Posology : מינונים

4.2       Posology and method of administration
Adults:

Posology of intravenous administration:
The recommended dose of Carmustine Raz 100mg as a single agent in previously untreated patients is 150 to 200 mg/m2 intravenously every 6 weeks. This may be given as a single dose or divided into two daily injections such as 75 to 100 mg/m2 on two successive days.

When Carmustine Raz 100mg is used in combination with other myelosuppressive medicinal products or in patients in whom bone marrow reserve is depleted, the doses should be adjusted accordingly.

A repeat course of Carmustine Raz 100mg should not be given until circulating blood elements have returned to acceptable levels (platelets above 100,000/ mm3, leukocytes above 4,000/ mm3), and this is usually in six weeks. Blood counts should be monitored frequently and repeat courses should not be given before six weeks because of delayed hematologic toxicity.

Doses subsequent to the initial dose should be adjusted according to the hematologic response of the patient to the preceding dose in both monotherapy as well as in combination therapy with other myelosuppressive medicinal products. The following schedule is suggested as a guide to dosage adjustment:

Nadir after Prior Dose                              Percentage of prior dose Leucocytes/ mm3      Platelets/ mm3                 to be given
>4000                >100,000                       100
3000 - 3999          75,000 - 99,999                100
2000 - 2999          25,000 - 74,999                70
<2000                <25,000                        50

Children:
Carmustine should be used with extreme caution in children due to the high risk of pulmonary toxicity (see Warnings).

Elderly:
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dose range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and renal function should be monitored.
Method of administration:
Following reconstitution (please, see Section 6.6) with sterile diluent (3 ml vial provided) and dilution with water for injection, Carmustine Raz 100mg should be administered by intravenous drip over one to two hour period. The time of infusion should not be less than one hour otherwise it leads to burning and pain at the injected area. The injected area should be monitored during the administration.
There are no limits for the period of application of carmustine therapy. In case the tumor remains uncurable or some serious or untolerable side effects appear, the carmustine therapy must be terminated.