How is carboplatin given?
It is given as an infusion into a vein (intravenously or IV) through a cannula, central venous catheter or implantable port.
What are the side effects of carboplatin?
Nausea and vomiting
Anti-sickness drugs can be given to reduce or prevent these symptoms. Please tell your doctor or nurse if your child’s sickness is not controlled or persists.
Bone marrow suppression
There will be a temporary reduction in how well your child’s bone marrow works. This means he or she may become anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising or bleeding, or any signs of infection, especially a high temperature.
Altered kidney function
Carboplatin may change how well your child’s kidneys work over a period of time. Your child may have a blood and urine test or a GFR (Glomerular Filtration Rate) before treatment is started and then at stages during and after treatment to monitor kidney function.
Changes in hearing
As your child’s treatment progresses, he or she may not initially be able to hear high pitched sounds. If further treatment with carboplatin is necessary, then your child’s hearing may deteriorate further. Your child will have a hearing test before and during the course of treatment and at long-term follow up clinics. If your child develops a hearing loss, please discuss this with your doctor or nurse. If your child is of school age, it will also be necessary to discuss this with your child’s teachers.
Temporary effect on liver function
Carboplatin can sometimes cause some mild changes to your child’s liver function. This should return to normal when the treatment is finished. Blood tests will be taken to monitor your child’s liver function.
Your child may lose all of his or her hair, or it may become thinner. This is temporary and the hair will grow back once the treatment has finished.
Some children receiving carboplatin may have an allergic reaction to the drug. This reaction may be mild to severe. Signs of a mild allergic reaction include skin rashes and itching, high temperature, shivering, redness of the face, a feeling of dizziness or a headache. If you see any of these signs, please report them to a doctor or nurse. Signs of a severe allergic reaction include any of the above, as well as shortness of breath or chest pain. If you are in hospital and your child shows signs of a severe allergic reaction, call a doctor or nurse immediately. If you are at home and your child shows signs of a severe allergic reaction, call an ambulance immediately.
Carboplatin and interactions with other medicines
Some medicines can react with carboplatin, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.
Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.
For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.
For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.