Carmustine

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Test-interactions 9 Mechanism-of-action 10 More General Terms 11 Internet Database 12 References

Introduction

• Tradename: BiCNU.

Indications

• brain tumors ( astrocytoma)
• multiple myeloma
• Hodgkin's disease
• non-Hodgkin's lymphoma
• melanoma
• lung cancer

Contraindications

• pregnancy

• Patient information:

• contraception indicated during therapy
  

• pregnancy category = ?

Dosage

• 150-200 mg/m2 every 6 weeks
• max cumulative dose: 1400 mg/m2
• do NOT mix with solutions containing bicarbonate
• administer in glass container

• Powder for injection: 100 mg
• Caution: do not mix with solution containing bicarbonate.

Pharmacokinetics

• rapidly distributes to all tissues
• CSF concentration is about 70 times blood concentration
• metabolized by liver, removed by kidney
• 1/2 life is 20 minutes
• not removed by dialysis
  

• elimination via kidney
• 1/2life = 20 minutes
• elimination by hemodialysis = -

Adverse-effects

• common (> 10%)

• pain at site of injection
• nausea/vomiting

• occurs within 2-4 hours
• high emetic potential

• increased LFTs (reversible hepatic toxicity)

• less common (1-10%)

• anemia, stomatitis, facial flushing, alopecia, diarrhea, anorexia

• uncommon (< 1%)

• myelosuppression: delayed 4-6 weeks
• interstitial pneumonitis & pulmonary fibrosis* (prolonged or high doses)
• hyperpigmentation, dermatitis
• renal failure,
• ocular toxicity & retinal hemorrhages
• ataxia, dizziness

• other: seizures [3]
• * monitor: pulmonary function testing, baseline & periodically, DLCO < 70% predicted indicates high risk
  

• drug adverse effects of alkylating agents

Drug-interactions

• cimetidine may decrease metabolism of BCNU, thus increasing toxicity
• amphotericin may enhance cellular uptake of BCNU
• digoxin
• phenytoin

Test-interactions

• increases serum K+

Mechanism-of-action

• alkylating agent

More General Terms

• alkylating agent nitrosourea
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 2578

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
3. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998

carmustine (BCNU, BiCNU, Carmubris)