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Carmustine parenteral

Updated 2 Feb 2023 | Alkylating agents


Parenteral formulations of carmustine.

Drugs List

  • carmustine 100mg powder and solvent for solution for infusion vials
  • Therapeutic Indications


    Conditioning prior to haematopoietic progenitor cell transplantation
    Hodgkin's disease
    Lymphoma - non-Hodgkin's
    Myeloma - multiple
    Tumour of the brain

    Brain tumours, including glioblastoma, brain-stem gliomas, medulloblastoma, astrocytoma, ependymoma and metastatic brain tumours.

    Multiple myeloma, in combination with glucocorticoid such as prednisone.

    Hodgkin's disease, as secondary therapy in combination with other approved drugs in patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy.

    Non-Hodgkin's lymphomas, as secondary therapy in combination with other approved drugs in patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy.

    Conditioning treatment prior to autologous haematopoietic progenitor cell transplantation (HPCT) in malignant haematological diseases (Hodgkin's/Non-Hodgkin's lymphoma).


    Whilst the doses stated below are those recommended by the manufacturer, local cancer network protocols for the relevant indication should be consulted.

    Doses may vary significantly if this agent is used as monotherapy or different combinations.
    When using this agent, specialist literature, national guidelines, cancer network protocols and Trust chemotherapy protocols should be consulted.


    Initial dose
    150mg to 200mg per metre squared every 6 weeks. This may be given as a single dose or as two daily injections on two consecutive days.

    Subsequent doses
    Subsequent doses should be adjusted based on the haematological response of the patient in the prior treatment cycle.
    Leucocyte count 3000 per mm cubed and above, and platelet count 75,000 and above
    100% of prior dose.
    Leucocyte count above 2000 and up to 3000 per mm cubed, and platelet count above 25,000 and up to 75,000
    70% of prior dose.
    Leucocyte count below 2000 per mm cubed, and platelet count below 25,000
    50% of prior dose.

    Conditioning treatment prior to HPCT
    Carmustine (300mg to 600mg per metre squared) is given in combination with other chemotherapeutic agents in patients with malignant haematological diseases before HPCT.


    For intravenous infusion via a drip, over a 1-2 hour period.


    Children under 18 years
    Leucocyte count below 4 x 10 to the power of 9 / L
    Platelet count below 100 x 10 to the power of 9/ L
    Severe renal impairment

    Precautions and Warnings

    History of thoracic radiotherapy
    Tobacco smoking
    Epileptic disorder
    Hepatic impairment
    Renal impairment
    Respiratory disease

    Advise patient ability to drive or operate machinery may be impaired
    Give pre-treatment counselling and consideration of sperm cryopreservation
    Contains alcohol
    Consult local policy on the safe use of anti-cancer drugs
    Staff: Not to be handled by pregnant staff
    Treatment to be administered by or under supervision of specialist
    Perform chest X-ray prior to and periodically during treatment
    Monitor full blood count regularly
    Monitor hepatic function regularly
    Monitor pulmonary function regularly
    Monitor renal function regularly
    Potentially mutagenic and carcinogenic
    Female: Contraception required during and for 6 months after treatment
    Male: Contraception required during and for 6 months after treatment
    Breastfeeding: Do not breastfeed during & for 1 week after treatment

    Pregnancy and Lactation


    Carmustine is contraindicated during pregnancy.

    The manufacturer recommends that carmustine should not be given to pregnant women. There is limited available data on the use of carmustine in pregnant women. Carmustine has been shown to be carcinogenic, mutagenic and embryotoxic in animal studies.


    Carmustine is contraindicated during breastfeeding.

    The manufacturer recommends discontinuing breastfeeding during treatment with carmustine and for seven days after treatment. It is not known whether this agent or its metabolites are excreted in human breast milk. The low molecular weight of Carmustine suggests that it may be secreted into breast milk. The effect on the breast-fed infant is unknown.

    Side Effects

    Acute leukaemia
    Blurred vision
    Bone marrow dysplasias
    Chest pain
    Conjunctival flushing
    Disturbances in liver enzymes and bilirubin (transient)
    Electrolyte disturbances
    Grand mal seizure
    Injection site reactions
    Interstitial fibrosis
    Localised ocular toxicity
    Muscle pain
    Opportunistic infections
    Pulmonary toxicity
    Renal toxicity
    Retinal haemorrhage
    Status epilepticus
    Teratogenic effects
    Veno-occlusive disease


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2022

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Carmustine 100mg powder and solvent for solution for infusion. Tillomed Laboratories Ltd. October 2021.
    Summary of Product Characteristics: Carmustine 100mg powder and solvent for concentrate for solution for infusion vials. Sovereign Medical Ltd. November 2021.

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