Generic Name: Carmustine implants (kar-MUS-teen), Polifeprosan 20 with Carmustine implant
Trade Name: Gliadel® wafer
For which conditions is this drug approved? Polifeprosan 20 with carmustine implant is FDA approved for the treatment of high-grade glioma and recurrent glioblastoma multiforme. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Carmustine belongs to a group of drugs referred to as nitrosoureas. Carmustine produces its anti-cancer effects by causing chemical reactions that result in damage to both DNA and amino acids in a cell. The DNA and amino acid damage caused by carmustine ultimately result in cellular death.
How is polifeprosan 20 with carmustine implant typically given (administered)? Carmustine implants are dime-sized “wafers” that are placed in the cavity in the brain that remains following the surgical removal of the cancer.The wafers slowly dissolve, allowing carmustine to be continuously delivered to the area of the brain that was directly surrounding the cancer in order to kill any cancer cells left behind after surgery. The amount of wafers placed during surgery depends upon the size of the surgical cavity and the ability to appropriately place the wafers in the cavity.
How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with carmustine implants. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients will have their surgical wound assessed to check for normal healing and infection.
What are the common (occur in 30% or more of patients) side effects of treatment with carmustine?
• Abnormal healing of the surgical wound
• Brain edema (swelling)
These side effects may occur as a result of brain surgery alone but may occur more frequently when the carmustine implant is used.
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
When should patients notify their physician?
• Signs of infection at the site of surgery – pus, increasing tenderness, swelling or redness
• Drainage from the site of surgery
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.
Copyright © 2010 CancerConnect Last updated 07/10.
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