Carmustine is a chemotherapy medicine used to treat several cancers. It comes as an intravenous (IV) infusion and as a small wafer placed in the brain during surgery (Gliadel Wafer). You will receive it in a hospital or clinic.
Brand Name(s)
- United States: BiCNU (discontinued), Gliadel Wafer
- Canada: BiCNU
Warning(s)
Carmustine can cause serious side effects. Knowing the risks helps you watch for problems early.
- Severe bone marrow suppression: Your body may make fewer white cells, red cells, and platelets. This raises the risk of infection, anemia, and bleeding.
- Blood counts: You will need frequent blood tests, often for at least 6 weeks after each dose.
- Lung toxicity: Serious and sometimes fatal lung problems can happen, especially with higher total lifetime doses. Lung issues can appear years later. Risk may be higher if treated as a child.
- Infection and bleeding risk (injection): You may get infections more easily and bleed or bruise more. Wash hands often and avoid people who are sick. Use a soft toothbrush and an electric razor.
- Vaccines (injection): Some vaccines may not work as well or may increase infection risk. Ask your care team before any vaccines.
- Organ effects: This drug may affect the liver and kidneys. Your care team may check your labs and organ function.
- Skin and vein injury (injection): Leaking of the drug outside the vein can damage tissue. Tell your nurse right away if you feel pain, burning, or see redness or swelling at the IV site.
- Fertility: Carmustine may affect the ability to have children.
- Pregnancy: This drug can harm an unborn baby. You will have a pregnancy test before starting.
- Birth control: If you can become pregnant, use birth control while taking carmustine and for 6 months after the last dose. If your partner can become pregnant, use birth control during treatment and for 3 months after the last dose.
- Breastfeeding: Do not breastfeed during treatment. You may need to avoid breastfeeding for 7 days after the last dose. Ask your care team how long to wait.
- Second cancers (injection): There is a small increased risk of later bone marrow problems or leukemia.
- Gliadel Wafer: Not approved for use in children.
Call your care team or seek urgent help for signs of serious problems, such as fever or chills, trouble breathing, chest pain, severe dizziness, seizures, confusion, sudden weakness on one side, bad headache with fever and stiff neck, or any heavy bleeding.
Kind of Cancers It Is Used For (not a complete list)
- Brain tumors, including glioblastoma and anaplastic astrocytoma (IV and Gliadel Wafer)
- Hodgkin lymphoma (IV)
- Non-Hodgkin lymphoma (IV)
- Multiple myeloma (IV)
Your care team may use carmustine for other cancers based on your situation.
Mechanism of Action
Carmustine is a nitrosourea, a type of alkylating chemotherapy. It damages cancer cell DNA by adding chemical links (cross-links). This blocks DNA repair and cell division, leading to cancer cell death.
- It can cross the blood–brain barrier, which is helpful for brain tumors.
- Gliadel Wafer slowly releases carmustine directly into brain tissue after surgery to target tumor cells nearby.
Common Side Effects
Everyone is different. Some side effects are more common with the IV form than with the wafer.
- Injection (IV):
- Nausea, vomiting, diarrhea, or decreased appetite
- Headache
- Hair loss
- Feeling very tired or weak
- Low blood counts (can raise the risk of infection, anemia, and bleeding)
- Changes in liver or kidney tests
- Cough or shortness of breath
- Gliadel Wafer (implant):
- Nausea or vomiting
- Constipation
- Stomach or back pain
- Feeling tired or weak
Serious but less common effects can include infections, bleeding, lung problems, liver or kidney problems, seizures, and symptoms of meningitis (with the wafer). Report new or worsening symptoms promptly.
Tips that may help:
- Ask about anti-nausea medicines before and after IV treatment.
- Keep all lab and follow-up appointments, including blood and lung function checks.
- Practice good hand hygiene. Avoid people who are sick.
- Use a soft toothbrush and an electric razor to reduce bleeding risk.
Last reviewed: 2025-12-17
