Carmustine interactions

Conditions

Conditions in which Carmustine needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.

  2 sources

  1. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb (2001):
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb (2001):

• Infections

  Major

  Nitrosoureas can induce delayed myelosuppression. The use of nitrosoureas may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with nitrosoureas. Close clinical monitoring of hematopoietic function is recommended.

  2 sources

  1. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb (2001):
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb (2001):

• Pulmonary Fibrosis

  Major

  Pulmonary toxicity characterized by pulmonary infiltrates and/or fibrosis has been reported during carmustine therapy. Toxicity has occurred within nine days of initiation of therapy at doses usually > 1400 mg/m2. However, cases of delayed onset pulmonary fibrosis occurring up to 17 years after treatment have also been reported. Late reduction in pulmonary function, progressive fibrosis, and death have been noted. Risk factors include past history of lung disease and duration of treatment. Therapy with carmustine should be administered cautiously in patients with a history of pulmonary disease. Pulmonary function studies prior to and during therapy are recommended.

  7 sources

  1. Sweet DL "Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU)." Ann Intern Med 91 (1979): 132-3
  2. Weiss RB, Muggia FM "Pulmonary effects of carmustine (bischloroethylnitrosourea, BCNU)." Ann Intern Med 91 (1979): 131-2
  3. O'Driscoll BR, Kalra S, Gattamaneni HR, Woodcock AA "Late carmustine lung fibrosis. Age at treatment may influence severity and survival." Chest 107 (1995): 1355-7
  4. Lena H, Desrues B, Le Coz A, Quinquenel ML, Delaval P "Severe diffuse interstitial pneumonitis induced by carmustine (BCNU)." Chest 105 (1994): 1602-3
  5. Patten GA, Billi JE, Rotman HH "Rapidly progressive, fatal pulmonary fibrosis induced by carmustine." JAMA 244 (1980): 687-8
  6. Weinstein AS, Diener-West M, Nelson DF, Pakuris E "Pulmonary toxicity of carmustine in patients treated for malignant glioma." Cancer Treat Rep 70 (1986): 943-6
  7. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb (2001):

• Kidney Diseases

  Moderate

  Renal abnormalities such as azotemia, and progressive decline in renal function have been reported after prolonged therapy with large doses of carmustine and lomustine. Lower total doses have also resulted in kidney damage. Therapy with carmustine or lomustine should be administered cautiously in patients with a history of or predisposition to renal dysfunction. Clinical monitoring of renal function is recommended.

  5 sources

  1. Seffart G ed. "Drug Dosage in Renal Insufficiency." Dordrecht, South Holland, : Kluwer Academic Publishers (1991):
  2. Ellis ME, Weiss RB, Kuperminc M "Nephrotoxicity of lomustine. A case report and literature review." Cancer Chemother Pharmacol 15 (1985): 174-5
  3. Weiss RB, Poster DS "THE RENAL TOXICITY OF CANCER CHEMOTHERAPEUTIC AGENTS." Cancer Treat Rev 9 (1982): 37-561982
  4. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb (2001):
  5. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb (2001):

• Liver Diseases

  Minor

  A reversible increase in liver transaminase, alkaline phosphatase, and bilirubin levels has been reported during therapy with nitrosoureas. Therapy with nitrosoureas should be administered cautiously in patients with a history of or predisposition to compromised hepatic function.

  2 sources

  1. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb (2001):
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb (2001):