Carboplatin

Carboplatin is a type of chemotherapy drug. It is a treatment for a number of different cancer types.

You pronounce carboplatin as car-bo-pla-tin.

You can have carboplatin by itself or in combination with other chemotherapy drugs. This depends on the type of cancer you have.

You might also have carboplatin as part of a clinical trial.

How does carboplatin work?

Carboplatin is one of a group of drugs called alkylating agents, which is a type of chemotherapy

Carboplatin works by sticking to one of the cancer cell's DNA strands. DNA is the genetic code that is in the nucleus of all animal and plant cells. It controls everything the cell does. The cell cannot then grow and divide into 2 new cells.

How do you have carboplatin?

You have carboplatin as a drip into your bloodstream (intravenously). 

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

If you don't have a central line

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.

How often do you have carboplatin?

You have carboplatin as a course of several cycles of treatment . Each cycle varies depending on what type of cancer you have.

Each treatment of carboplatin takes between 15 to 60 minutes. The amount of time you have carboplatin over will depend on your treatment plan.

Your healthcare team can give you more details about your treatment plan.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of carboplatin?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increased risk of getting an infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums and nosebleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Less commonly you might also bleed from other areas of the body. For instance, some people might notice their poo is quite dark or they might pass fresh blood.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Changes to how your liver works

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Kidney damage

To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.

Tummy (abdominal) cramps and pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Low level of minerals in the blood

Carboplatin can cause low levels of minerals such as sodium, potassium, calcium and magnesium in your blood. Some minerals are more likely to cause symptoms than others. Low calcium and magnesium could cause muscle cramping or twitching. In most cases low mineral levels are picked up on blood tests. 

You have regular blood tests during treatment to check this. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness. Some allergic reactions can be life threatening. Alert your nurse or doctor if notice any of these symptoms
• diarrhoea
• constipation
• sore mouth and ulcers - use mouthwashes to keep your mouth clean and let your team know if you need painkillers
• numbness and tingling in arms, hands, legs and feet (peripheral neuropathy). This can happen soon after starting treatment and usually isn't permanent
• hearing problems - this can be ringing in your ears (tinnitus) or changes to your hearing
• hair loss - this can be either thinning of the hair or complete loss and is not usually permanent
• loss of taste or changes to how food and drink tastes - your taste should return after treatment is finished
• changes to your vision including your eyesight getting worse. This is temporary and should return to normal after treatment
• changes to the way your heart works. Symptoms might include feeling tired, short of breath and lacking energy. Your doctor will do tests if they are worried you have heart changes
• sore or painful muscles, joints and bones
• problems with passing urine - drink plenty of water and tell your nurse or doctor
• inflammation of the lungs. This can cause shortness of breath and a cough. Let your healthcare team know straight away if you are finding it difficult to breathe
• wheezing and tightness of the chest
• tiredness and weakness (fatigue)

Other side effects

The following side effects have also been reported. But it's not clear how often they happen. You might have one or more of them. They include:

• a stroke. Symptoms can include drooping of one side of the face, being unable to smile, having numbness or weakness on one side of the body or being unable to talk. Dial 999 immediately if you have these symptoms
• loss of appetite
• blood clots that can be life threatening; signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your healthcare team straight away if you have any of these symptoms
• changes to your blood pressure - this can be either high or low
• pain, redness or swelling at the injection site. Tell your nurse straight away as this can cause damage to the tissue
• not enough fluid in the body (dehydration) - drink plenty of fluids
• inflammation of the pancreas which can cause tummy pain and feeling or being sick
• a rare disorder of the nerves causing headache, confusion and changes of vision, Contact your healthcare team straight away, this condition is reversible
• a kidney condition that can cause bloody diarrhoea, vomiting, fever, bloating, tummy pain or cramping. Contact your team straight away if you have these symptoms
• developing a second cancer
• a blood disorder where your red blood cells get destroyed faster than they can be made (haemolytic anaemia)
• small blood clots in the blood vessels inside the kidney (haemolytic uremic syndrome). Symptoms can include bloody diarrhoea, weakness, high temperature or being sick
• feeling generally unwell
• changes to the levels of chemicals in your blood due to the breakdown of tumour cells (tumour lysis syndrome). You have regular blood tests to check for this

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, food and drink

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Contraception and pregnancy

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. 

Women must use reliable contraception during treatment. Men must use reliable contraception during treatment and for at least 6 months afterwards. 

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.