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carmustine

Generic Name: carmustine (kar MUS teen)
Brand Name: BiCNU, Gliadel

What is carmustine?

Carmustine is a cancer medicine that interferes with the growth and spread of cancer cells in the body.

Carmustine is used to treat brain tumors, Hodgkin's disease, multiple myeloma, and non-Hodgkin's lymphoma.

Carmustine is sometimes given with other cancer medicines.

Carmustine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about carmustine?

Carmustine can lower blood cells that help your body fight infections and help your blood to clot. Carmustine can also cause serious lung problems. You will need frequent medical tests while receiving this medicine. Call your doctor if you have unusual bruising or bleeding, tiredness, weakness, or breathing problems.

What should I discuss with my healthcare provider before receiving carmustine?

You should not be treated with carmustine if you are allergic to it.

To make sure carmustine is safe for you, tell your doctor if you have ever had:

  • lung disease or breathing problems;

  • bone marrow suppression; or

  • kidney disease.

Carmustine may harm an unborn baby. Use effective birth control to prevent pregnancy while you are receiving this medicine.

It is not known whether carmustine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while receiving this medicine.

How is carmustine given?

Carmustine is injected into a vein through an IV. A healthcare provider will give you this injection.

Carmustine is usually given once every 6 weeks. You may be given either a single injection, or multiple injections over a 2-day period. You may also be given medication to prevent nausea or vomiting. Follow your doctor's dosing instructions very carefully.

Tell your caregivers if you feel any burning or pain around the IV needle when carmustine is injected.

Carmustine can lower blood cells that help your body fight infections and help your blood to clot. Carmustine can also cause serious lung problems, especially if you receive high doses. You will need frequent medical tests to check your blood cells and lung function. Your cancer treatments may be delayed based on the results of these tests.

Carmustine can have long-lasting effects on your body. Your blood will need to be tested weekly for at least 6 weeks after each dose.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your carmustine injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving carmustine?

This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Carmustine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You may have an infusion reaction during the injection or within 2 hours afterward. This may include eye redness, skin redness, and severe warmth or tingling under your skin.

Some side effects may not occur until 4 to 6 weeks after your carmustine injection.

Call your doctor at once if you have:

  • easy bruising, unusual bleeding (may last for 1 or 2 weeks);

  • shortness of breath (especially with exertion);

  • a seizure (convulsions);

  • a dry cough or hack, rapid but shallow breathing;

  • unexplained weight loss;

  • tiredness, body aches;

  • clubbing (widening and rounding) of your fingertips or toes;

  • little or no urination; or

  • pain, burning, swelling, or skin changes where the injection was given.

Common side effects may include:

  • bleeding, bruising;

  • tiredness;

  • nausea, vomiting; or

  • breathing problems.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side effects (complete list)

Carmustine dosing 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.

What other drugs will affect carmustine?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cimetidine;

  • phenobarbital; or

  • phenytoin.

This list is not complete. Other drugs may interact with carmustine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about carmustine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01.

Date modified: November 15, 2017
Last reviewed: September 19, 2017

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