Dangerous Drug: Carmustine (BCNU)(car mus’ teen)
BiCNU, Gliadel
PREGNANCY CATEGORY D
Drug Classes
Alkylating agent
Antineoplastic
Nitrosourea
Therapeutic Actions
Cytotoxic: Alkylates DNA and RNA and inhibits several enzymatic processes, leading to cell death.
Indications
Palliative therapy alone or with other agents (injection) for brain tumors: Glioblastomas, brainstem glioma, medullablastoma, astrocytoma, ependymoma, metastatic brain tumors
Hodgkin lymphoma and non-Hodgkin lymphomas (as secondary therapy)
Multiple myeloma (with prednisone)
Adjunct to surgery for the treatment of recurrent glioblastoma as implantable wafer after removal of tumor (wafer)
Treatment of newly diagnosed high-grade malignant glioma as adjunct to surgery and radiation (wafer)
Unlabeled uses: Treatment of mycosis fungoides (topical), cutaneous T-cell lymphoma, hematopoietic stem-cell transplantation, colorectal carcinoma, malignant melanoma
Contraindications and Cautions
Contraindicated with allergy to carmustine.
Use cautiously with radiation therapy, chemotherapy, hematopoietic depression, impaired renal or hepatic function, pregnancy (teratogenic and embryotoxic), lactation.
Available Forms
Powder for injection—100 mg; wafer (Gliadel)—7.7 mg
Dosages
Adults and pediatric patients
IV
As single agent in untreated patients, 150–200 mg/m2 IV every 6 wk as a single dose or in divided daily injections (75–100 mg/m2 on 2 successive days). Do not repeat dose until platelets exceed 100,000/mm3, leukocytes exceed 4,000/mm3. Adjust dosage after initial dose based on hematologic response, as follows:
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