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Related to carmustine: lomustine, BiCNU, Mechlorethamine


a cytotoxic alkylating agent of the nitrosourea group, used as an antineoplastic agent, primarily against brain tumors, multiple myeloma, colorectal carcinoma, Hodgkin's disease, and non-Hodgkin's lymphomas. Called also BCNU.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Gliadel Wafer

Pharmacologic class: Alkylating agent

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy.

• Most common and severe toxic effect is bone marrow suppression-notably thrombocytopenia and leukopenia, which may contribute to bleeding and overwhelming infections in already compromised patient. Monitor blood counts weekly for at least 6 weeks after dose. Don't give courses more often than every 6 weeks.


Unclear. Thought to interfere with bacterial cell-wall synthesis by cross-linking strands of DNA and disrupting RNA transcription, causing cell to rupture and die. Exhibits minimal immunosuppressant activity.


Intracavitary wafer implant: 7.7 mg (available in packages of eight wafers)

Powder for injection: 100-mg vials

Indications and dosages

Brain tumor; multiple myeloma; Hodgkin's disease; other lymphomas

Adults and children: 150 to 200 mg/m2 I.V. as a single dose q 6 to 8 weeks, or 75 to 100 mg/m2/day for 2 days q 6 weeks, or 40 mg/m2/day for 5 days q 6 weeks. Repeat dose q 6 weeks if platelet count exceeds 100,000/mm3 and white blood cell (WBC) count exceeds 4,000/mm3.

Adjunct to brain surgery

Adults: Up to 61.6 mg (eight wafers) implanted in surgical cavity created during brain tumor resection

Dosage adjustment

• Based on WBC and platelet counts

Off-label uses

• Mycosis fungoides


• Hypersensitivity to drug

• Radiation therapy

• Chemotherapy

• Pregnancy or breastfeeding


Use cautiously in:

• infection; depressed bone marrow reserve; respiratory, hepatic, or renal impairment

• females of childbearing age.


• Know that drug may be used alone or in conjunction with other treatments, such as surgery or radiation.

• Follow facility policy when preparing, administering, and handling drug.

• Reconstitute drug by dissolving vial of 100 mg with 3 ml of sterile dehydrated alcohol (provided with drug), followed by 27 ml of sterile water for injection; yields solution with concentration of 3.3 mg carmustine/ml. Solution may be further diluted with 5% dextrose injection and delivered by I.V. infusion over 1 to 2 hours.

• Know that infusion lasting less than 1 hour causes intense pain and burning at I.V. site.

• Infuse solution in glass containers only; drug is unstable in plastic I.V. bags.

• Know that skin contact with reconstituted drug may cause transient hyperpigmentation. If contact occurs, wash skin thoroughly with soap and water.

• Be aware that oxidized regenerated cellulose may be placed over wafers to secure them against surgical cavity surface.

• Know that resection cavity should be irrigated after wafer placement and that dura should be closed in watertight fashion.

Adverse reactions

CNS: ataxia, drowsiness

GI: nausea, vomiting, diarrhea, esophagitis, stomatitis, anorexia

GU: azotemia, renal failure, nephrotoxicity

Hematologic: anemia, leukopenia, thrombocytopenia, cumulative bone marrow depression, bone marrow dysplasia

Hepatic: hepatotoxicity

Respiratory: pulmonary fibrosis, pulmonary infiltrates

Skin: alopecia, hyperpigmentation, facial flushing, abnormal bruising

Other: I.V. site pain, secondary malignancies


Drug-drug. Anticoagulants, aspirin, nonsteroidal anti-inflammatory drugs: increased risk of bleeding

Antineoplastics: additive bone marrow depression

Cimetidine: potentiation of bone marrow depression

Digoxin, phenytoin: decreased blood levels of these drugs

Live-virus vaccines: decreased antibody response to vaccines, increased risk of adverse reactions

Drug-diagnostic tests. Alkaline phosphatase, aspartate aminotransferase, bilirubin, nitrogenous compounds (urea): increased levels

Hemoglobin, WBCs: decreased values

Drug-behaviors. Smoking: increased risk of respiratory toxicity

Patient monitoring

• Assess baseline kidney and liver function tests.

