Carmustine (Generic Name)

Other Names: BCNU, bischloronitrosourea

About This Drug

Carmustine is a drug used to treat cancer. This drug is given intravenously (IV).

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs 25 to 35 days after the drug is given and may last for 60 days. It may increase your risk of infection, fatigue, and bleeding.
  • Phlebitis, which is redness and tenderness of a vein
  • Nausea and vomiting. These symptoms may occur within two hours after you receive the drug and may last up to 24 hours.
  • Changes in liver function. This is temporary, and your liver function should return to normal once this drug is stopped. Your liver function will be tested as needed.

Possible Side Effects (Less Common)

  • Facial flushing
  • Changes in kidney function. Your kidney function will be checked as needed.
  • Soreness of the mouth or throat
  • Dizziness
  • Lack of muscle coordination
  • Changes in lung tissue may occur with high amounts of this drug. These changes may not be permanent, and your lung tissue may return to normal. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating the Side Effects

  • Ask your doctor or nurse about medication to help prevent or lessen nausea or vomiting.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • During the IV infusion, if you experience pain, redness, or swelling at the site of the IV infusion, please tell your nurse immediately.

Food and Drug Interactions

Do not take Vitamin A supplements while you are being treated with carmustine. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare.

Tell your doctor or nurse immediately if you have any of the following symptoms during the time you are receiving this drug:

  • Difficulty catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat rapidly (palpitations)
  • Dizziness or lightheadedness
  • Flushing/itching/rash/hives

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Unusual bleeding or bruising
  • Fever of 100.5 F (38 C) or above
  • Chills
  • Persistent cough or difficulty catching your breath
  • Vomiting more than twice in one day
  • Yellowing of skin or eyes
  • Dizziness

Revised December 2011

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