LOMUSTINE

COMMON BRAND NAME(S): Ceenu, Gleostine

GENERIC NAME(S): LOMUSTINE

Description: Lomustine inhibits the synthesis of DNA and RNA via alkylation although carbamoylation and modification of cellular proteins may also be involved.

Pharmacokinetics:

Absorption: Rapidly absorbed from the GI tract (oral); also absorbed after topical application. Peak plasma concentrations of metabolites after 1-6 hr (oral).

Distribution: Widely distributed; drug and metabolites cross the blood-brain barrier; active metabolites appear in CSF within 30 min (oral); metabolites present in milk.

Metabolism: Hepatic via hydroxylation; enterohepatically recycled.

Excretion: Via urine (approx 50%); via faeces (<5%); via expired air (<10%).

Uses

This medication is an alkylating agent used to treat various types of cancer by slowing or stopping the growth of cancer cells.

How to use lomustine

Take this medication by mouth as a single dose as directed by your doctor. (See also Warning section.) Your dose may consist of 2 or more different strengths/colors of capsules. Taking this medication on an empty stomach with a full glass of water may decrease nausea and vomiting. Unless your doctor instructs you otherwise, drink plenty of fluids to avoid a serious loss of body water (dehydration).

The dosage is based on your medical condition, other treatments (e.g., radiation, chemotherapy), body size, and response to therapy (e.g., side effects such as low white blood cell count).

Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.

Wear rubber or latex gloves when you handle the capsules.

Since this drug can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the capsules.

Warnings

Lomustine may cause serious blood disorders (decreased bone marrow function leading to low number of white blood cells/platelets and anemia).

It can also lower your body’s ability to fight an infection and increase your risk of bleeding.

Side effects

Notify your doctor or pharmacist promptly if these effects persist or worsen:

Nausea
Vomiting
loss of appetite
diarrhea
mouth/lip sores
hair loss (hair growth returns after treatment)

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Confusion
swelling of lower legs/feet
vision changes

Tell your doctor immediately if any of these rare but very serious side effects occur:

coughing up blood
persistent nausea/vomiting
stomach/abdominal pain
black tarry stools
unusual tiredness
change in the amount of urine
dark or pink urine
yellow eyes/skin

Pulmonary fibrosis, a sever but sometimes fatal lung problem, has occurred in patients using this drug.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including:

rash,
itching/swelling (especially of the face/tongue/throat)
severe dizziness
trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Allergic reaction to this medication
This medication should not be used if you have a current infection
Patients with medical history of:

blood disorder (e.g., anemia, clotting problem)
kidney disease
liver disease
lung disease

Do not have immunizations/vaccinations without the consent of your doctor
avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose
Limit alcoholic beverages
This medication is not recommended for use during pregnancy
breast-feeding while using this drug is not recommended

Consult your doctor regardin the precautions mentioned above.

Interactions:

This drug should not be used with nalidixic acid or live vaccines because very serious interactions may occur. Tell your doctor or pharmacist before starting lomustine if you are currently using either of the medications listed above, or have received or plan to receive any vaccines.

Tell your doctor or pharmacist of “blood thinners” (e.g., heparin, warfarin), other drugs that can affect the immune system (e.g., chemotherapy, cyclosporine), and all prescription and nonprescription/herbal products you may use before using this medication.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Overdose & Brands

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (e.g., complete blood count, kidney/liver/lung tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

It is important that you take lomustine as scheduled by your doctor. If you miss a dose, contact your doctor immediately to obtain a new dosing schedule.

Storage

Store in a tightly closed container at room temperature below 104 degrees F (40 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands:

Also marketed as:

Ceenu [ Bristol-Myers Squibb ]