In this patient population the majority of haematological toxicities were very mild and of relatively short duration, with more than 80% of documented hAEs being of grade 1 and more than 70% of patients with no hAEs or grade 1 hAEs only. chemotherapy drugs in obese patients. Carboplatin has minimal hepatic metabolism; rather, it undergoes spontaneous hydrolysis to become active. 0 This irreversible binding results in the inhibition of DNA replication. In the subgroup of patients with radionuclide GFR measurement (n=10), themean age was 41 years (range 2354), andthe mean carboplatin dose administered was 1.9% higher (median difference+74.5mg, range 228 to+178mg) than if it would have been if based on Crea-Cl from formula estimation (Cockroft-Gault). Treatment is usually repeated every four . carboplatin and cyclosporine both increase nephrotoxicity and/or ototoxicity. Individuals with altered immunocompetence may have reduced immune responses to the vaccine. Use in Cancer. Once inside the cell, carboplatin is hydroxylated by water to form the active compound, then it covalently binds to DNA at two sites, forming interstrand and intrastrand cross-links. capreomycin and carboplatin both increase nephrotoxicity and/or ototoxicity. Monitor Closely (1)amikacin and carboplatin both increase nephrotoxicity and/or ototoxicity. carboplatin decreases effects of meningococcal group B vaccine by pharmacodynamic antagonism. Either increases toxicity of the other by pharmacodynamic synergism. National Library of Medicine 1-4. . This combination may also be used with other drugs or treatments or to treat other types of cancer. Additive myelosuppression. Use Caution/Monitor. Carboplatin is given as an infusion into a vein, usually given once every 4 weeks. Monitor Closely (1)ofatumumab SC, carboplatin. But the pattern of hAEs with more than 80% being grade 1 was similar in both groups, and the differences are not statistically significant. carboplatin decreases effects of influenza A (H5N1) vaccine by pharmacodynamic antagonism. Before day 10 and after day 24, no new toxicities higher than grade 1 were documented. carboplatin and polymyxin B both increase nephrotoxicity and/or ototoxicity. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. vitamin E, carboplatin. Kidney disease affects drug pharmacokinetics and pharmacodynamics, and level of kidney function is a key consideration in the use of drugs. As a temporary measure, it has been suggested that physicians limit the dose of car- boplatin in order to avoid overdosing if they are using the IDMS method to measure serum creatinine. Platinum coordination compound; covalently binds to DNA; cross-links strands of DNA, Additive: cisplatin, etoposide, floxuridine, ifosfamide, ifosfamide with etoposide, paclitaxel, Y-site (partial list): allopurinol, etoposide PO4, filgrastim, gemcitabine, granisetron, linezolid, ondansetron, paclitaxel, piperacillin-tazobactam, propofol, 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). %%EOF official website and that any information you provide is encrypted See the Side Effects section for more information. All material on this website is protected by copyright, Copyright 1994-2022 by WebMD LLC. Haematological adverse events after carboplatin AUC 7: patients with Crea-Cl <125mL/min vs>125mL/min and no dose capping. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. %PDF-1.5 % Men should use a reliable form of birth control during treatment and for some time afterwards. Themain inclusion criteria were a normal blood count at treatment and a minimum of two documented blood count measurements during the first 8 weeks after treatment. Monitor Closely (1)carboplatin, hydroxyurea. A total of 22 hAEs occurred, with a mean of 2.2 hAEs per patient, 77% (17/22) of them were of grade 1. These dosing recommendations apply to the initial course of treatment. carboplatin and cisplatin both increase nephrotoxicity and/or ototoxicity. In most clinical trials, doctors give 75 mg of cisplatin per session. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. Avoid or Use Alternate Drug. Patients and physicians can contact RxPathways at (866) 706-2400 or visit the website for more information on these programs www.pfizerrxpathways.com. Avoid or Use Alternate Drug. Refer to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for standard dosing recommendations based on regimen. Four (5.4%) patients had no hAEs. In the chemotherapy of advanced ovarian cancer, an effective combination for previously untreated patients consists of: Carboplatin Injection - 300 mg/m2 IV on day 1 every four weeks for six cycles (alternatively see Formula Dosing). WARNING: Carboplatin can cause severe blood disorders (such as anemia, bone marrow suppression) that can result in infection and bleeding problems. