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lomustine

Generic Name: lomustine (LOE mus teen)
Brand Name: Gleostine, CeeNU

What is lomustine?

Lomustine is a cancer medicine that interferes with the growth of cancer cells and slows their spread in the body.

Lomustine is used to treat brain tumors in people who have already received surgery or radiation. Lomustine is also used to treat Hodgkin's disease.

Lomustine is sometimes given with other cancer medicines.

Lomustine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about lomustine?

Lomustine can lower blood cells that help your body fight infections and help your blood to clot. Serious and sometimes fatal infections may occur up to 6 weeks after you are treated with this medicine. Call your doctor if you have easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), or signs of infection (fever, chills, body aches).

Lomustine can have long lasting effects on your body. Your blood will need to be tested once per week for at least 6 weeks after each dose of this medicine.

What should I discuss with my healthcare provider before taking lomustine?

You should not use lomustine if you are allergic to it.

To make sure lomustine is safe for you, tell your doctor if you have:

  • bone marrow suppression;

  • liver disease;

  • kidney disease; or

  • a history of lung or breathing problems.

Using lomustine may increase your risk of developing other types of cancer, such as leukemia. Ask your doctor about your specific risk.

Do not use lomustine if you are pregnant. It could harm the unborn baby or cause birth defects. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 2 weeks after your treatment ends.

This medicine may affect fertility (your ability to have children), whether you are a man or a woman.

It is not known whether lomustine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take lomustine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Lomustine is taken in a single dose once every 6 weeks. Follow your doctor's dosing instructions very carefully.

Because an overdose of lomustine can be fatal, you will be given only enough of this medicine to take one dose every 6 weeks. To get the correct dose, you may need to take 2 or more capsules that are different types and colors.

Wear disposable rubber gloves when you handle a lomustine capsule. Throw the gloves away after one use.

Do not open the lomustine capsule. Do not use a broken pill. The medicine from a broken pill can be dangerous if it gets on your skin. If this occurs, wash with soap and water. Ask your doctor or pharmacist how to safely handle and dispose of a broken capsule.

Lomustine can cause nausea and vomiting for up to 24 hours after you take it. You may have loss of appetite that lasts for several days. Taking lomustine on an empty stomach may reduce nausea and vomiting. You may also be given anti-nausea medications. Call your doctor if you vomit right after taking a lomustine capsule.

Lomustine can have long lasting effects on your body. Your blood will need to be tested once per week for at least 6 weeks after each dose of this medicine.

Your lung function, kidney function, and liver function may also need to be checked.

Store at room temperature away from heat and moisture. Keep the bottle tightly closed until you are ready to take the medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of lomustine.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of lomustine can be fatal.

Overdose symptoms may include stomach pain, vomiting, diarrhea, loss of appetite, dizziness, cough, feeling short of breath, or signs of infection.

What should I avoid while taking lomustine?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while using lomustine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Lomustine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • jaundice (yellowing of the skin or eyes);

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • signs of infection--fever, chills, sore throat, blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;

  • kidney problems--confusion, little or no urinating; swelling in your feet or ankles; feeling tired or short of breath; or

  • low red blood cells (anemia)--pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating.

Late-onset lung damage has occurred in some adults who had been treated for brain tumors during childhood. These patients had been treated with both radiation and medicine similar to lomustine. Lung symptoms developed up to 17 years after treatment. Call your doctor at once if you have:

  • chest discomfort, dry cough or hack;

  • shortness of breath on exertion; or

  • weakness or tired feeling, loss of appetite, and rapid weight loss.

Common side effects may include:

  • nausea, vomiting;

  • delayed infection;

  • mouth sores; or

  • temporary hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Lomustine dosing information

Usual Adult Dose for Brain/Intracranial Tumor:

As a single agent in previously untreated patients:
-130 mg/m2 orally as a single dose every 6 weeks

As a single agent in patients with compromised bone marrow function:
-100 mg/m2 orally as a single dose every 6 weeks

Comments:
-The dose should be adjusted accordingly when this drug is used in combination with other myelosuppressive drugs.
-All doses of this drug should be rounded to the nearest 10 mg by the prescriber.
-Only a single dose of this drug should be dispensed.

Uses:
As a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in the following:
-BRAIN TUMORS: both primary and metastatic tumors; in patients who have already received appropriate surgical and/or radiotherapeutic procedures.
-HODGKIN'S DISEASE: secondary therapy in combination with other approved drugs; in patients who relapse while being treated with primary therapy or who fail to respond to primary therapy.

Usual Adult Dose for Hodgkin's Disease:

As a single agent in previously untreated patients:
-130 mg/m2 orally as a single dose every 6 weeks

As a single agent in patients with compromised bone marrow function:
-100 mg/m2 orally as a single dose every 6 weeks

Comments:
-The dose should be adjusted accordingly when this drug is used in combination with other myelosuppressive drugs.
-All doses of this drug should be rounded to the nearest 10 mg by the prescriber.
-Only a single dose of this drug should be dispensed.

Uses:
As a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in the following:
-BRAIN TUMORS: both primary and metastatic tumors; in patients who have already received appropriate surgical and/or radiotherapeutic procedures.
-HODGKIN'S DISEASE: secondary therapy in combination with other approved drugs; in patients who relapse while being treated with primary therapy or who fail to respond to primary therapy.

Usual Pediatric Dose for Brain/Intracranial Tumor:

As a single agent in previously untreated patients:
-130 mg/m2 orally as a single dose every 6 weeks

As a single agent in patients with compromised bone marrow function:
-100 mg/m2 orally as a single dose every 6 weeks

Comments:
-The dose should be adjusted accordingly when this drug is used in combination with other myelosuppressive drugs.
-All doses of this drug should be rounded to the nearest 10 mg by the prescriber.
-Only a single dose of this drug should be dispensed.

Uses:
As a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in the following:
-BRAIN TUMORS: both primary and metastatic tumors; in patients who have already received appropriate surgical and/or radiotherapeutic procedures.
-HODGKIN'S DISEASE: secondary therapy in combination with other approved drugs; in patients who relapse while being treated with primary therapy or who fail to respond to primary therapy.

Usual Pediatric Dose for Hodgkin's Disease:

As a single agent in previously untreated patients:
-130 mg/m2 orally as a single dose every 6 weeks

As a single agent in patients with compromised bone marrow function:
-100 mg/m2 orally as a single dose every 6 weeks

Comments:
-The dose should be adjusted accordingly when this drug is used in combination with other myelosuppressive drugs.
-All doses of this drug should be rounded to the nearest 10 mg by the prescriber.
-Only a single dose of this drug should be dispensed.

Uses:
As a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in the following:
-BRAIN TUMORS: both primary and metastatic tumors; in patients who have already received appropriate surgical and/or radiotherapeutic procedures.
-HODGKIN'S DISEASE: secondary therapy in combination with other approved drugs; in patients who relapse while being treated with primary therapy or who fail to respond to primary therapy.

What other drugs will affect lomustine?

Other drugs may interact with lomustine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about lomustine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2016-02-19, 1:12:27 PM.

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