On the part of the organs of hematopoiesis: the main toxic factor limiting the dose of carboplatin, is the suppression of bone marrow hematopoiesis. Myelosuppression is dose-dependent. The lowest level of platelets and white blood cells / granulocytes is usually achieved 2-3 weeks after the start of the drug, with thrombocytopenia occurring more often. Adequate recovery to indicators that allow the next dose of carboplatin to take, usually takes at least 4 weeks. A sufficiently large number of patients may also exhibit symptoms of anemia (hemoglobin value less than 11 g / dl), the intensity of which depends on the total dose of the drug. It may be necessary to perform transfusion therapy, especially in patients undergoing long-term treatment (for example, more than 6 cycles of drug administration). There is also the possibility of clinical complications such as fever, infectious diseases, sepsis / septic shock and carboplatin (decreased clearance of bleeding.
From the gastrointestinal tract: in the first 6-12 hours after taking the drug, there is a possibility of nausea and / or vomiting, which lasts up to 24 hours or longer. The risk of emetic effect can be reduced by carrying out preventive therapy with antiemetic agents. In some cases, other types of adverse effects on the gastrointestinal tract, such as inflammation of the oral mucosa, diarrhea, constipation, and abdominal pain, may also occur.
From the side of the central nervous system and the peripheral nervous system: there is a possibility of occurrence of peripheral neuropathies, mainly in the form of paresthesia and reduction of deep tendon reflexes, which is more likely for patients older than 65 years with prolonged or previous treatment with cisplatin. It is also possible the appearance of symptoms of a violation of the central nervous system. Long-term therapy with the drug may lead to cumulative neurotoxicity.
From the side of the kidneys: there may be a temporary increase in the concentrations of creatinine and urea in the blood serum. There may be acute kidney damage. The risk of the appearance of nephrotoxicity on the background of admission can be observed easily and, as a rule,a temporary increase in the concentrations of ACT, creatinine) increases with an increase in the dose of carboplatin, as well as in patients who have previously been treated with cisplatin.
From the electrolyte balance: hypokalemia, hypocalcemia, hyponatremia and / or hypomagnesemia are possible.
Allergic reactions: erythematous rash, fever, itching, urticaria, bronchospasm, arterial hypotension and anaphylactic reactions. These reactions can occur only a few minutes after the administration of carboplatin. Exfoliative dermatitis may occur.
From the organ of hearing: ototoxicity manifests itself in the form of noise in the ears and hearing impairment.
On the part of the visual system: there is a possibility of temporary deterioration or complete loss of vision (possible loss of ability to distinguish colors and see light), as well as other visual impairment. Improvement and / or complete restoration of vision, usually occurs within a few weeks after discontinuation of the drug. In patients with impaired renal function, treated with high doses of carboplatin, cortical blindness was observed.
From the hepatobiliary system: there may be a temporary increase in alkaline phosphatase, a concentration of bilirubin in the blood serum. In patients who received high doses of carboplatin with autologous bone marrow transplantation, significant violations of the liver function were observed.
Local reactions: pain at the injection site, allergic reactions.
Other side effects: changes in taste, alopecia, asthenia, influenza-like symptoms (fever, fever), haemolytic-uremic syndrome, myalgia / arthralgia, heart failure, cerebrovascular disorders.