Lomustine

Lomustine is a prescription medication used to treat certain types of brain tumors. Lomustine is also used with other medications to treat Hodgkin's lymphoma (Hodgkin's disease) that has not improved or that has worsened after treatment with other medications. Lomustine belongs to a group of drugs called alkylating agents. These work by slowing or stopping the growth of cancer cells in your body.

This medication comes in capsule form and is taken by mouth as a single dose and will not be repeated for at least 6 weeks. Take on an empty stomach. When handling lomustine, be sure to wear rubber or latex gloves that can not be penetrated.

Common side effects of lomustine include nausea, vomiting, and loss of appetite.

Lomustine is a prescription medication used to treat certain types of brain tumors. Lomustine is also used with other medications to treat Hodgkin's lymphoma (Hodgkin's disease) that has not improved or that has worsened after treatment with other medications.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Lomustine may be found in some form under the following brand names:

• CeeNU

• Gleostine

Common side effects of lomustine include the following:

• nausea
• vomiting
• loss of appetite
• sores in the mouth and throat
• unusual tiredness or weakness
• pale skin
• fainting
• hair loss
• unsteady walk
• slurred speech

This is not a complete list of lomustine side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

No drug interactions have been identified. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Serious side effects have been reported with lomustine including the following:

• lowered blood count. The number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious or life-threatening infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, chills, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; bloody vomit; or vomiting blood or brown material that resembles coffee grounds.
• Lung, liver, and kidney complications
• Development of new cancers

Do not take lomustine if you are allergic to lomustine or to any of its ingredients.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of lomustine, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking lomustine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to lomustine or to any of its ingredients
• have liver or kidney problems
• have heart or lung problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. It is recommended to avoid becoming pregnant if taking this medication.

It is not known if lomustine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using lomustine.

• Take lomustine exactly as prescribed.
• Lomustine comes as a capsule to take by mouth.
• It is usually taken once every 6 weeks on an empty stomach.
• Your full dose may contain two or more different types and colors of capsules. Take all of the capsules given to you in the prescription bottle at the same time. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
• Do not take more or less of it or take it more often than prescribed by your doctor.
• You should wear rubber or latex gloves when you handle the capsules so that your skin does not come into contact with the capsules.
• If contact occurs, wash immediately and thoroughly.
• Swallow the capsules whole; do not split, chew, or crush them.

Take lomustine exactly as prescribed.

The recommended dose of Lomustine in adult and pediatric patients as a single agent in previously untreated patients is 130 mg/m² as a single oral dose every 6 weeks.

Dose adjustments may be made based on other medications you are taking or other conditions you have.

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

• Stored in a well-closed container at room temperature.
• Avoid excessive heat (over 40°C, 104°F).
• Keep this and all other medications out of the reach of children.

Lomustine should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents.

Bone marrow suppression, notably thrombocytopenia and leukopenia, which may contribute to bleeding and overwhelming infections in an already compromised patient, is the most common and severe of the toxic effects of lomustine.

Since the major toxicity is delayed bone marrow suppression, blood counts should be monitored weekly for at least 6 weeks after a dose. At the recommended dosage, courses of lomustine should not be given more frequently than every 6 weeks.

The bone marrow toxicity of lomustine is cumulative and therefore dosage adjustment must be considered on the basis of nadir blood counts from prior dose.