Carmustine

IMPORTANT WARNING:

Carmustine can cause a severe decrease in the number of blood cells in your bone marrow. This increases the risk that you will develop a serious infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, chills, or other signs of infection; unusual bleeding or bruising; black and tarry stools; red blood in stools; bloody vomit; vomited material that looks like coffee grounds.

Carmustine also can cause lung damage, even years after treatment. The lung damage can cause death, especially in patients treated with carmustine as children. Tell your doctor if you have or have ever had lung disease.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to carmustine.

WHY is this medicine prescribed?

Carmustine injection is used to treat certain types of brain tumors. Carmustine injection is also used along with prednisone to treat multiple myeloma (a type of cancer of the bone marrow). It is also used with other medications to treat Hodgkin's lymphoma (Hodgkin's disease) and non-Hodgkin's lymphoma (cancer that begins in the cells of the immune system) that has not improved or that has worsened after treatment with other medications. Carmustine is in a class of medications called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Carmustine injection comes as a powder to be added to fluid and injected over at least 2 hours intravenously (into a vein) by a doctor or nurse in a medical office or hospital outpatient clinic. It is usually injected once every 6 weeks. It may also be injected in smaller doses once a day for 2 days in a row every 6 weeks.

Your doctor may need to delay your treatment or adjust your dose if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with carmustine.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving carmustine injection,

• tell your doctor and pharmacist if you are allergic to carmustine or any of the ingredients in carmustine injection. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, you are taking or plan to take. Be sure to mention any of the following: cimetidine (Tagamet) and phenytoin (Dilantin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Other medications may also interact with carmustine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

• tell your doctor if you have or have ever had kidney or liver disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not become pregnant while you are receiving carmustine injection. If you become pregnant while receiving carmustine, call your doctor. Carmustine may harm the fetus.

What SIDE EFFECTS can this medicine cause?

Carmustine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• headache
• loss of balance or coordination
• pale skin
• fainting
• dizziness
• fast or irregular heartbeat
• chest pain
• darkened skin

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• swelling, pain, redness, or burning at the injection site
• upset stomach
• extreme tiredness or weakness
• lack of energy
• loss of appetite
• pain in the upper right part of the stomach
• yellowing of the skin or eyes
• decreased urination
• swelling of the hands, feet, ankles, or lower legs

Carmustine injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Carmustine may increase the risk that you will develop other cancers. Talk to your doctor about the risk(s) of receiving carmustine injection.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.