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Carboplatin and etoposide

Carboplatin and etoposide are chemotherapy drugs you have together. You might have them as a treatment for a number of different cancer types.

How carboplatin and etoposide work

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have carboplatin and etoposide

You usually have carboplatin and etoposide into your bloodstream (intravenously). 

You might also have etoposide as capsules. They are pink in colour. You take them on an empty stomach with a glass of water.

Into your bloodstream

You 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 each time you have treatment.

Taking your capsules

You must take your capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When you have carboplatin and etoposide

You have carboplatin and etoposide as cycles of treatment. This means that you have the drugs and then a rest to allow your body to recover. Each cycle of treatment lasts 3 weeks (21 days).

Depending on your cancer type you may have between 4 and 6 cycles.

This is one way of having carboplatin and etoposide:

Day 1
  • you have carboplatin as a drip over 1 hour
  • you have etoposide as a drip over 1 hour
Day 2 and 3
  • you have etoposide as a drip over 1 hour
  • OR
  • you take etoposide capsules
Day 4 to 21
  • You have no treatment

You then start a new cycle of treatment.

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.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely 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. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

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

Increased risk of 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. 

Bruising, bleeding gums or nose bleeds

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 petechia).

Less commonly you might bleed from other areas of the body. Tell your medical team if you notice any bleeding.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all 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 treating it once it has started.

Tummy (abdominal) pain

Tell your doctor or nurse if you have this. They can check for the cause of the pain and give you medicine to help. 

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Feeling generally unwell

Speak to your doctor or nurse if you feel generally unwell after taking this drug.

Tiredness and weakness

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Changes in the levels of minerals, proteins and enzymes in your body

Your blood contains different levels of minerals, proteins and enzymes. This treatment can change the levels of calcium, phosphate, magnesium, sodium, potassium, creatinine, and urea in your blood.

You have regular blood tests to check for any changes in these levels. 

Liver changes

You might have liver changes that can cause yellowing of the skin and whites of the eyes. This is called jaundice. It is caused by high levels of bile pigments in the blood. Let your doctor or nurse know straight away if you have this.

You might also have changes in the levels of liver enzymes.

You have regular blood tests to check for any changes in the way your liver is working.

Changes in skin colour

Areas of skin may get darker or lighter. This usually gets better after treatment finishes but occasionally it can be permanent. Let your doctor or know if this happens.

Sore mouth, throat and lips

Your mouth, throat and lips might get sore. It may be painful to swallow drinks or food. You will have mouth washes to keep your mouth healthy. You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.

Tell your doctor or nurse if your mouth and throat is sore.

Changes to your taste

Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually goes back to normal a few weeks after your treatment finishes.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 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. Contact your treatment team if notice any of these symptoms
  • a heart attack – you’ll be closely monitored when having this treatment
  • changes to the way your heart works, including an irregular heart beat (arrhythmia) - your doctor will do tests to check for this
  • difficulty breathing due to tightening or inflammation of the lung tissue – symptoms include shortness of breath, cough, wheezing or tightness of the chest. Let your nurse or doctor know straight away if you have this
  • numbness and tingling in your arms, hands, legs and feet
  • skin changes such as a rash, dry and itchy skin or sensations of burning and prickling
  • low or high blood pressure
  • dizziness
  • eyesight changes – such as temporary loss of sight, blurred vision, eye pain, flashes of light, or floaters (tiny spots that appear in your vision)
  • hearing changes that might cause ringing in the ears (tinnitus), part or total hearing loss in one or both ears and feeling of fullness in the ear
  • inflammation around the drip site which can cause pain and swelling
  • a second cancer called acute leukaemia
  • kidney damage – you have blood tests before treatment to check how well your kidneys are working
  • loose or watery poo (diarrhoea)
  • reddening of the skin in areas treated with radiotherapy

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening
  • high temperature (fever)
  • difficulty swallowing
  • feeling sleepy
  • seizures (fits)
  • swelling of the skin most commonly your lips, tongue, around the eyes, feet, and hands – this can happen suddenly or develop over a few hours. Let your nurse or doctor know straight away

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:

  • blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
  • inflammation of your pancreas – symptoms include severe tummy pain, feeling or being sick, a high temperature or you may have loose poo
  • a rare disorder of the nerves causing headache, fits, confusion and changes in vision - contact your health team straight away, this condition is reversible
  • high levels of chemicals in your blood due to the breakdown of tumour cells - you will 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, foods and drinks

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards.

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.

Loss of fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

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 the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • 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 oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

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

Information and help

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