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Brand Name :
Gliadel Wafer
(United States) [Available]Synonyms :
Carmustine
Class :
Class: Antineoplastic agents and Subclass: Nitrosoureas  
Brand Name :
Gliadel Wafer
(United States) [Available]Synonyms :
Carmustine
Class :
Class: Antineoplastic agents and Subclass: Nitrosoureas  
Dosage Forms & Strengths:   Â
powder for injection   Â
100mg   Â
Wafer, Implant   Â
7.7mg   Â
150 - 200
mg
Intravenous (IV)
as a single dose for at least six weeks
Or divided into daily injections as a dose of 75-100 mg/m2 given IV for every two days
150 - 200
mg/m^2
Intravenous (IV)
as a single dose for at least six weeks
Or divided into daily injections as a dose of 75-100 mg/m2 given IV for every two days
150 - 200
mg/m^2
Intravenous (IV)
as a single dose for at least six weeks
Or divided into daily injections as a dose of 75-100 mg/m2 given IV for every two days
10
mg
Topical
once daily for 7–14 weeks and maximum continue up to 17 weeks, after six weeks, if there is an inadequate response, then the second course of topical therapy is administered with a dose of 20 mg once daily for 4 to 8 weeks until it is tolerable
7.7 mg 8 wafers i.e., 61.6 mg of total dose implanted intracranially
7.7 mg 8 wafers i.e., 61.6 mg of total dose implanted intracranially
Dosage Forms & Strengths:   Â
powder for injection   Â
100mg   Â
Wafer, Implant   Â
7.7mg   Â
may diminish the serum concentration of primidone
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of infection increases    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, it may increase the myelosuppressive activities of carmustine    Â
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of neutropenia increases    
when both the drugs are combined, carmustine may decrease the renal secretion of deferiprone and result in an increased serum level    
when both the drugs are combined, carmustine reduces the effects of the vaccine by immunosuppressive effects and leads to the risk of infection    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, carmustine increases the immunosuppressive effects of fingolimod    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, the metabolism of carmustine increases    
influenza virus vaccine h n live
when both the drugs are combined, carmustine decreases the effects of vaccine live by antagonism    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of the measles virus vaccine decreases    Â
when both the drugs are combined, the therapeutic efficacy of the mumps virus vaccine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of the rotavirus vaccine decreases    
when both the drugs are combined, the risk or severity of infection increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of the smallpox vaccine decreases    
when both the drugs are combined, the serum concentration of carmustine decreases    
when both the drugs are combined, the risk or severity of adverse effects decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine increases the immunosuppressive effects of tofacitinib    
when both the drugs are combined, the therapeutic efficacy of the typhoid vaccine decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of infection increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of infection increases    
varicella zoster vaccine (recombinant)
when both the drugs are combined, the therapeutic efficacy of varicella-zoster vaccine (recombinant) decreases    
when both the drugs are combined, the risk or severity of infection increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the risk or severity of adverse effects decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of the cholera vaccine decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine may decrease the renal secretion of digoxin and increases the serum level    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine increases the myelosuppressive effects of filgrastim    
when carmustine combines with floxuridine, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the serum concentration of fosphenytoin decreases    
when both the drugs are combined, carmustine may decrease the renal secretion of ganciclovir and increases the serum level    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of pulmonary toxicity increases    
when both the drugs are combined, the metabolism of mephenytoin decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine may decrease the renal secretion of naltrexone and increases the serum level    
when both the drugs are combined, ocrelizumab increases the immunosuppressive effects of carmustine    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of palifermin decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine increases the effects of myelosuppression of lipegfilgrastim    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, the serum concentration of phenytoin decreases    
when both the drugs are combined, the metabolism of carmustine increases    
when both the drugs are combined, roflumilast may increase the immunosuppressive effects of carmustine    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of sipuleucel-t decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the therapeutic efficacy of tetanus toxoid decreases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, carmustine may decrease the renal secretion of valganciclovir and increases the serum level    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
when both the drugs are combined, the risk or severity of adverse effects increases    
may enhance the risk or severity of adverse effects when combined with clobetasol propionate
It may enhance the serum concentration when combined with alkalinizing agents
it may diminish the excretion rate when combined with permethrin, resulting in an enhanced serum level
it may diminish the metabolism when combined with azelastine
when bromazepam and carmustine are used together, there is a potential reduction in the bromazepam's metabolism
carmustine has the potential to reduce the rate of excretion of idebenone, leading to an elevation in levels of serum
Combining tegafur with carmustine can reduce tegafur’s metabolism
