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Lomustine (CeeNU®)   

Brand name: CeeNU  

 

Generic name: Lomustine   

Other names: CCNU  

Therapeutic Class: alkylating agent   

Manufacturer / Distributor: OTL Pharma 

Availability:  Lomustine is available by prescription only  

Indications:  Lomustine is used to treat the following malignancies :  

·         melanoma  

·          breast cancer 

·          lung cancer

·          myeloma multiple 

·         hodgkin's Lymphoma 

·         non hodgkin's Lymphoma 

·          cancers of the gastrointestinal tract 

·          Primary or secondary brain tumors.   

 

Lomustine is sometimes used in the treatment of non cancerous medical conditions such as mycosis fungoides and psoriasis. Ask your doctor or pharmacist for more information on the drug.  

Dosage form:  Lomustine comes in capsule form to be taken by mouth  

Dosage:  usually, the recommended doses of lomustine are 100 to 130 mg/m2 every 6 weeks, in monochemotherapy; and 70 mg/m2 every 3 weeks in polychemotherapy.  

Storage:  keep lomustine at room temperature (15-25 ° C), away from light, moisture and heat above 40 ° C. Lomustine and all other medications should not be used beyond the expiration date printed on the container. Keep all medicines, including  lomustine, out of children's reach.

Overdose:  Lomustine overdose is dangerous primarily because of its profound and long term myelotoxicity (state of being destructive to bone marrow)  . An overdose of Lomustine can lead to decrease in white blood cells and/or platelets (decreased to 50,000 and less), which can become life serious health problems 4 to 5 weeks after initiation of the treatment. If you believe you have taken an overdose, contact your doctor immediately.  

Missing dose:  in case you missed taking the medication at the recommended time, you can take the medication right away; do not double the next dose to recover the missed one, it can be dangerous. In fact, Lomustine is usually taken once every 3 or 6 weeks; you have no reason to double the dose.   

Contraindications : Lomustine is contraindicated in these conditions:  

  • pregnancy  
  • breastfeeding   
  • severe renal impairment  
  • allergy to Lomustine or has one of its ingredients   
  • A blood count with WBC inferior to 4000/mm ³ or has less than 100,000 platelets / mm³.  

 

Mechanism of action (MOA): Lomustine slows or stops the growth of cancer cells in your body by attacking their DNA. 

Interactions: Lomustine should not be associated with cyclosporine and tacrolimus due to a significant risk of Immunosuppression (reduction of the activation or efficacy of the immune system)  and lymphoma. Patients who are treated with Lomustine should not take live attenuated vaccine.  

Side effects: d  espite the beneficial effects of lomustine in combating cancer, it can damage non-cancerous cells, and lead to the development of adverse effects; the most common Lomustine side effects include:    

  • nausea 
  • vomitting 
  • fatigue  
  • hair loss 
  • darkened and dry skin  
  • decreased appetite   
  • Weight loss.   

Lomustine can also cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:   

  • red or bloody urine  
  • persistent cough  
  • sore throat and fever 
  • dizziness  
  • confusion 
  • black, tarry stools  
  • daytime sleepiness (lethargy) 
  • unusual bruising or bleeding  
  • yellowing of the skin or eyes (jaundice)   
  • Shortness of breath or difficulty breathing.