Carmustine uses generic names in all descriptions of drugs. BCNU is the trade name for Carmustine. BiCNU is another name for carmustine. In some cases, health care professionals may use the trade name BCNU or other names BiCNU when referring to the generic drug name carmustine.

Drug type: Carmustine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "alkylating agent." (For more detail, see "How this drug works" section below).

What this drug is used for:
  • Used to treat certain types of brain tumors; glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma and metastatic brain tumors.
  • Other cancers treated with carmustine include multiple myeloma, Hodgkin's disease, non-Hodgkin's lymphomas, melanoma, lung cancer, colon cancer.

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given :
  • Carmustine is usually given by an infusion into a vein (intravenous, IV).
  • There is no pill form of this medication.
  • There is a form of this medication (Gliadel® wafer) that can be placed and left in the cavity after surgical removal of a brain tumor. The carmustine wafer allows for delivery of the drug directly to the site of the brain tumor. (See separate listing "carmustine wafer" for more details regarding this formulation).
  • The amount of carmustine that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects :
Important things to remember about the side effects of carmustine :
  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • The side effects of carmustine and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients taking carmustine :
  • Nausea and vomiting, usually within 2-4 hours of infusion, lasting for about 4-6 hours. Anti-nausea nausea medication is given prior to infusion to prevent or decrease this side effect.
  • Facial flushing (see skin problems).
  • Pain and burning at the injection site. (Can be relieved by diluting the drug, let your health care provider know if you are experiencing pain during the infusion).
  • Low blood counts. Your white blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, and/or bleeding. This effect is usually delayed, onset 2 weeks after dose with nadir 5-6 weeks later.

The following side effects are less common (occurring in 10-29%) for patients receiving carmustine :
  • Increases in blood tests measuring liver function, these return to normal once treatment is stopped. (see liver problems).
  • Low red blood cell count (anemia).
  • Low blood pressure (hypotension) with high dose therapy.
  • Dizziness, loss of coordination.
  • Eye problems: (temporary redness and/or blurring), retinal bleeding.

Delayed effects :
  • Pulmonary toxicity (damage to the lungs) is uncommon in low doses of carmustine. However it is more common with cumulative or high doses. This toxicity may be delayed up to 3 years after treatment. A history of lung disease may increase the risk of this reaction, or use of other lung-toxic drugs. Your doctor will check your lung function prior to the start carmustine and will order periodic checks (pulmonary function tests), particularly if you are receiving high doses of carmustine.
  • There is a slight risk of developing a blood cancer such as leukemia after taking carmustine. Talk to your doctor about this risk.

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.