Why is this medication prescribed?

Gliadel (carmustine implant) is prescribed for the treatment of certain types of brain tumors, specifically malignant gliomas, including glioblastoma multiforme. Gliadel is a biodegradable implant that contains the chemotherapy drug carmustine. It is used as part of the treatment plan for patients who have undergone surgery to remove the tumor, as a means to target any remaining cancer cells in the surrounding tissue.

How should this medicine be used?

Gliadel is used in combination with surgery to remove the tumor and other treatments like radiation therapy and chemotherapy. It is inserted directly into the brain during surgery. The implant slowly releases carmustine over a period of several weeks, providing a localized and sustained dose of the medication directly to the tumor site.

Here’s how Gliadel is typically used:

• Surgical Implantation: During surgery to remove the brain tumor, the neurosurgeon will place the Gliadel wafers directly into the space left by the tumor removal. The number of wafers used depends on the size of the tumor cavity.
• Post-Surgery Care: After implantation, the area where the wafers are placed will be closed, and the patient will recover in the hospital.
• Monitoring: Patients will be monitored closely following surgery and throughout their treatment course to manage any potential side effects and assess the response to treatment.

It’s essential for patients to follow their healthcare provider’s instructions carefully regarding the use of Gliadel and to attend all follow-up appointments to ensure the best possible outcome and minimize complications.

Other uses for this medicine

While Gliadel (carmustine implant) is primarily used for the treatment of certain types of brain tumors, there are no other FDA-approved uses for this medication. It’s specifically designed for use in the treatment of malignant gliomas such as glioblastoma multiforme.

What special precautions should I follow?

Regarding special precautions for Gliadel, it’s crucial to consider the following:

• Pregnancy and Breastfeeding: Gliadel may cause harm to a developing fetus, so it’s essential to inform your healthcare provider if you are pregnant or planning to become pregnant. Similarly, it’s not known whether Gliadel passes into breast milk, so breastfeeding while using this medication is not recommended.
• Allergies: Inform your healthcare provider if you have any allergies, especially to carmustine or other alkylating agents, as this may affect your suitability for treatment with Gliadel.
• Infections: Gliadel may increase the risk of developing infections. Inform your healthcare provider if you develop signs of infection such as fever, chills, sore throat, or unusual tiredness.
• Liver and Kidney Function: Gliadel may affect liver and kidney function. Your healthcare provider may perform tests to monitor your liver and kidney function while you are using this medication.
• Other Medications: Inform your healthcare provider about all other medications you are taking, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Some medications may interact with Gliadel, potentially increasing the risk of side effects or reducing its effectiveness.
• Implant Handling: Gliadel wafers are implanted directly into the brain during surgery. Special care must be taken during implantation to ensure the wafers are placed correctly and to minimize the risk of complications such as bleeding or infection.
• Side Effects: Be aware of potential side effects of Gliadel, which may include headache, seizures, brain swelling, infection at the surgical site, and changes in mental status. Inform your healthcare provider promptly if you experience any concerning symptoms.

Always follow your healthcare provider’s instructions and consult them if you have any questions or concerns about using Gliadel. They can provide personalized guidance based on your medical history and individual circumstances.

What special dietary instructions should I follow?

Regarding special dietary instructions for Gliadel, there are no specific dietary restrictions associated with this medication. However, it’s essential to maintain a balanced and healthy diet to support overall health and well-being during treatment.

What should I do if I forget a dose?

If a dose of Gliadel is missed, it cannot be simply taken later since it is surgically implanted during brain surgery. However, if you have any concerns about your treatment schedule or if you experience any unexpected symptoms, it’s crucial to contact your healthcare provider promptly for guidance. They can provide appropriate advice based on your individual circumstances and treatment plan.

What side effects can this medication cause?

Gliadel (carmustine implant) can cause various side effects, some of which may be serious. It’s essential to be aware of potential side effects and to promptly inform your healthcare provider if you experience any concerning symptoms. Common side effects of Gliadel may include:

• Headache: Patients may experience headaches following Gliadel implantation.
• Seizures: Seizures can occur as a side effect of Gliadel treatment. Patients should be monitored closely for seizure activity.
• Brain Swelling (Cerebral Edema): Some patients may develop brain swelling, also known as cerebral edema, as a result of Gliadel treatment. Symptoms of cerebral edema may include headache, confusion, changes in vision, and neurological deficits.
• Infection: There is a risk of infection at the surgical site following Gliadel implantation. Signs of infection may include fever, redness, swelling, warmth, or drainage at the surgical site.
• Changes in Mental Status: Gliadel treatment may cause changes in mental status, such as confusion or disorientation.
• Bleeding: There is a risk of bleeding at the surgical site following Gliadel implantation. Patients should be monitored for signs of bleeding, such as excessive bruising or bleeding from the surgical site.
• Nausea and Vomiting: Some patients may experience nausea and vomiting as a side effect of Gliadel treatment.
• Hair Loss: Hair loss (alopecia) may occur as a side effect of Gliadel treatment.
• Fatigue: Patients may experience fatigue or weakness following Gliadel implantation.
• Speech and Language Difficulties: Some patients may experience speech and language difficulties as a result of Gliadel treatment.

It’s important to note that this is not a comprehensive list of all possible side effects of Gliadel. Some side effects may be rare but serious. Patients should discuss any concerns or unexpected symptoms with their healthcare provider promptly. Additionally, healthcare providers will monitor patients closely for potential side effects during and after Gliadel treatment.

What should I know about storage and disposal of this medication?

Storage and disposal of Gliadel:

• Storage: Gliadel wafers should be stored at controlled room temperature, typically between 20-25°C (68-77°F). It should be kept in its original packaging until ready for use. Avoid exposure to excessive heat or moisture. Keep Gliadel out of reach of children and pets.
• Disposal: Because Gliadel wafers are implanted during surgery and not taken orally, there are no specific instructions for disposal. Any unused or expired Gliadel wafers should be disposed of according to local regulations for hazardous medical waste. Your healthcare provider or hospital can provide guidance on proper disposal procedures.

In case of emergency/overdose

In the event of an emergency or suspected overdose of Gliadel, immediately seek medical assistance or contact your local poison control center. Overdose with Gliadel may lead to an increased risk of side effects such as cerebral edema, seizures, and infection. Prompt medical attention is crucial in managing any potential complications.

What other information should I know?

• Gliadel wafers are intended for single use during brain surgery and should not be reused.
• Inform all healthcare providers involved in your care, including dentists and pharmacists, that you have received Gliadel treatment.
• Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to treatment and manage any potential side effects.
• Keep a record of all medications you are taking, including Gliadel, and discuss any changes with your healthcare provider.
• Report any new or worsening symptoms to your healthcare provider promptly, as they may indicate complications or the need for adjustments to your treatment plan.

Always follow your healthcare provider’s instructions and guidance regarding the use of Gliadel, including storage, disposal, and what to do in case of emergencies or overdose. They can provide personalized advice based on your individual circumstances and medical history.