carmustine

Generic Name: carmustine (kar MUS teen)

Brand Names: BiCNU, Gliadel

What is carmustine?

Carmustine is a cancer medication 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 medications.

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

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

Do not use carmustine if you are pregnant. It could harm the unborn baby. You should not use this medication if you are allergic to carmustine.

Before receiving carmustine, tell your doctor if you have bone marrow suppression, liver or kidney disease, or a history of lung or breathing problems.

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

Carmustine can cause nausea and vomiting that may last up to 6 hours after your injection. Carmustine can lower blood cells that help your body fight infections. Your blood will need to be tested weekly for at least 6 weeks after you receive a dose of carmustine. Your kidneys, liver, and lung function may also need to be tested. Do not miss any follow-up visits to your doctor.

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

You should not receive this medication if you are allergic to it.

To make sure you can safely receive carmustine, tell your doctor if you have any of these other conditions:

• 
  

  bone marrow suppression;

  
  


• liver disease;


• kidney disease; or


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  a history of lung or breathing problems.

  
  

FDA pregnancy category D. Do not use carmustine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether carmustine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are being treated with carmustine.

How is carmustine given?

Carmustine is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Carmustine must be given slowly, and the IV infusion can take at least 2 hours to complete.

Carmustine is usually given once every 6 weeks. You may be given either a single injection or multiple injections over a 2-day period. 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 cause nausea and vomiting that may last up to 6 hours after your injection. You may be given anti-nausea medications to help prevent these side effects.

Carmustine can lower blood cells that help your body fight infections. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests. Visit your doctor regularly.

To be sure your blood cells do not get too low, your blood will need to be tested weekly for at least 6 weeks after you receive a dose of carmustine. This medication can have long-lasting effects on your body. Your kidneys, liver, and lung function may also need to be tested. Do not miss any follow-up visits to your doctor for blood or urine tests.

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.

Overdose symptoms may include severe forms of the serious side effects listed in this medication guide.

What should I avoid while receiving carmustine?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Carmustine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

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  new or worsening cough, fever, trouble breathing;

  
  


• 
  

  feeling short of breath on exertion;

  
  


• 
  

  chest discomfort, dry cough or hack;

  
  


• 
  

  feeling weak or tired, loss of appetite, rapid weight loss;

  
  


• 
  

  fever, chills, body aches, flu symptoms, sores in your mouth and throat;

  
  


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  easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  
  


• 
  

  pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

  
  


• 
  

  urinating less than usual or not at all;

  
  


• 
  

  drowsiness, confusion, mood changes, increased thirst, swelling, weight gain, feeling short of breath;

  
  


• 
  

  severe burning, irritation, or skin changes where the injection was given; or

  
  


• 
  

  redness of your eyes or skin and severe warmth or tingling under your skin (within 2 to 4 hours after your carmustine injection).

  
  

Less serious side effects may include:

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  nausea, vomiting;

  
  


• 
  

  headache; or

  
  


• 
  

  mild pain, swelling, redness, or darkened skin color where the injection was given.

  
  

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.

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 other medications you use, especially cimetidine (Tagamet).

There may be other drugs that can interact with carmustine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More carmustine resources

• Carmustine Side Effects (in more detail)
• Carmustine Use in Pregnancy & Breastfeeding
• Carmustine Drug Interactions
• Carmustine Support Group
• 0 Reviews for Carmustine - Add your own review/rating

• carmustine Implantation Advanced Consumer (Micromedex) - Includes Dosage Information


• Carmustine Professional Patient Advice (Wolters Kluwer)


• Carmustine MedFacts Consumer Leaflet (Wolters Kluwer)


• Carmustine Monograph (AHFS DI)


• BiCNU Prescribing Information (FDA)


• Bicnu Advanced Consumer (Micromedex) - Includes Dosage Information


• Gliadel Prescribing Information (FDA)


• Gliadel Implant Wafer MedFacts Consumer Leaflet (Wolters Kluwer)

Compare carmustine with other medications

• Brain Tumor
• Glioblastoma Multiforme
• Hodgkin's Lymphoma
• Malignant Glioma
• Multiple Myeloma
• Non-Hodgkin's Lymphoma

Where can I get more information?

• Your doctor or pharmacist can provide more information about carmustine.

See also: carmustine side effects (in more detail)