When domeperidone and carmustine is used together, this leads to reduction in the domeperidone’s metabolism
When mometasone furoate is used together with carmustine, this leads to enhanced risk or seriousness of adverse outcomes
When carmustine is used together with somatotropin, this leads to a rise in carmustine’s metabolism
When carmustine is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
carmustine leads to a reduction in the rate of excretion of eucalyptus oil which leads to increased level of serum
cefpirome leads to a reduction in the rate of excretion of carmustine which leads to increased level of serum
carmustine leads to a reduction in the rate of excretion of chromous sulfate, which leads to an increased level of serum
carmustine leads to a reduction in the rate of excretion of pentaerythritol tetranitrate, which leads to an increased level of serum
carmustine leads to a reduction in the rate of excretion of potassium acetate, which leads to an increased level of serum
carmustine leads to a reduction in the rate of excretion of potassium perchlorate, which leads to an increased level of serum
carmustine leads to a reduction in the rate of excretion of nitric oxide, which leads to an increased level of serum
carmustine: it may increase the risk or severity of CNS depression
carmustine: it may increase the risk or severity of CNS depression
carmustine: it may increase the risk or severity of CNS depression
carmustine: it may increase the risk or severity of CNS depression
carmustine: it may increase the risk or severity of CNS depression
carmustine may decrease the excretion rate of almasilate, leading to higher serum levels
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when both drugs are combined, there may be an increased risk or severity of adverse effects   
when both drugs are combined, there may be an increased risk or severity of adverse effects   
it may increase the level of serum concentration of memantine
It may enhance the serum concentration when combined with alkalinizing agents
It may diminish the excretion when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
It may enhance the serum concentration when combined with alkalinizing agents
melphalan flufenamide: they may increase the toxic effect of carmustine
the excretory rate of carmustine may be reduced when taken with mofebutazone, resulting in increased serum levels of carmustine
the rate of excretion of aurothioglucose may be reduced with carmustine
the rate of excretion of carmustine may be reduced
when combined with carmustine, metabolism of bufylline may be reduced
carmustine might lead to a reduction in the rate of excretion of telavancin, potentially leading to elevated levels of serum
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, carmustine may decrease the renal secretion of levofloxacin and increases the serum level    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, carmustine may decrease the renal secretion of levofloxacin and increases the serum levels    
when both the drugs are combined, the metabolism of lomefloxacin decreases    
when both the drugs are combined, the metabolism of carmustine decreases    
when both the drugs are combined, the metabolism of carmustine decreases    Â
when both the drugs are combined, carmustine may decrease the renal secretion of ofloxacin and increases the serum levels    
when both the drugs are combined, carmustine may decrease the renal secretion of penbutolol and increases the serum levels    
when both the drugs are combined, carmustine may decrease the renal secretion of sparfloxacin and increases the serum levels 
Action and spectrum:Â
Carmustine works by adding alkyl groups to cancer cells DNA by inhibiting DNA replication and RNA transcription leading to cell death. Carmustine is not phase-specific that acting on cancer cells at any stage of the cell cycle.Â
Adverse drug reactions:   Â
Frequency defined:   Â
>10%   Â
Seizure   Â
cerebral edema   Â
Depression   Â
Skin rash    Â
Nausea    Â
vomiting    Â
constipation   Â
Urinary tract infection   Â
Weakness    Â
Wound healing impairment    Â
1% to 10%   Â
Chest pain    Â
Intracranial hypertension   Â
Cerebral hemorrhage   Â
Meningitis    Â
Abdominal pain    Â
Abscess   Â
Back pain    Â
Frequency not defined:   Â
Occlusive arterial disease   Â
Burning sensation of skin   Â
Hyperpigmentation   Â
Gynecomastia   Â
Acute leukemia, anemia   Â
Bone marrow dysplasia   Â
Leukemia   Â
leukopenia    Â
Thrombocytopenia  Â
Blackbox warning:Â
Bleeding riskÂ
Â
Contraindication/Caution:Â
ContraindicationsÂ
CautionsÂ
Pregnancy warnings:   Â
Breastfeeding warnings:   Â
Pregnancy Categories:     Â
Pharmacology:Â
Carmustine also known as BCNU which treats various cancers like multiple myeloma, hodgkins, and non hodgkins lymphoma.Â
Absorption:Â
IV has rapid absorption when compared to oral.Â
Distribution:Â
It is rapidly distributed.Â
It is highly lipophilic, which crosses the blood-brain barrier effectively.Â
Metabolism:Â
Metabolized in liver and other tissues.Â
It undergoes spontaneous degradation.Â
Excretion:Â
The primary excreted through the kidneys with a significant portion through urine with half-life of 15 to 30 minutesÂ
Â
Administration:Â
Carmustine is a meÂdicine given through an IV eveÂry six weeks by a doctor or nurse. TheÂy may give other medicineÂs to help with side effeÂcts. Tell them right away if the injeÂction hurts. After brain tumor surgery, a carmustine implant is ofteÂn put in. Carmustine can make bleeÂding more likely, so report any heÂavy bleeding right away. You may also get infeÂctions more often, so regular cheÂckups are needeÂd. Blood tests happen weeÂkly for at least six weeks. The dose might change based on teÂst results.Â
Patient leaflet information:Â
Why do we use carmustine?Â
Carmustine treats brain tumors, lymphomas, multiple myeloma, and melanoma. It works by alkylating and cross-linking DNA strands leading to cell death. Carmustine can be given intravenously or as a wafer implant during surgery providing localized treatment to brain tumors.Â
Pronunciation: kar-MUS-teenÂ
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