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BiCNU Warnings and Precautions

Your healthcare provider can help minimize potential complications with BiCNU by asking you about any other medical conditions you have or other medications you are taking. BiCNU can cause dangerous complications, such as significantly low blood cell counts, lung damage, or drug interactions. Important warnings and safety precautions with BiCNU also apply to women who are pregnant or nursing.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving BiCNU® (carmustine) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Lung disease
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With BiCNU

Some warnings and precautions to be aware of prior to using this medication include the following:
  • This medicine is associated with serious and potentially life-threatening side effects. Your healthcare provider will weigh the benefits of treatment against the risks before making a recommendation for your situation. You will be monitored closely during treatment. Your healthcare provider may delay treatment, adjust your dose, or stop treatment altogether if you experience serious side effects.
  • BiCNU can significantly reduce the amount of blood cells in your body, which could increase your risk for the following problems:
    • Anemia due to low red blood cells
    • Infections due to low white blood cells
    • Bleeding due to low platelets.
  • Your healthcare provider will monitor your blood cell counts weekly after each BiCNU dose. Let your healthcare provider know if you develop any signs of low blood cell counts, such as:
    • Unusual bleeding or bruising
    • Signs of infection, such as:
      • Fever
      • Chills
      • Aches and pains
    • Signs of anemia, such as:
      • Tiredness
      • Shortness of breath
      • Paleness.
  • BiCNU may cause lung damage, especially in people who receive multiple doses of the medication. There have even been reports of lung damage occurring up to 17 years after treatment in people who were given the medication as children. In some cases, the lung damage caused death.
  • You should know that this medication may increase your risk for developing other types of cancer, including leukemia.
  • Your healthcare provider will monitor your kidneys, lungs, liver, and blood cell counts using various laboratory tests during treatment. Make sure to keep all of your healthcare provider and laboratory appointments.
  • This medication may cause eye damage if given as an injection into the carotid arteries (the arteries that deliver blood to the head and brain). Although it is only approved to be given as an injection into a vein, intracarotid use (into the carotid artery) has also been studied.
  • You could experience a reaction at the site of your infusion, especially if the medication leaks from your vein to the surrounding tissue. Let your healthcare provider know right away if you experience any injection site reactions, such as:
    • Burning
    • Stinging
    • Redness
    • Swelling
    • Pain.
  • BiCNU is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see BiCNU and Pregnancy).
  • It is not known whether BiCNU passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see BiCNU and Breastfeeding).
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