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs. Monitor Closely (1)carboplatin and tobramycin both increase nephrotoxicity and/or ototoxicity. Monitor Closely (1)carboplatin and gentamicin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Use Caution/Monitor. Our data are also in line with a single-centre retrospective study that identified no significant toxicity in an even smaller number of patients receiving carboplatin with GFR>110mL/min, who did not have their doses capped. carboplatin, chlorambucil. Chatelut E, Rostaing L, V G, et al. Combination may also increase tenofovir levels. Purpose The glomerular filtration rate (GFR) is essential for carboplatin chemotherapy dosing; however, the best method to estimate GFR in patients with cancer is unknown. The site is secure. Monitor Closely (1)carboplatin, cyclophosphamide. Serious - Use Alternative (1)carboplatin, axicabtagene ciloleucel. carboplatin and cisplatin both increase nephrotoxicity and/or ototoxicity. The NCCN Guidelines are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Patients received an intravenous carboplatin dose of 560 mg/m 2 (in children 10 kg) or 18.7 mg/kg (in children <10 kg) during one hour. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC. Dose (mg) = target AUC x (GFR + 25) is now the recommended formula. Use Caution/Monitor. Dos eof carboplatin(AUC) for ea hpatient in armis d terminedbytreating physician. Additive myelosuppression. Pharmacokinetics of carboplatin in a . The recipient will receive more details and instructions to access this offer. Use Caution/Monitor. This study also showed a trend between the AUC of single agent Carboplatin Injection administered to previously treated patients and the likelihood of developing toxicity. Monitor Closely (1)carboplatin, ifosfamide. A concern with one cycle of carboplatin is the potential for inadequate dosing, leading to an increased risk of relapse. New Trials in Gynecologic Cancers: Could Your Patient Benefit? voclosporin, carboplatin. Immunosuppressive therapies (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, corticosteroids [greater than physiologic doses]) may reduce immune response to dengue vaccine. No new hAEs other than grade 1 occurred before day 10 and after day 24. On the other hand this facilitates the generalisability of our results and conclusions for daily clinical practice. Use Caution/Monitor. Some experts and clinical guidelines recommend capping of the carboplatin dose at a Crea-Cl of 125mL/min because of concerns of excessive toxicity in view of changes in assays used to measure serum-creatinine and alerts by the Food and Drug Administration (FDA) and Gynecologic Oncology Group (GOG).3 4, Stage I seminoma is the most commonly diagnosed testis cancer and accounts for 40%45% of all testis cancers.5 The risk of recurrence after tumour orchiectomy is 10%20%; active surveillance and adjuvant treatment are possible management options.6 Contemporary guidelines favour active surveillance for seminoma stage I and single-dose carboplatin is listed as adjuvant treatment option.6 7 Many of the patients receiving single-dose carboplatin area under the curve (AUC) 7 have a very good renal function, and hence high absolute doses of carboplatin are frequently administered: about 50% of patients treated on study protocols and reported in cohorts had a GFR of 125mL/min and higher.8 9. Your doctor will determine the dose of carboplatin for you based on your weight, height, and kidney function. The authors concluded that carboplatin doses should be based on actual GFR and that dose titration at subsequent carboplatin treatments should occur in case of myelotoxicity.11, Although radionuclide measurement of GFR is the referencestandard for the calculation of the carboplatin dose in patients with seminoma stage I, the majority of our patients had estimations of Crea-Cl from serum-creatinine values by the Cockcroft-Gault formula before radioisotope measurement was introduced at our institutions in 2014.1216 According to the published literature, it is reasonable to conclude that the rates of adverse events could be further improved by basing the carboplatin dose on radioisotope-measured GFR, as this eliminates the inaccuracy associated with formula-based Crea-Cl estimations.12 1719 In addition, a post-hoc analysis of the large prospective MRC TE19/EORTC 30982 trial revealed that lowering carboplatin doses by 10% was associated with a trend for an increased rate of recurrences (in those patients in whom the carboplatin dosecalculation was based on a Crea-Cl estimate from a 24-hour urine collection).8 However, this has not been reproduced in a cohort from routine clinical practice so far and has been challenged recently.1. Concerns about toxicity or overdosing in obese patients with cancer, based on the use of actual body weight, are unfounded. Either increases toxicity of the other by pharmacodynamic synergism. