Monograph Details
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Neoplasms
> Alkylating agents
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BICNU |
| Manufacturer |
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Bristol-Myers Squibb |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Alkylating agent. |
| Generic Name |
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Carmustine 100mg/vial; lyophilized pwd for IV infusion after reconstitution and dilution; preservative-free. |
| Indications |
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Palliative therapy as a single agent or in combination with other chemotherapeutic agents for brain tumors (glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, metastatic brain tumors), multiple myeloma (in combination with prednisone), Hodgkin's disease (as secondary therapy in patients who relapse or fail to respond to primary therapy), Non-Hodgkin's lymphomas (as secondary therapy in patients who relapse or fail to respond to primary therapy). |
| Children |
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Not recommended. |
| Adults |
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Pretreat with antiemetics. Give by slow IV infusion. Previously untreated patients as a single agent: Initially 150–200mg/m2 every 6 weeks. May give as one single dose or divided into daily injections (eg, 75–100mg/m2) on 2 consecutive days. Adjust subsequent doses based on hematologic response (see literature). In combination therapy: adjust doses accordingly (see literature). |
| Contraindications |
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Bone marrow suppression. |
| Precautions |
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Monitor blood counts weekly for > 6 weeks after a dose. Do not give repeat doses until platelets are >100,000/mm3 and leukocytes are 4000/mm3. Monitor liver and renal function. Perform pulmonary function tests prior to and during therapy. History of lung disease. Patients with baseline < 70% of the predicted Forced Vital Capacity or Carbon Monoxide Diffusing Capacity, and cumulative doses > 1400mg/m2 increase risk of pulmonary toxicity. Elderly. Pregnancy (Cat.D), nursing mothers: not recommended. |
| Adverse Reactions |
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Delayed myelosuppression leading to infection and bleeding, pulmonary toxicity, delayed pulmonary fibrosis, secondary malignancies, nausea, vomiting, hepatotoxicity, nephrotoxicity, neuroretinitis, chest pain, headache, hypersensitivity, hypotension, tachycardia. Intensive flushing of the skin and suffusion of the conjunctiva related to rapid IV infusion. |
| How Supplied |
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Single-use vial—1 (w. 3mL sterile diluent) |
| Additional Resources |
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• Related Prescribing Note |
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