Medication Guide App

Carmustine Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Brain/Intracranial Tumor

For use as a single agent in previously untreated patients: 150 to 200 mg/m2 IV every 6 weeks. This dose can be given as a single or divided daily injections (75 to 100 mg/m2 on two successive days). When used with other myelosuppressive drugs or in patients in whom bone marrow reserve is depleted, doses should be adjusted accordingly. A repeat course should not be administered until platelets are >100,000/mm3 and leukocytes are >4,000/mm3. An adequate number of neutrophils should be present on a peripheral blood smear. Blood counts should be monitored weekly. Repeat courses should not be administered before 6 weeks because of delayed and cumulative toxicity.

Usual Adult Dose for non-Hodgkin's Lymphoma

For use as a single agent in previously untreated patients: 150 to 200 mg/m2 IV every 6 weeks. This dose can be given as a single or divided daily injections (75 to 100 mg/m2 on two successive days). When used with other myelosuppressive drugs or in patients in whom bone marrow reserve is depleted, doses should be adjusted accordingly. A repeat course should not be administered until platelets are >100,000/mm3 and leukocytes are >4,000/mm3. An adequate number of neutrophils should be present on a peripheral blood smear. Blood counts should be monitored weekly. Repeat courses should not be administered before 6 weeks because of delayed and cumulative toxicity.

Usual Adult Dose for Hodgkin's Disease

For use as a single agent in previously untreated patients: 150 to 200 mg/m2 IV every 6 weeks. This dose can be given as a single or divided daily injections (75 to 100 mg/m2 on two successive days). When used with other myelosuppressive drugs or in patients in whom bone marrow reserve is depleted, doses should be adjusted accordingly. A repeat course should not be administered until platelets are >100,000/mm3 and leukocytes are >4,000/mm3. An adequate number of neutrophils should be present on a peripheral blood smear. Blood counts should be monitored weekly. Repeat courses should not be administered before 6 weeks because of delayed and cumulative toxicity.

Usual Adult Dose for Multiple Myeloma

For use as a single agent in previously untreated patients: 150 to 200 mg/m2 IV every 6 weeks. This dose can be given as a single or divided daily injections (75 to 100 mg/m2 on two successive days). When used with other myelosuppressive drugs or in patients in whom bone marrow reserve is depleted, doses should be adjusted accordingly. A repeat course should not be administered until platelets are >100,000/mm3 and leukocytes are >4,000/mm3. An adequate number of neutrophils should be present on a peripheral blood smear. Blood counts should be monitored weekly. Repeat courses should not be administered before 6 weeks because of delayed and cumulative toxicity.

Usual Adult Dose for Glioblastoma Multiforme

polifeprosan 20 with carmustine implant (brand name = Gliadel Wafer):
Each wafer contains 7.7 mg of carmustine, resulting in a dose of 61.6 mg when eight wafers are implanted. It is recommended that eight wafers be placed in the resection cavity if the size and shape of it allows. Should the size and shape not accommodate eight wafers, the maximum number of wafers as allowed should be placed. Since there is no clinical experience, no more than eight wafers should be used per surgical procedure.

Usual Adult Dose for Malignant Glioma

polifeprosan 20 with carmustine implant (brand name = Gliadel Wafer):
Each wafer contains 7.7 mg of carmustine, resulting in a dose of 61.6 mg when eight wafers are implanted. It is recommended that eight wafers be placed in the resection cavity if the size and shape of it allows. Should the size and shape not accommodate eight wafers, the maximum number of wafers as allowed should be placed. Since there is no clinical experience, no more than eight wafers should be used per surgical procedure.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

The following guidelines are recommended following the initial dose of carmustine injection:

If the nadir following the initial dose includes a leukocyte count >=3,000/mm3 and the platelet count is >75,000/mm3, then 100% of the dose may be repeated.

If the nadir following the initial dose includes a leukocyte count of 2,000 to 2,999/mm3 or the platelet count is 25,000-74,999/mm3, then 75% of the dose may be repeated.

If the nadir following the initial dose includes a leukocyte count <2,000/mm3 or the platelet count is <25,000/mm3, then 50% of the dose may be repeated.

Precautions

Carmustine should only be administered under the supervision of a qualified physician who is experienced in the use of cancer chemotherapeutic agents.

Bone marrow suppression (primarily thrombocytopenia and leukopenia) is the most severe and common of the toxic effects. Bone marrow toxicity from carmustine is cumulative. Because delayed bone marrow suppression is the major toxicity, blood counts should be monitored weekly for at least six weeks after a dose.

Delayed pulmonary toxicity may occur years after treatment and may result in death. Baseline pulmonary function studies should be conducted along with frequent pulmonary function tests during treatment.

Pulmonary toxicity from carmustine appears to be dose related. Patients receiving greater than 1400 mg/m2 cumulative dose are at significantly higher risk than those receiving less.

Periodic monitoring of renal and hepatic function tests is also recommended.

Long-term use of nitrosoureas has been associated with the development of secondary malignancies.

Injection site reactions may occur during the administration of carmustine. Given the possibility of extravasation, close monitoring of the infusion site for possible infiltration during drug administration is recommended.

Local soft tissue toxicity has been reported following extravasation of carmustine. Infiltration of carmustine may result in swelling, pain, erythema, burning sensation, and skin necrosis. A specific treatment for extravasation reactions is unknown at this time.

Dialysis

Data not available

Hide
(web4)