Carmustine

'Carmustine is a cytotoxic alkylating agent of the nitrosourea group. Chemically Carmustine is 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU). All alkylating agent have or can form an alkyl group that becomes covalently bound to cellular constituents. Carmustine is anticancer drug and effective in the treatment of tumors, Hodgkin''s disease and certain cancers, used alone or in combination with different anticancer drugs to slow or stop the growth of cancerous or abnormal cells. Administered intravenously.'

Brands
Adult Dose
Dose: 80 mg/sq.meter
Single Dose: 150 (147)
Frequency: 24 hourly
Route: IV Inf
Instructions: Over 2 Hours for 3 Days
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
Carmustine also known as BCNU. . It is of Synthetic origin and belongs to Nitrosourea. It belongs to Alkylating Agents pharmacological group on the basis of mechanism of action and also classified in Antineoplastic Agent, Alkylating Agent pharmacological group.The Molecular Weight of Carmustine is 214.00.
Contraindications
Carmustine is contraindicated in conditions like Pre-existing lung disease.
Effects
The severe or irreversible adverse effects of Carmustine, which give rise to further complications include Pulmonary fibrosis, Fatal hepatotoxicity, Focal neurologic deficits.Carmustine produces potentially life-threatening effects which include Fibrosing alveolitis, Interstitial pneumonitis. which are responsible for the discontinuation of Carmustine therapy.The signs and symptoms that are produced after the acute overdosage of Carmustine include Myelosuppression, Leucopenia.The symptomatic adverse reactions produced by Carmustine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Local irritation.
Indications
'Carmustine is primarily indicated in conditions like Hodgkin''s disease, Malignant brain tumours, Multiple myeloma, Myeloma, lymphoma and brain tumours, Non-hodgkin''s lymphoma, Tumours.'
Interactions
Carmustine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmphotericin BBusulphanCimetidine (HCl)CyclophosphamideMethotrexatePhenobarbitoneRotavirus vaccineThe administration of live, attenuated virus or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received Carmustine.MajorIn general, live virus or bacterial vaccines should not be used in patients receiving Carmustine.SulfapyridineConcurrent use with sulfonamides may result in an increased incidence of hepatotoxicity. Patients, especially those on prolonged administration or those with a history of liver disease.Should be carefully monitored.Theophylline These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconstituted soln) Store at room temperature or refrigerator. Protect from Sunlight. Use within 8 hrs if kept at room temperature.
Warnings
Carmustine should be used with caution in patients with pre-existing liver disease, kidney disease, lung disease, breathing trouble, recent exposure to chicken pox or any allergy. This medication must be handled carefully because it can irritate the skin. Carmustine should be avoided during pregnancy or lactation.
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