Carmustine
Brand names: BiCNU, Gliadel
Carmustine is a nitrosourea alkylating cytotoxic agent used in brain tumours, certain lymphomas and myeloma, available as an injection and as an implantable wafer.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It alkylates and cross-links DNA and also carbamoylates proteins, disrupting DNA replication and leading to cell death.
Prescribing in practice
- Delayed and cumulative bone marrow suppression is a major dose-limiting toxicity and can occur weeks after administration, requiring prolonged blood count monitoring.
- Pulmonary toxicity, including delayed pulmonary fibrosis, can occur and necessitates baseline and ongoing assessment of lung function.
- It is hepatotoxic and nephrotoxic with cumulative exposure, so liver and renal function should be monitored.
Monitoring
Monitor full blood count for a prolonged period after each dose, together with pulmonary, liver and renal function.
Counselling the patient
- Report any breathlessness or a persistent cough, which may indicate lung effects.
- Seek urgent advice if you develop fever, bruising or bleeding as your blood counts can fall.
- Attend all scheduled blood tests, as effects on the bone marrow may appear some weeks after treatment.
Evidence & guidelines
Carmustine's use is established in standard oncology practice and reflected in the SPC and treatment guidelines.
Reference: NICE TA121; ESMO; BSH; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.