unused solution should be disposed of in accordance with local regulations for the handling of cytotoxic waste.
- Do not use after the expiry date: Check the expiry date printed on the vial label and outer carton. The expiry date refers to the last day of the stated month.
Keep this and all medicines out of the sight and reach of children. Do not dispose of medicines via household waste or wastewater. Ask your pharmacist how to dispose of unused medicines safely. These measures help protect the environment.
What Does Carboplatin Actavis Contain?
Carboplatin Actavis is formulated as a simple aqueous solution with minimal excipients, which contributes to its chemical stability and compatibility with standard intravenous infusion equipment (aluminium-free). The formulation details are as follows:
- Active substance: Carboplatin — 10 mg per millilitre of concentrate.
- Other ingredients: Water for injections.
Appearance: Carboplatin Actavis is a clear, colourless to slightly yellow liquid supplied in glass vials.
Available pack sizes: 1 × 5 ml (50 mg), 5 × 5 ml (5 × 50 mg), 1 × 15 ml (150 mg), 1 × 45 ml (450 mg), and 1 × 60 ml (600 mg). Not all pack sizes may be marketed in every country.
Dilution for infusion: Before administration, the concentrate must be diluted with 5% dextrose (glucose) solution or 0.9% sodium chloride solution to a final concentration as low as 0.5 mg/ml (500 micrograms/ml). Carboplatin must not be mixed with any other medicinal product except these two approved diluents.
Carboplatin is a cytotoxic (cancer-killing) medication and must be prepared and handled only by trained healthcare professionals wearing appropriate personal protective equipment (safety goggles, protective gown, disposable gloves, and face mask). Preparation should take place in a designated area, preferably under a laminar airflow cabinet. Spills should be treated with dilute sodium hypochlorite solution (1% available chlorine). Pregnant staff should not handle cytotoxic preparations. All contaminated materials must be disposed of as high-risk cytotoxic waste.
Frequently Asked Questions About Carboplatin
The Calvert formula is a dosing equation specifically developed for carboplatin: Dose (mg) = Target AUC × (GFR + 25). Unlike most chemotherapy drugs that are dosed based on body surface area (mg/m²), carboplatin dosing with the Calvert formula takes into account the patient’s individual kidney function (GFR), which is the primary determinant of carboplatin clearance. This results in more consistent drug exposure (measured as AUC — area under the concentration-time curve) across patients with varying levels of kidney function, leading to more predictable efficacy and toxicity. The target AUC is chosen by the oncologist based on the treatment regimen and whether the patient has received prior chemotherapy.
A carboplatin infusion typically takes between 15 and 60 minutes. The exact duration depends on the dose administered, the volume of diluted solution, and institutional protocols. Before the carboplatin infusion, you will usually receive anti-nausea medications (antiemetics) and may receive intravenous hydration. After the infusion, you may be monitored for a period before being discharged. The entire visit to the treatment centre, including preparation, administration, and post-treatment observation, typically takes several hours.
Carboplatin is typically administered once every 3 to 4 weeks (one treatment cycle). The exact frequency depends on the specific treatment protocol and the recovery of your blood counts between cycles. Your oncologist will check your blood counts (particularly neutrophils and platelets) before each cycle to ensure they have recovered sufficiently. Treatment should not be repeated until the neutrophil count is at least 2,000 cells/mm³ and the platelet count is at least 100,000 cells/mm³. The total number of cycles varies depending on the type of cancer, treatment response, and tolerability, but commonly ranges from 4 to 6 cycles.
Hair loss (alopecia) is listed as a common side effect of carboplatin, meaning it may affect up to 1 in 10 patients. When carboplatin is used as a single agent, hair loss tends to be mild to moderate. However, when carboplatin is combined with other chemotherapy drugs — particularly taxanes such as paclitaxel, which very commonly cause hair loss — complete hair loss is more likely. Hair typically begins to regrow after treatment ends, usually within a few months, and may initially return with a different texture or colour before returning to its original state.
Both carboplatin and cisplatin are platinum-based chemotherapy drugs that work by damaging cancer cell DNA, but they have important differences. Cisplatin was the first platinum drug developed and is more reactive, leading to more severe kidney damage (nephrotoxicity), hearing damage (ototoxicity), nerve damage (neurotoxicity), and nausea/vomiting. Carboplatin was developed as a less toxic alternative and has a different leaving group (cyclobutanedicarboxylate instead of chloride), making it less reactive. Carboplatin’s main dose-limiting toxicity is myelosuppression (low blood counts, especially platelets), rather than kidney damage. In many cancer types, both drugs demonstrate comparable efficacy, and the choice between them depends on the specific tumour type, treatment setting, and the patient’s individual risk factors and comorbidities.
There is no known direct pharmacological interaction between carboplatin and alcohol. However, because carboplatin can affect liver function and because chemotherapy already places a significant burden on your body, most oncologists advise limiting or avoiding alcohol during treatment. Alcohol can worsen nausea, dehydration, and fatigue — symptoms that are already common during chemotherapy. It is best to discuss your individual situation with your oncologist, who can provide personalised guidance based on your overall health and treatment plan.
References
- European Medicines Agency (EMA). Carboplatin – Summary of Product Characteristics. Available from: www.ema.europa.eu. Last updated 2024.
- U.S. Food and Drug Administration (FDA). Carboplatin Injection – Prescribing Information. Available from: www.accessdata.fda.gov. Last revised 2024.
- Calvert AH, Newell DR, Gumbrell LA, et al. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989;7(11):1748-1756. doi:10.1200/JCO.1989.7.11.1748
- du Bois A, Lück HJ, Meier W, et al. A randomized clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel as first-line treatment of ovarian cancer (AGO-OVAR3). J Natl Cancer Inst. 2003;95(17):1320-1329. doi:10.1093/jnci/djg036
- Ozols RF, Bundy BN, Greer BE, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study (GOG-158). J Clin Oncol. 2003;21(17):3194-3200. doi:10.1200/JCO.2003.02.153
- Horn L, Mansfield AS, Szczęsna A, et al. First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer (IMpower133). N Engl J Med. 2018;379(23):2220-2229. doi:10.1056/NEJMoa1809064
- Paz-Ares L, Dvorkin M, Chen Y, et al. Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet. 2019;394(10212):1929-1939. doi:10.1016/S0140-6736(19)32222-6
- National Comprehensive Cancer Network (NCCN). Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer. Version 2.2025.
- European Society for Medical Oncology (ESMO). Clinical Practice Guidelines: Epithelial Ovarian Cancer. 2024.
- World Health Organization (WHO). Model List of Essential Medicines – 23rd list. 2023. Carboplatin is listed as an essential antineoplastic medicine.
- British National Formulary (BNF). Carboplatin. National Institute for Health and Care Excellence (NICE). Available from: bnf.nice.org.uk. Accessed January 2026.
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