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. Also, an unlikely but very serious allergic reaction to this drug may occur within minutes of receiving a dose. Thesum of percentagesof different grades may differ from percentage of overall due to rounding. Monitor Closely (1)carboplatin decreases effects of influenza virus vaccine (H5N1), adjuvanted by pharmacodynamic antagonism. Carboplatin dosing. Chemotherapy and biotherapy guidelines and recommendations for practice. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. Tell your doctor right away if you develop any of the following symptoms: easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever), unusual tiredness, rash, itching, swelling, severe dizziness, or trouble breathing.Vomiting is a common side effect of this medication. Contact the applicable plan It is a retrospective study with a small number of patients. palifermin increases toxicity of carboplatin by Other (see comment). Immunosuppressive drugs may reduce the immune response to influenza vaccine. Our results should be interpreted with caution in regard to the weaknesses and strengths of this study. CARBOPLATIN-TAXOL is used to treat: Carcinoma of unknown primary. Coadministration may increase risk of myelosuppressive effects. Carboplatin is also used in a variety of malignancies such as ovarian cancer, bladder cancer, metastatic breast cancer, cervical cancer, esophageal cancer, head and neck cancer, lymphoma, lung cancer, unknown primary adenocarcinoma and testicular cancer. Either increases toxicity of the other by pharmacodynamic synergism. A total of 15 hAEs occurred, with a mean of 1.7 hAEs per patient, 87% (13/15) of them were of grade 1and no clinical interventions were necessary. carboplatin, cyclophosphamide. Use Caution/Monitor. MISSED DOSE: It is important to get each dose of this medication as scheduled. Monitor Closely (1)carboplatin decreases effects of sipuleucel-T by pharmacodynamic antagonism. Use Caution/Monitor. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Using healthcare services efficiently without compromising patients safety will become increasingly important in the future in view of rising healthcare costs, economic constraints and other limitations for healthcare services. Use Caution/Monitor. Carboplatin Injection is usually administered by an infusion lasting 15 minutes or longer. No clinical interventions were necessary. Use Caution/Monitor. carboplatin, streptozocin. Carboplatin is apparently not cell-cycle specific. The Cmax values and areas under the plasma concentration versus time curves from 0 to infinity (AUC inf) increase linearly with dose, although the increase was slightly more than dose proportional. Accessibility A six-weekly dosing schedule for pembrolizumab in patients with cancer based on evaluation using modelling and simulation [pub - lished correction appears in Eur J Cancer. Results Practice pattern studies demonstrate that up to 40% of obese patients receive limited chemotherapy doses that are not based on actual body weight. contraindicated; D/C carboplatin at least 7 days prior to cidofovir tx: combo may incr. No excess of toxicity occurs in patients with carboplatin dosingbased onCrea-Cl greater than 125mL/min. Additive myelosuppression. Always ask your health care professional for complete information about this product and your specific health needs. Use Caution/Monitor. The chemotherapy drug is usually administered intravenously. Most Either increases effects of the other by immunosuppressive effects; risk of infection. Unfortunately, only 22% (10 of 45 studies) compared the target AUC and measured AUC (6-15). Use Caution/Monitor. commonly, these are "preferred" (on formulary) brand drugs. Use Caution/Monitor. This guideline does not address dosing for novel targeted agents. Avoid concurrent or sequential use to decrease risk for ototoxicity. In 36 patients with Crea-Cl<125mL/min, a total of 74 hAEs (81% grade 1) were documented, corresponding to a mean of 2.1 (95%CI 1.8 to 2.6) hAEs per patient. Avoid or Use Alternate Drug. Coadministration with other other myelosuppressive anticancer agents, including DNA damaging agents, may potentiate and prolongate the myelosuppressive toxicity. 