Bicnu

Generic name: Carmustine
Drug class: Alkylating agents

Usage of Bicnu

Carmustine injection is used alone or together with other medicines to treat certain type of brain tumors (eg, glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, and metastatic brain tumors), cancer of the lymph system (eg, Hodgkin's disease, non-Hodgkin's lymphoma), and a certain type of cancer in the bone marrow (eg, multiple myeloma). It may also be used to treat other kinds of cancer, as determined by your doctor.

Carmustine belongs to the group of alkylating agents. It interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by carmustine, other effects may occur. Some of these may be serious and must be reported to your doctor. Other effects (eg, hair loss), may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with carmustine, you and your doctor should talk about the benefits this medicine will do as well as the risks.

This medicine is to be given only by or under the immediate supervision of your doctor.

Bicnu side effects

Along with its needed effects, medicines like carmustine can sometimes cause some unwanted effects such as blood problems, loss of hair, and other side effects; these are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Cough

pain or redness at the injection site

trouble breathing

Less common

Black, tarry stools

blood in the urine or stools

cough or hoarseness, accompanied by fever or chills

fever or chills

flushing of the face

lower back or side pain, accompanied by fever or chills

painful or difficult urination, accompanied by fever or chills

pinpoint red spots on the skin

sores in the mouth or on the lips

unusual bleeding or bruising

unusual tiredness or weakness

Rare

Decrease in urination

swelling of the feet or lower legs

Incidence not known

Abdominal or stomach pain, severe

bleeding gums

bone pain

chest pain

cloudy urine

confusion

dark urine

decreased frequency or amount of urine

difficulty with swallowing

dizziness

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

dry mouth

fast, pounding, or irregular heartbeat or pulse

feeling of warmth

hives, itching, or skin rash

increased blood pressure

increased thirst

loss of appetite

nausea or vomiting

pain in the lower back or side

pale skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

redness of the face, neck, arms, and occasionally, upper chest

seizures

sore throat

sweating

swelling of the face, fingers, or lower legs

swollen glands

thirst

tightness in the chest

troubled breathing with exertion

weight gain

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Diarrhea

discoloration of the skin along the injection site

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Bicnu

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies on the relationship of age to the effects of carmustine injection have not been performed in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of carmustine injection in geriatric patients. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving carmustine injection.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Measles Virus Vaccine, Live

Mumps Virus Vaccine, Live

Rotavirus Vaccine, Live

Rubella Virus Vaccine, Live

Varicella Virus Vaccine, Live

Zoster Vaccine, Live

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adenovirus Vaccine

Bacillus of Calmette and Guerin Vaccine, Live

Cholera Vaccine, Live

Cimetidine

Dengue Tetravalent Vaccine, Live

Influenza Virus Vaccine, Live

Melphalan

Phenobarbital

Poliovirus Vaccine, Live

Smallpox Vaccine

Typhoid Vaccine, Live

Yellow Fever Vaccine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Relate drugs

How to use Bicnu

Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

This medicine is usually given every 6 weeks. This maybe given as a single dose or divided into daily injections on 2 consecutive days.

Carmustine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your doctor to help you plan a way to take them at the right times.

This medicine often causes nausea and vomiting, which usually last no longer than 4 to 6 hours. It is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your doctor for ways to lessen these effects.

Warnings

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Females need to use an effective form of birth control during treatment and for at least 6 months while you are using this medicine to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Males need to use an effective form of contraceptive during treatment and for at least 3 months after your last dose to prevent your partner from becoming pregnant.

This medicine may increase your risk of developing cancer and lung problems (such as pulmonary fibrosis or toxicity). This is more likely if you receive high doses of this medicine or use it for a long time.

While you are being treated with carmustine injection, and after you stop treatment with it, do not have any immunizations (vaccines) without your doctor's approval. Carmustine may lower your body's resistance and the vaccine may not work as well for you or you might get the infection the vaccine is meant to prevent. In addition, you should not be around other persons living in your household who receive live vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long. If you have questions about this, talk to your doctor.

Carmustine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.

Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.

Avoid contact sports or other situations where bruising or injury could occur.

If carmustine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the injection site.

This medicine may increase risk of lung problems while smoking.

If you plan to have children, talk with your doctor before using this medicine. Some men using this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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