Carmustine

Brand name(s):
BiCNU,Gliadel

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

Carmustine should only be administered under the supervision of
a qualified healthcare provider experienced in the use of cancer chemotherapeutic
agents.

Serious side effects have been reported with the use of carmustine including:
allergic reactions (difficulty breathing; closing of the throat; swelling
of the lips, tongue, or face; or hives); decreased bone marrow function
and blood problems (extreme fatigue; easy bruising or bleeding; black,
bloody or tarry stools; fever or chills; or signs of infection such as
fever; chills, or sore throat); severe nausea, vomiting, diarrhea, and
loss of appetite; and others. Talk to your doctor about the possible side
effects from treatment with carmustine.

In some cases, second cancers have been reported to occur during and
following treatment with carmustine. Also, carmustine has been associated
with the lung disorder pulmonary fibrosis. Talk to your doctor about the
risks and benefits of this medication.
What is carmustine?

Carmustine is a cancer (antineoplastic) medication. carmustine
interferes with the growth of cancer cells and slows their growth and
spread in the body.

Carmustine is used to treat cancerous brain tumors and some types
of blood cancer (multiple myeloma, Hodgkin’s disease, and non-Hodgkin’s
lymphomas).

carmustine may also be used for purposes other than those listed in this
medication guide.
Who should not take carmustine?

Before taking carmustine, tell your doctor if you have

* had recent vaccinations;
* blood or bone marrow problems;
* kidney disease; or
* liver disease.

You may not be able to take carmustine, or you may require a dosage adjustment
or special monitoring during treatment if you have any of the conditions
listed above.
carmustine is in the FDA pregnancy category D. This means that carmustine
is known to cause birth defects in an unborn baby. Do not take carmustine
without first talking to your doctor if you are pregnant or if you could
become pregnant during treatment. Contraceptive measures are recommended
during treatment with carmustine. It is not known whether carmustine passes
into breast milk. Do not take carmustine without first talking to your
doctor if you are breast feeding a baby.
How should I take carmustine?

Carmustine should only be administered under the supervision of
a qualified healthcare provider experienced in the use of cancer chemotherapeutic
agents.

Your doctor will determine the correct amount and frequency of treatment
with carmustine depending upon the type of cancer being treated and other
factors. Talk to your doctor if you have any questions or concerns regarding
the treatment schedule.

The Gliadel wafers are surgically implanted in the brain where they release
the medication and gradually dissolve.

Your doctor will probably want you to have regularly scheduled blood
tests and other medical evaluations during treatment with carmustine to
monitor progress and side effects.

Your healthcare provider will store carmustine injection or wafers as
directed by the manufacturer. If you are storing carmustine injection
at home, follow the directions provided by your healthcare provider
What happens if I miss a dose?

Contact your doctor if you miss a dose of carmustine.
What should I avoid while taking carmustine?

Carmustine can lower the activity of your immune system making
you susceptible to infections. Avoid contact with people who have colds,
the flu, or other contagious illnesses and do not receive vaccines that
contain live strains of a virus (e.g., live oral polio vaccine) during
treatment with carmustine. In addition, avoid contact with individuals
who have recently been vaccinated with a live vaccine. There is a chance
that the virus can be passed on to you.

Skin accidentally exposed to carmustine injection should be rinsed thoroughly
with soap and warm water.
What are the possible side effects of carmustine?
If you experience any of the following serious side effects, seek emergency
medical attention or contact your doctor immediately:

* an allergic reaction (shortness of breath; closing of your throat;
difficulty breathing; swelling of your lips, face, or tongue; or hives);
* decreased bone marrow function and blood problems (extreme fatigue;
unusual easy bruising or bleeding; black, bloody or tarry stools; or fever,
chills, sore throat or signs of infection);
* seizures, brain swelling, or brain infection (Gliadel wafers only);
* shortness of breath or dry cough;
* abdominal pain or yellowing of the eyes or skin; or
* little or no urine production.

Other less serious side effects may be more likely to occur. Talk to
your doctor if you experience

* nausea or vomiting;
* intense flushing of the skin and reddening of the eyes;
* redness, burning, or irritation at the injection site.
* headache; or
* rash.

In some cases, second cancers have been reported to occur during and
following treatment with carmustine. Also, carmustine has been associated
with the lung disorders pulmonary fibrosis. Talk to your doctor about
the risks and benefits of this medication.

Side effects other than those listed here may also occur. Talk to your
doctor about any side effect that seems unusual or that is especially
bothersome.
What other drugs will affect carmustine?
Do not receive "live" vaccines during treatment with carmustine.
Administration of a live vaccine may be dangerous during treatment with
carmustine.

Other drugs may interact with carmustine. Talk to your doctor and pharmacist
before taking any other prescription or over-the-counter medicines, including
herbal products, during treatment with carmustine.
Where can I get more information?

Your pharmacist has additional information about carmustine written for
health professionals that you may read.
What does my medication look like?

Carmustine is available with a prescription under the brand name
BiCNU for injection and Gliadel Wafer for implantation. Other brand or
generic formulations may also be available. Ask your doctor or pharmacist
any questions you have about this medication, especially if it is new
to you.

* BiCNU 100 mg-powder in vials for injection
* Gliadel Wafer 7.7 mg -wafer for implantation