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Precautions and Warnings With Carmustine Implant

People who receive chemotherapy treatment with carmustine implants should be aware of precautions for using this drug safely, including warnings for people who have bleeding problems, a seizure disorder, or an infection. People who have medical issues such as these may have an increased risk for complications. Also, women who are pregnant or nursing may need to avoid this medication.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving a carmustine implant (Gliadel®) if you have:
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 Carmustine Implant Precautions and Warnings

Some warnings and precautions to be aware of prior to receiving this medication include the following:
  • People who undergo surgery for glioma (a type of brain tumor) and receive carmustine implants are at risk for potentially serious complications, including seizures, brain infections, swelling of the brain, and abnormal wound healing. Your healthcare provider will monitor you closely for these problems.
  • If the wafers are not implanted properly, they could block the flow of cerebrospinal fluid (the clear fluid that surrounds the brain and spinal cord). If this happens, the fluid could accumulate and cause pressure on the brain (known medically as obstructive hydrocephalus). Let your healthcare provider know if you have any symptoms of increased pressure on the brain, such as:
    • Headaches
    • Nausea
    • Vomiting
    • Problems with coordination, balance, vision, concentration, or memory.
  • In clinical studies, there were reports of seizures occurring days and weeks after these implants were placed in the brain, even in people who had never had a seizure before.
  • Brain swelling has been reported to occur in people given carmustine implants. If you develop brain swelling, you may need to have another surgery. In some cases, the wafers may need to be removed.
  • Abnormal wound healing has been reported in people who received carmustine implants in clinical trials. Examples of abnormal wound healing include:
    • Reopening of the surgical wound
    • Delayed healing of the surgical wound
    • Leakage of cerebrospinal fluid.
  • Brain infections, such as meningitis, have occurred in people who received carmustine implants. Contact your healthcare provider right away if you develop any signs of meningitis, such as:
    • Fever
    • A severe headache
    • Nausea and vomiting
    • A stiff neck.
  • Carmustine, the active ingredient in the implants, has been reported to cause other types of cancer in animal studies. It is unknown whether carmustine implants are associated with the same risks.
  • The carmustine implant is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Gliadel and Pregnancy).
  • It is unknown whether carmustine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving these implants (see Gliadel and Breastfeeding).
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Carmustine Implant Information

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