Products
Carmustine is commercially available in many countries as a powder and solvent for the preparation of an infusion solution (BiCNU). An implant is also available in some countries (Gliadel).
Structure and properties
Carmustine (C5H9Cl2N3O2, Mr = 214.0 g/mol) belongs to the nitrosoureas. It exists as a yellowish, granular powder that is very sparingly soluble in water. The substance melts at 31 °C with decomposition. Therefore, the drug must be stored in a refrigerator.
Effects
Carmustine (ATC L01AD01) has cytotoxic and antitumor properties. The effects are due to alkylation of nucleic acids RNA and DNA, as well as enzymes and other proteins. It leads to cell death independently of the cell cycle. Carmustine is a prodrug. The effects are mediated by metabolites (BCU).
Indications
For the treatment of cancer:
- Gliomas (brain tumors)
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphoma
Dosage
According to the professional information. The drug is administered as an intravenous infusion.
Contraindications
- Hypersensitivity
- Pregnancy
Full precautions can be found in the drug label.
Interactions
Carmustine is a substrate of CYP450 isozymes. Interactions have been described with phenytoin, cimetidine, melphalan, and digoxin.
Adverse effects
Myelosuppression is the most common adverse effect.
