BICNU 100 MG FLK

BICNU (Carmustine) is an injectable chemotherapy medication used primarily in the treatment of various types of cancers. It is available in a 100 mg vial, typically prepared for intravenous infusion. Carmustine is a potent alkylating agent that interferes with DNA replication, making it effective in targeting rapidly dividing cancer cells.

How BICNU Works

Mechanism of Action

1. Alkylating Agent:
   • Carmustine is classified as an alkylating agent. It works by adding alkyl groups to the DNA of cancer cells. This process forms cross-links in the DNA strands, which inhibits the cell’s ability to replicate and divide.
2. DNA Cross-Linking:
   • By cross-linking DNA, Carmustine prevents DNA repair and replication. This leads to cell cycle arrest and apoptosis (programmed cell death) in cancer cells.
3. Cell Cycle Specificity:
   • Carmustine is not specific to any particular phase of the cell cycle. This allows it to be effective against both dividing and non-dividing cancer cells.
4. Penetration of Blood-Brain Barrier:
   • Carmustine can cross the blood-brain barrier, making it useful in treating brain tumors and other central nervous system malignancies.

Side Effects

Common Side Effects

• Nausea and Vomiting:
  • Frequently observed side effects, often managed with anti-nausea medications.
• Bone Marrow Suppression:
  • Includes decreased white blood cell count (leukopenia), red blood cell count (anemia), and platelet count (thrombocytopenia).
• Fatigue:
  • Patients may experience general tiredness and weakness.
• Loss of Appetite:
  • Reduced desire to eat, which can lead to weight loss.

Serious Side Effects

• Lung Toxicity:
  • Potential for severe lung damage, including interstitial pneumonitis.
• Liver Toxicity:
  • Liver enzyme abnormalities and jaundice.
• Renal Toxicity:
  • Kidney damage, including potential for renal failure.
• Secondary Malignancies:
  • Risk of developing secondary cancers due to the mutagenic effects of the drug.

Indications

BICNU is indicated for:

• Brain Tumors:
  • Used in the treatment of primary brain tumors, including gliomas and glioblastomas.
• Hodgkin’s Lymphoma:
  • Part of combination therapy regimens for Hodgkin’s lymphoma.
• Non-Hodgkin’s Lymphoma:
  • Utilized in certain types of non-Hodgkin’s lymphoma.
• Multiple Myeloma:
  • Included in treatment regimens for multiple myeloma.

Contraindications

BICNU should not be used in the following conditions:

• Hypersensitivity:
  • Known hypersensitivity to Carmustine or any component of the formulation.
• Severe Bone Marrow Suppression:
  • Contraindicated in patients with severe bone marrow suppression or significant hematologic abnormalities.
• Severe Liver or Kidney Dysfunction:
  • Use with caution in patients with severe liver or kidney impairment.
• Pregnancy and Breastfeeding:
  • Not recommended during pregnancy or breastfeeding due to potential harm to the fetus or infant.

Price in Different Countries

The price of BICNU can vary by country and pharmacy. Below is a table with approximate prices and references for further details.

Country	Price (Per 100 mg Vial)	Reference
United States	$2,500 – $3,000	GoodRx
United Kingdom	£1,800 – £2,200	NHS UK
Canada	CAD $3,000 – $3,500	Canada Pharmacy
Australia	AUD $4,000 – $4,500	PBS Australia
India	₹30,000 – ₹35,000	1mg

Top 5 Global Brands

BICNU is the primary brand name for Carmustine, but several other brands and generics are available globally for similar treatments. Here are the top global brands:

1. BICNU (Carmustine) – Bristol-Myers Squibb:
   • The original and well-known brand for Carmustine.
2. Gliadel (Carmustine) – Eisai:
   • A brand of Carmustine used in wafer form for direct implantation into brain tumors.
3. Temodal (Temozolomide) – Merck:
   • Although not Carmustine, Temodal is used in similar indications for brain tumors and has similar properties.
4. Alkeran (Melphalan) – GlaxoSmithKline:
   • Another alkylating agent used for multiple myeloma and ovarian cancer, with a similar mechanism of action.
5. Cytoxan (Cyclophosphamide) – Bristol-Myers Squibb:
   • A widely used alkylating agent in oncology, with a broad range of indications.