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. Comment: Palifermin should not be administered within 24 hrbefore, during infusion of, or within 24 hr after administration of antineoplastic agents. The products discussed herein may have different product labeling in different countries. No statistically significant differences between Crea-Cl>125mL/min (no capping) versus capping at Crea-Cl 125mL/min were found. Either increases effects of the other by immunosuppressive effects; risk of infection. This drug is available at the lowest co-pay. Avoid or Use Alternate Drug. Monitor Closely (1)carboplatin and vancomycin both increase nephrotoxicity and/or ototoxicity. There were no statistically significant differences nor trends between different cohorts. Carboplatin has no appreciable schedule-dependent activity and even in low-dose weekly fractions requires antiemetics. Please read the attached PDF for the complete article, which includes: Ascension Seton Physician Resource Line 512.324.0129, COVID-19 Emergency Healthcare Provider Questionnaire, Carboplatin_Dosing_2nd_draft_DrLink.pdf (.pdf), Cerner Mobile Apps Now Available for Provider Use, Attention Providers: e-Prescribing of Controlled Substances (EPCS) is now live, Dell Seton Medical Center at The University of Texas, Dell Children's Medical Center of Central Texas. In general, however, single intermittent courses of Carboplatin Injection should not be repeated until the neutrophil count is at least 2,000 and the platelet count is at least 100,000. Monitor Closely (1)dichlorphenamide and carboplatin both decrease serum potassium. 2nd ed. Use Caution/Monitor. Common side effects include low blood cell levels, nausea, and electrolyte problems. Our scientific content is evidence-based, scientifically balanced and non-promotional. . There is no known antidote for Carboplatin Injection overdosage. Use Caution/Monitor. Submit a medical question for Pfizer prescription products. Therefore this study provides a rationale to concentrate any blood count analyses at the time when the thrombocytenadir and white cell/neutrophilnadir are most likely to occur (median day 15 and day 22, respectively)if the treating physician regards a routine analysis necessary. Shepherd ST, Gillen G, Morrison P, et al.. This effect is apparently cell-cycle nonspecific. Carboplatin and gemcitabine drug monographs, Cancer Care Ontario. sharing sensitive information, make sure youre on a federal The exposure to carboplatin is well characterized by its AUC, which is associated with its antineoplastic activity as well as toxicity. Most It is primarily excreted by the kidneys via tubular filtration. Carboplatin may harm an unborn baby. Monitor Closely (1)adefovir and carboplatin both increase nephrotoxicity and/or ototoxicity. Calvert AH, Newell DR, Gumbrell LA, et al. Use Caution/Monitor. Carboplatin Injection - 300 mg/m 2 IV on day 1 every four weeks for six cycles (alternatively see Formula Dosing ). Unlike cisplatin, it has minimal protein binding and distributes well into ascites, pleural fluid, liver, kidney, skin and tumor tissues. NOTES: Laboratory and/or medical tests (such as complete blood counts, kidney function tests, blood mineral levels) should be performed to monitor your progress or check for side effects. Concomitant therapy is expected to increase the risk of immunosuppression. Use Caution/Monitor. Antioxidants such as vitamin E enhance the efficacy, and reduce toxicity, of antineoplastic drugs. Immunosuppressive therapies may reduce immune response to H5N1 vaccine. Thymoma or thymic carcinoma that is advanced and has not been treated. Additive myelosuppression. hbbd```b``Y"@$:T7A$W] lF X To avoid toxicity, FDA recommends capping the carboplatin dose for a desired AUC. The .gov means its official. If you prefer, you may contact the U.S. Food and Drug Administration (FDA) directly by visiting www.fda.gov/medwatch or by calling (800)-332-1088. Either increases toxicity of the other by pharmacodynamic synergism. carboplatin, dacarbazine. A simple formula for calculating dosage, based upon a patient's glomerular filtration rate (GFR in mL/min) and Carboplatin Injection target area under the concentration versus time curve (AUC in mg/mLmin), has been proposed by Calvert. The practice of carboplatin dosing is not concordant among different centres and oncologistsfor example, some may use measured actual glomerular filtration rate (GFR) by a radioisotope method, while others prefer to use formula-based estimations of creatinine-clearance (Crea-Cl) from a single serum-creatinine value for the dose calculation according to the Calvert-formula1 2; in addition, the issue of dose capping versus non-capping in patients with very high GFR is not resolved. Dosing of Carboplatin Dosing for carboplatin is far different than dosing for cisplatin. sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of carboplatin by Other (see comment). In addition, we analysed the pattern of acute hAEs to offer guidance for monitoring. Carboplatin