• Monitor CBC for up to 6 weeks after giving dose to detect delayed bone marrow toxicity.

• Know that pulmonary function tests should be performed before therapy begins and regularly throughout therapy to assess for toxicity.

Patient teaching

• Instruct patient to report signs and symptoms of allergic response and other adverse reactions.

• Inform patient that severe flushing may follow I.V. dose but should subside in 2 to 4 hours.

• Tell patient to avoid activities that can cause injury. Advise him to use soft toothbrush and electric razor to avoid gum and skin injury.

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

• Instruct patient to monitor urinary output and report significant changes.

• Inform patient that drug may cause hair loss.

• Advise patient that he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


An antineoplastic agent.
Synonym(s): BCNU
Farlex Partner Medical Dictionary © Farlex 2012


An antineoplastic drug, C5H9Cl2N3O2, used to treat various malignancies, including Hodgkin and non-Hodgkin lymphomas, melanoma, multiple myeloma, and brain tumors.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A chemotherapeutic related to lomustine (CCNU) and semustine, which partially overlaps the activity/toxicity of alkylating agents.
Hodgkin lymphoma, non-Hodgkin lymphoma, melanoma, myeloma, brain tumours, gastrointestinal carcinomas; BCNU crosses the blood-brain barrier and may be used for meningeal leukaemia and brain tumours.
Side effects
Nausea, vomiting, decreased platelets, reduced WBCs, secondary leukaemia, pulmonary fibrosis, renal failure.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


BCNU Oncology An anticancer alkylating nitrosourea
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


An antineoplastic agent.
Synonym(s): BCNU.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


An alkylating agent anticancer drug. A brand name is Bicnu.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


An antineoplastic agent.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Association of carmustine with a lipid emulsion: in vitro, in vivo and preliminary studies in cancer patients.
There are currently 75 drugs associated with pulmonary fibrosis, including amiodarone, bleomycin, busulfan, carmustine, lomustine and nitrofurantoin.
Other chemotherapeutic agents such as gemcitabine, carmustine, and bleomycin have been associated with lung toxicity.
The Brain Tumor Cooperative Group NIH Trial 87-01: a randomized comparison of surgery, external radiotherapy, and carmustine versus surgery, interstitial radiotherapy boost, external radiation therapy, and carmustine.
The reported cooperative effects of MJ with other drugs are shown in Table 3: (1) BCNU (carmustine), an alkylating nitrosourea agent with no cytotoxic effect on pancreatic carcinoma cell line MIA PaCa-2 in vitro combined with MJ showed enhanced cell death [170].
(Headquarters: Tokyo, President & CEO: Haruo Naito, "Eisai") announced today that it will receive the Marketing Authorization Holder (MAH) license for the antineoplastic agent Gliadel 7.7 mg Implant (carmustine, "Gliadel") in Japan from Nobelpharma Co., Ltd.
Most recently, Emcure-Heritage acquired the global rights to an exclusive oncology brand product, BiCNU (Carmustine for Injection), which serves as an anchor product in the company's growing oncology franchise.
Drugs included carmustine, etoposide, melphalan, and cytarabine given over a 6-day period.
Permeability of latex and polyvinyl chloride gloves to carmustine. Am J Hosp Pharm.
O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation and low MGMT-encoded protein expression as prognostic markers in glioblastoma patients treated with biodegradable carmustine wafer implants after initial surgery followed by radiotherapy with concomitant and adjuvant temozolomide.
The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) is the most established preparative regimen for lymphoma in the setting of auto-HSCT.
Global Banking News-October 22, 2018-Amneal passes US FDA approval for marketing Carmustine for Injection USP in 100 mg/vial