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Generic Name: carmustine (CAR muh steen)
Brand Names: BiCNU, Gliadel

What is Gliadel (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.

What is the most important information I should know about Gliadel (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.

Who should not take Gliadel (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.

How should I take Gliadel (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 happens if I overdose?

Symptoms of a carmustine overdose tend to be similar to side effects caused by the medication, although often more severe.

What should I avoid while taking Gliadel (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.

Gliadel (carmustine) side effects

• 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 Gliadel (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

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.