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CeeNU (lomustine) Disease Interactions

There are 4 disease interactions with CeeNU (lomustine):

Major

Lomustine (Includes CeeNU) ↔ Pulmonary Infiltrates/Fibrosis

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

Pulmonary infiltrates and/or fibrosis have been reported during lomustine therapy. Toxicity occurred after 6 months of cumulative doses usually > 1100 mg/m2. Late reduction in pulmonary function, progressive fibrosis, and death have been noted. It is recommended to permanently discontinue therapy in patients diagnosed with pulmonary fibrosis. Therapy with lomustine should be administered cautiously in patients with preexisting pulmonary dysfunction. Pulmonary function studies prior to and during therapy are recommended.

References

  1. Dent RG "Fatal pulmonary toxic effects of lomustine." Thorax 37 (1982): 627-9
  2. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nitrosoureas (Includes CeeNU) ↔ Infections

Severe Potential Hazard, High plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

Nitrosoureas can induce delayed myelosuppression. The use of nitrosoureas may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with nitrosoureas. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nitrosoureas (Includes CeeNU) ↔ Myelosuppression

Severe Potential Hazard, High plausibility

Applies to: Bone Marrow Depression/Low Blood Counts, Fever, Bleeding

Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.

References

  1. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Nitrosoureas (Includes CeeNU) ↔ Hepatic Dysfunction

Minor Potential Hazard, Low plausibility

Applies to: Liver Disease

A reversible increase in liver transaminase, alkaline phosphatase, and bilirubin levels has been reported during therapy with nitrosoureas. Therapy with nitrosoureas should be administered cautiously in patients with a history of or predisposition to compromised hepatic function.

References

  1. "Product Information. BiCNU (carmustine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. CeeNU (lomustine)." Bristol-Myers Squibb, Princeton, NJ.

CeeNU (lomustine) drug Interactions

There are 210 drug interactions with CeeNU (lomustine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2017 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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