Carmustine - Intravenous

Carmustine is used on its own or together with other medicines to treat brain tumours and certain types of cancer of the blood and lymph nodes.

This medicine may be used to treat other conditions as decided by your doctor.

Carmustine injection is to be given intravenously (into the vein) as an infusion. It is delivered directly into the bloodstream via the blood vessel.

Your doctor or nurse will administer the injection for you.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the type of your condition and your response to the medication.

Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Carmustine.

If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.

Inform your doctor if you have the following conditions:

• current lung problem or history of lung disease
• kidney disease

Let your doctor know if you are pregnant. It is important that you do not get pregnant while using this medicine. Both men and women must use proven birth control methods during Carmustine therapy and for 6 months (in women) or 3 months (in men) after stopping the treatment. You may wish to discuss other reliable methods of birth control with your doctor.

Inform your doctor if you are breastfeeding. Your doctor may advise you to discontinue breastfeeding while you are being treated with this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Pregnancy tests must be done before treatment to know if this medicine is suited for you to use.
• Routine tests (e.g. lung, liver or kidney function, complete blood count) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of signs and symptoms of infection, bleeding, lung problems, and injection site reactions may also be needed.

Carmustine may cause any of the following side effects: headache, dizziness, nausea, vomiting, constipation, diarrhoea, decreased appetite, and hair loss.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• shortness of breath or trouble breathing, fever, cough
• burning sensation, pain, redness, swelling, blisters, skin sores at the injection site
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles

This medicine will cause the level of your red blood cells, white blood cells and platelets to drop.

Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.

White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, cough, or flu that does not go away.

Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital
• cimetidine (medicine that reduces stomach acid production)
• digoxin (medicine for heart disease)
• melphalan (another medicine for cancer)

This list does not include all medicines that may interact with Carmustine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in the refrigerator, between 2-8°C.

Protect from light.

Medicines must not be used past the expiry date.

As Carmustine is a cancer medicine, always return any unused or expired medicine to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.