Drug General Information (ID: DDI4WZY6BT)
Drug Name			Carmustine		Drug Info		Thiotepa		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Alkylating Agents				Alkylating Agents
Structure

Mechanism of Carmustine-Thiotepa Interaction (Severity Level: Major)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Carmustine				Thiotepa
Mechanism 1		Immunomodulatory effects				Immunomodulatory effects
Key Mechanism Factor 1
		Factor Name		Immunosuppressive effects
		Factor Description		Immunosuppression is when your immune system is not functioning as it should. The immune system is made up of cells, tissues and organs that help the body fight off infections. If the immune system is suppressed, an infection that your body was able to control may become serious or even fatal.
Mechanism Description		Additive immunosuppressive effects by the combination of Carmustine and Thiotepa
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Carmustine				Thiotepa
Mechanism 2		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 2
		Factor Name		Myelosuppressive effects
		Factor Description		Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that leads to a decrease in the production of blood cells. Some blood cell disorders include: erythrocytopenia (anemia), leukopenia (neutropenia), and thrombocytopenia (thrombocytopenia).
Mechanism Description		Additive myelosuppressive effects by the combination of Carmustine and Thiotepa

Recommended Action
Management		It is not advisable to combine chemotherapeutic agents (or modalities) that have the same mechanism of action. If these agents must follow each other, it is important that recovery from the first agent (or modality) be complete, as indicated by white blood cell count, before therapy with a second agent (or modality) is instituted.

References
1	Product Information. Thiotepa (thiotepa). Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.