The Basics
What is Carmustine?
Used to treat certain types of brain tumors, and, along with prednisone, to treat multiple myeloma.
Brand names for Carmustine
Bicnu
How Carmustine is classified
Antineoplastic Agents, Alkylating, Nitrosourea Compounds
Carmustine During Pregnancy
Carmustine pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Carmustine while pregnant
BiCNU (carmustine for injection) can cause fetal harm when administered to a pregnant woman based on the mechanism of action [see CLINICAL PHARMACOLOGY] and findings in animals . Limited available data with BiCNU use in pregnant women are insufficient to inform a drug-associated risk of major birth defects and miscarriage. Carmustine was embryotoxic in rats and rabbits and teratogenic in rats (thoracoabdominal closure, neural tube, and eye defects and malformations of the skeletal system of the fetus) when given in doses lower than the maximum cumulative human dose based on body surface area. Consider the benefits and risks of BiCNU for the mother and possible risks to the fetus when prescribing BiCNU to a pregnant woman. Adverse outcomes in pregnancy occur regardless of the health of the mother or the use of medications. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively
Taking Carmustine While Breastfeeding
What are recommendations for lactation if you're taking Carmustine?
No information is available on the use of carmustine during breastfeeding. Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially alkylating agents such as carmustine.[1] The manufacturer recommends that breastfeeding be discontinued during carmustine therapy and for 1 month after the last dose.
Maternal / infant drug levels
No information is available on the use of carmustine during breastfeeding. Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially alkylating agents such as carmustine.[1] The manufacturer recommends that breastfeeding be discontinued during carmustine therapy and for 1 month after the last dose.
Possible effects of Carmustine on milk supply
Some evidence indicates that carmustine can increase serum prolactin.[2]
Possible alternatives to Carmustine
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Pistilli B, Bellettini G, Giovannetti E et al. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: How should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013;39:207-11. PMID: 23199900
2. Constine LS, Rubin P, Woolf PD et al. Hyperprolactinemia and hypothyroidism following cytotoxic therapy for central nervous system malignancies. J Clin Oncol. 1987;5:1841-51. PMID: 3681371
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
