How BiCNU Works and How It’s Taken

BiCNU is a chemotherapy medicine. It is not fully known how BiCNU works. It may work by damaging DNA and RNA, which are materials inside cells.

This DNA and RNA damage may lead to cancer cell death. Doctors prescribe BiCNU in combination with prednisone when adults with multiple myeloma need palliative treatment.

BiCNU is given as an intravenous (IV) infusion, typically once every six weeks. It may be given as one dose or split over two days in a treatment center.

Typical Dosing for Multiple Myeloma

The recommended dose of BiCNU for multiple myeloma is 150 to 200 milligrams per square meter, given through a vein every six weeks. The dose is based on body surface area, a standard calculation using height and weight that healthcare providers use to determine dosing.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

BiCNU Side Effects

In clinical studies, the most common side effects of BiCNU used with prednisone for multiple myeloma were reported in more than 1 percent of people. They include:

• Nausea
• Vomiting
• Renal toxicity (kidney problems)
• Pneumonitis (lung inflammation)
• Pulmonary toxicity (lung problems)
• Myelosuppression (a decrease in blood cell production by the bone marrow)

Serious Side Effects and Warnings

BiCNU can cause serious side effects that may require immediate medical attention. These include:

• Myelosuppression — Low blood cell counts can increase the risk of bleeding and serious infections.
• Pulmonary toxicity — Lung damage, including pneumonitis or lung scarring, can be life-threatening.
• Secondary cancers — New cancers can develop after treatment.
• Severe infusion reactions — Intense flushing, eye redness, burning, swelling, pain, skin injury, or tissue damage can occur if the drug leaks outside the vein.
• Seizures — Neurologic events can occur.
• Renal toxicity — Worsening kidney function, including kidney failure, can occur.
• Liver toxicity — Liver injury may show up as abnormal liver tests and can be serious.
• Veno-occlusive disease — Blocked small veins in the liver can cause serious liver problems.
• Serious allergic reactions — Skin reactions and swelling can occur.
• Fetal harm — BiCNU can harm your baby if you are pregnant.

Get medical help right away if you think you are having a serious reaction.

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What To Know Before Taking BiCNU

Before starting BiCNU, your doctor will check your kidney function and may do baseline lung function tests.

Tell your doctor if you have any allergies to carmustine or any ingredients in BiCNU. Do not take BiCNU if you have had a serious allergic reaction to carmustine or any of its ingredients.

Tell your doctor about all medications you take, including prescription drugs, over-the-counter medicines, and supplements.

BiCNU is also FDA-approved to treat certain brain tumors and relapsed or refractory Hodgkin lymphoma and non-Hodgkin lymphomas in combination with other drugs.

If you are pregnant, planning to become pregnant, or breastfeeding while taking BiCNU, talk with your doctor about the risks and benefits. BiCNU can harm your baby if you are pregnant. If you can become pregnant, use highly effective contraception during treatment and for six months after treatment.

If you have a partner who can become pregnant, use effective contraception during treatment and for at least three months after the final dose. Breastfeeding should be stopped while taking BiCNU.

Community FAQs

These answers are fact-checked by our editorial staff.

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Learn More

On MyMyelomaTeam, people share their experiences with multiple myeloma, get advice, and find support from others who understand.

Learn more about BiCNU and multiple myeloma care:

• Prescribing Information — BiCNU
• Myeloma Treatments: Risks and Benefits — MyMyelomaTeam
• Multiple Myeloma Frontline Treatment Options — International Myeloma Foundation