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BiCNU (carmustine) Disease Interactions

There are 5 disease interactions with BiCNU (carmustine):

Major

Carmustine (applies to BiCNU) pulmonary infiltrates/fibrosis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

Pulmonary toxicity characterized by pulmonary infiltrates and/or fibrosis has been reported during carmustine therapy. Toxicity has occurred within nine days of initiation of therapy at doses usually > 1400 mg/m2. However, cases of delayed onset pulmonary fibrosis occurring up to 17 years after treatment have also been reported. Late reduction in pulmonary function, progressive fibrosis, and death have been noted. Risk factors include past history of lung disease and duration of treatment. Therapy with carmustine should be administered cautiously in patients with a history of pulmonary disease. Pulmonary function studies prior to and during therapy are recommended.

References

  1. Lena H, Desrues B, Le Coz A, Quinquenel ML, Delaval P "Severe diffuse interstitial pneumonitis induced by carmustine (BCNU)." Chest 105 (1994): 1602-3
  2. Sweet DL "Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU)." Ann Intern Med 91 (1979): 132-3
  3. Weinstein AS, Diener-West M, Nelson DF, Pakuris E "Pulmonary toxicity of carmustine in patients treated for malignant glioma." Cancer Treat Rep 70 (1986): 943-6
  4. Patten GA, Billi JE, Rotman HH "Rapidly progressive, fatal pulmonary fibrosis induced by carmustine." JAMA 244 (1980): 687-8
  5. Weiss RB, Muggia FM "Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU)." Ann Intern Med 91 (1979): 131-2
  6. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  7. O'Driscoll BR, Kalra S, Gattamaneni HR, Woodcock AA "Late carmustine lung fibrosis. Age at treatment may influence severity and survival." Chest 107 (1995): 1355-7
View all 7 references
Major

Nitrosoureas (applies to BiCNU) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Nitrosoureas can induce delayed myelosuppression. The use of nitrosoureas may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with nitrosoureas. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nitrosoureas (applies to BiCNU) myelosuppression

Major Potential Hazard, High plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, Fever, Bleeding

Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.

References

  1. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Carmustine/lomustine- renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Renal abnormalities such as azotemia, and progressive decline in renal function have been reported after prolonged therapy with large doses of carmustine and lomustine. Lower total doses have also resulted in kidney damage. Therapy with carmustine or lomustine should be administered cautiously in patients with a history of or predisposition to renal dysfunction. Clinical monitoring of renal function is recommended.

References

  1. Seffart G ed. "Drug Dosage in Renal Insufficiency." Dordrecht, South Holland, : Kluwer Academic Publishers (1991):
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
  4. Weiss RB, Poster DS "THE RENAL TOXICITY OF CANCER CHEMOTHERAPEUTIC AGENTS." Cancer Treat Rev 9 (1982): 37-561982
  5. Ellis ME, Weiss RB, Kuperminc M "Nephrotoxicity of lomustine. A case report and literature review." Cancer Chemother Pharmacol 15 (1985): 174-5
View all 5 references
Minor

Nitrosoureas (applies to BiCNU) hepatic dysfunction

Minor Potential Hazard, Low plausibility. Applicable conditions: Liver Disease

A reversible increase in liver transaminase, alkaline phosphatase, and bilirubin levels has been reported during therapy with nitrosoureas. Therapy with nitrosoureas should be administered cautiously in patients with a history of or predisposition to compromised hepatic function.

References

  1. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.

BiCNU (carmustine) drug interactions

There are 208 drug interactions with BiCNU (carmustine)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.