Carmustine Injection

• Type: Anticancer (chemotherapy) medication

• Drug Class: Nitrosourea alkylating agent

• Form: Intravenous injection or infusion

How It Works

• Carmustine works by attaching alkyl groups to DNA in cancer cells.

• This causes DNA cross-linking, which prevents the cancer cell from replicating and leads to cell death.

• It is lipid-soluble, which means it can cross the blood-brain barrier, making it useful for brain tumors.

Common Uses

• Brain tumors (including glioblastoma, astrocytoma, medulloblastoma)

• Multiple myeloma

• Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma

• Sometimes used in bone marrow transplant conditioning regimens

Advantages

• One of the few chemotherapy drugs that can effectively reach the brain and central nervous system

• Can be used alone or in combination with other chemotherapy drugs

• Available as both IV injection and a biodegradable wafer implant (used during brain surgery to release the drug directly at the tumor site)

Possible Side Effects

• Bone marrow suppression (low white blood cells, red blood cells, platelets) — often delayed, appearing 4–6 weeks after treatment

• Nausea and vomiting

• Liver and kidney toxicity (with repeated use)

• Lung toxicity (rare but serious — pulmonary fibrosis)

• Fatigue, mouth sores

• Skin redness or darkening at injection site

• Rare: secondary cancers with long-term use

Precautions

• Requires frequent blood tests for several weeks after each dose to monitor bone marrow function

• Careful dosing needed to reduce risk of delayed bone marrow toxicity

• Use with caution in patients with preexisting lung, liver, or kidney problems

• Effective contraception is advised, as it may harm an unborn baby

• Should only be administered under supervision of an experienced oncology team