injection should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. The study was approved by the respective local ethical committees. Use Caution/Monitor. In order to provide you with relevant and meaningful content we need to know more about you. De-escalation Strategy in Seminoma: An Alternative Option? The revised manuscript has been seen and approved by all authors. Modify Therapy/Monitor Closely. However, due to the small number of patients in this subgroup (n=9), these results should be interpreted with caution. Monitor Closely (1)carboplatin, chlorambucil. Either increases effects of the other by immunosuppressive effects; risk of infection. Day 1: Docetaxel 60-75mg/m 2 IV over 60 minutes, followed by: Day 1: Carboplatin AUC 5-6 IV over 30 minutes. Immunosuppressive drugs may reduce the immune response to influenza vaccine. See: Some experts and clinical guidelines (Food and Drug Administration, American Societyof Clinical Oncology, Gynecologic Oncology Group) recommend capping of the carboplatin dose at a creatinine-clearance (Crea-Cl) of 125mL/min because of concerns of excessive toxicity. Monitor Closely (1)carboplatin decreases levels of phenytoin by unknown mechanism. Bone marrow suppression (leukopenia, neutropenia, and thrombocytopenia) is dose-dependent and is also the dose-limiting toxicity. Appropriate chemotherapy dosing for obese adult patients with cancer: American Society of Clinical Oncology clinical practice guideline. Either increases toxicity of the other by pharmacodynamic synergism. J Clin Oncol. Patient / Caregiver. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Avoid concurrent or sequential use to decrease risk for ototoxicity. These nine cases were analysed separately: themean age was 37 years (range 2256), and the mean carboplatin dose administered was 12.9% lower than the full dose calculated for AUC 7 (median difference 148mg; range 45344mg). 10mg/mL (in vials of 50, 150, 450, and 600 mg), 175 mg/m qWeek x 4 weeks with a 2 weeks recovery period between courses, 1-2 mL subconjunctival injection of 10 mg/mL solution per dose, influenza virus vaccine quadrivalent, adjuvanted, influenza virus vaccine trivalent, adjuvanted, elvitegravir/cobicistat/emtricitabine/tenofovir DF, influenza virus vaccine (H5N1), adjuvanted, sodium sulfate/?magnesium sulfate/potassium chloride, sodium sulfate/potassium sulfate/magnesium sulfate, 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, Median nadir occurs at day 21 in patients receiving single-agent carboplatin; in general, single intermittent courses should not be repeated until leukocyte, neutrophil, and platelet counts have recovered, Since anemia is cumulative, transfusions may be needed during treatment, particularly in patients receiving prolonged therapy; bone marrow suppression is increased in patients who have received prior therapy, especially regimens including cisplatin, 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, 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, Unreconstituted vials: Stable at controlled room temperature (20-25C [68-77F]); protect from light, Reconstituted vials and diluted solutions: Stable for 8 hr at room temperature (25C [77C]); since no antibacterial preservative is contained in the formulation, discard 8 hr after dilution, Unopened multidose vials: Stable to the date indicated on the package when stored at 20-25C (68-77F) and protected from light, Multidose vials maintain microbial, chemical, and physical stability for up to 14 days at 25C following multiple needle entries. Monitor Closely (1)busulfan, carboplatin. Use Caution/Monitor. Clinical data to support such recommendations are lacking, especially in patients with seminoma. Use Caution/Monitor. Monitor Closely (1)carboplatin decreases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor.carboplatin, streptozocin. Use Caution/Monitor. A higher relapse rate with 1 vs. 2 cycles has been seen when comparing different studies, and a higher risk of relapse was reported among patients receiving an inadequate dose of carboplatin in the MRC/EORTC trial (Dieckmann et al., 2000; Oliver et al., 2008). Anemia is cumulative, Vomiting is a frequent adverse effect and is dose related, Severe hypersensitivity to carboplatin, other platinum compounds, mannitol, Severe myelosuppression, significant bleeding, Pediatric patients, elderly, renal impairment, hearing impairment, neuropathy, neuromuscular disease, prior cisplatin treatment, concomitant neurotoxic agents, concomitant ototoxic agents, 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, 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, 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.
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