Myelosuppression: BiCNU causes suppression of bone marrow function (including thrombocytopenia and leukopenia), which may contribute to bleeding and overwhelming infections [see Precautions and Adverse Reactions].
Monitor blood counts weekly for at least 6 weeks after each dose. Adjust dosage based on nadir blood counts from the prior dose [see Dosage & Administration]. Do not administer a repeat course of BiCNU until blood counts recover.
Pulmonary Toxicity: BiCNU causes dose-related pulmonary toxicity. Patients receiving greater than 1400 mg/m2 cumulative dose are at significantly higher risk than those receiving less. Delayed pulmonary toxicity can occur years after treatment, and can result in death, particularly in patients treated in childhood [see Use in Specific Populations under Precautions and Adverse Reactions].