৳ 42,000/unit
Pack: ৳ 42,000
৳ 42,000/unit
Pack: ৳ 42,000
At a glance
Carmustine is a nitrosourea alkylating agent chemotherapy used in the treatment of brain tumors (glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, and metastatic brain tumors), multiple myeloma, and relapsed or refractory Hodgkin's and non-Hodgkin's lymphomas.
Indications
- Brain tumors (glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, metastatic brain tumors)
- Multiple myeloma (in combination with prednisone)
- Relapsed or refractory Hodgkin's lymphoma
- Relapsed or refractory non-Hodgkin's lymphoma
Pharmacology
The mechanism of action of carmustine is not fully understood. While carmustine alkylates DNA and RNA, it is not cross-resistant with other alkylators. As with other nitrosoureas, it may also inhibit several key enzymatic processes by carbamoylation of amino acids in proteins. The metabolites may contribute to antitumor activity and toxicities of carmustine.
Dosage
Adults (Single agent): 150-200 mg/m² IV every 6 weeks (as a single dose or divided into 2 consecutive days at 75-100 mg/m²).
Combination therapy or reduced bone marrow reserve: Dose adjustment required.
Administration: Reconstituted solution should be administered as a slow IV infusion over at least 2 hours.
Pediatric: Safety and effectiveness in children have not been established.
Geriatric: Dose selection should be cautious, usually starting at the low end of the dose range.
Side effects
Common (>1%): Nausea, vomiting, renal toxicity, pneumonitis, pulmonary toxicity, myelosuppression (bone marrow suppression).
Pulmonary fibrosis: Delayed-onset pulmonary fibrosis may occur up to 17 years after treatment (especially in patients treated at <5 years of age).
Other: Nephrotoxicity, ocular toxicity (with unapproved intraarterial intracarotid route), carcinogenicity (potentially carcinogenic to humans).
Use in pregnancy
Unsafe during pregnancy (Category D). Based on mechanism of action and animal findings, can cause fetal harm. Embryotoxic and teratogenic in rats and rabbits. No adequate studies in pregnant women. Use only if potential benefit justifies potential risk to the fetus.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Monitor infusion site closely during administration to prevent extravasation.
- Potentially carcinogenic to humans; monitor patients periodically and inform them of symptoms to seek medical help.
- Ocular toxicity has occurred with unapproved intraarterial intracarotid route.
- Embryo-fetal toxicity: Can cause fetal harm; advise females of reproductive potential of potential risk and to avoid pregnancy.
- Elderly patients are more likely to have decreased renal function; monitor renal function and select dose cautiously.
- Do not use during pregnancy and lactation (Category D).
Overdose effects
Overdose may cause severe myelosuppression, pulmonary toxicity, renal toxicity, and gastrointestinal toxicity. Supportive care and blood transfusions may be required.
Storage conditions
Store product and diluent in a refrigerator at 2-8°C. Unopened carmustine vials are stable for up to 3 years.