lomustine


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Related to lomustine: carmustine

lomustine

 [lo-mus´tēn]
a nitrosourea alkylating agent used as an antineoplastic agent in treatment of Hodgkin's disease and brain tumors, administered orally. Called also CCNU.

lomustine

CeeNU

Pharmacologic class: Alkylating drug (nitrosourea)

Therapeutic class: Antineoplastic

Pregnancy risk category D

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources. Most common and severe toxic effect is bone marrow suppression, which may contribute to bleeding and overwhelming infections in already compromised patients. Delayed bone marrow suppression is major toxicity, so monitor blood counts weekly for at least 6 weeks after dose. At recommended dosage, don't give courses more often than every 6 weeks. Bone marrow toxicity is cumulative; consider adjusting dosage based on nadir blood counts from previous dose.

Action

Inactivates neoplastic cells by alkylating DNA, causing DNA structural modification and fragmentation. Thought to act in late G1 or early S phase of cell cycle.

Availability

Capsules: 10 mg, 40 mg, 100 mg

Dose pack: two 10-mg capsules, two 40-mg capsules, and 100-mg capsules

Indications and dosages

Adjunctive therapy in primary and metastatic brain tumors; secondary therapy in Hodgkin's disease

Adults and children: As monotherapy, 130 mg/m2 P.O. as a single dose q 6 weeks in previously untreated patients. In bone marrow suppression, initial dosage is 100 mg/m2 P.O. q 6 weeks; don't repeat dose until platelet count exceeds 100,000/mm3 and white blood cell (WBC) count exceeds 4,000/mm3. When given with other myelosuppressive drugs, adjust dosage accordingly.

Dosage adjustment

• Bone marrow depression (based on WBC and platelet counts)

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• renal or hepatic dysfunction, bone marrow depression
• pregnant or breastfeeding patients.

Administration

• Obtain CBC with white cell differential before starting therapy.
• Administer antiemetic before giving drug, as prescribed, to minimize nausea.
• Give 2 to 4 hours after meals to enhance absorption.
• If vomiting occurs shortly after administration, notify prescriber.

Adverse reactions

CNS: anxiety, confusion, dizziness, hallucinations, lethargy, headache, paresthesia, light-headedness, drowsiness, fatigue, seizures

GI: nausea; vomiting; anorexia; sore mouth, lips, and throat; GI bleeding

GU: amenorrhea, azoospermia, progressive azotemia, nephrotoxicity, renal failure

Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression

Hepatic: hepatotoxicity

Skin: alopecia

Other: secondary cancers

Interactions

Drug-drug.Anticoagulants, non-steroidal anti-inflammatory drugs: increased bleeding risk

Myelosuppressants: increased bone marrow depression

Drug-diagnostic tests.Hemoglobin, platelets, red blood cells, WBCs: decreased values

Liver function tests, nitrogenous compounds: increased values

Patient monitoring

Watch for evidence of overdose, including bone marrow depression, nausea, and vomiting.

Monitor CBC and platelet counts closely. Watch for signs and symptoms of bleeding and bruising.
• Avoid I.M. injections if platelet count is below 100,000/mm3.
• Check kidney, liver, and pulmonary function tests frequently.
• Assess neurologic status carefully. Institute safety measures as needed to prevent injury.

Watch for signs and symptoms of secondary cancers.

Patient teaching

• Instruct patient to contact prescriber if he vomits shortly after taking drug.

Tell patient to immediately report easy bruising or bleeding, which may signal low platelet count.
• Advise patient to report changes in urination pattern.
• Instruct patient to avoid exposure to people with infections, because drug may make him more susceptible to infection.

Caution female of childbearing age to use reliable contraception and to immediately report suspected or confirmed pregnancy.
• Advise female patient to inform prescriber if she is breastfeeding.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Advise patient to minimize GI side effects by eating small, frequent servings of healthy food.
• Inform patient that drug may cause hair loss.
• Tell patient he'll undergo frequent blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

lo·mus·tine

(lō-mŭs'tēn),
An antineoplastic agent.
Synonym(s): CCNU

lomustine

/lo·mus·tine/ (lo-mus´tēn) an alkylating agent of the nitrosourea group, used as an antineoplastic in the treatment of Hodgkin's disease and brain tumors.

lomustine

[lōmus′tēn]
an antineoplastic alkylating agent.
indications It is prescribed in the treatment of a variety of malignant neoplastic diseases, including brain tumors and Hodgkin's disease.
contraindication Known hypersensitivity to this drug prohibits its use.
adverse effects Among the more serious adverse effects are bone marrow depression, nausea, and vomiting.

lomustine

CCNU Oncology An alkylating nitrosurea derivative used to treat lymphomas and other CAs Adverse effects BM suppression

lo·mus·tine

(lō-mŭs'tēn)
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea; an antineoplastic agent.

lo·mus·tine

(lō-mŭs'tēn)
An antineoplastic agent.

lomustine

(lō´məstēn´),
n brand name: CeeNU;
drug class: antineoplastic alkylating agent;
action: interferes with RNA and DNA strands, which leads to cell death;
uses: Hodgkin disease; lymphomas; melanomas; multiple myeloma; brain, lung, bladder, kidney, colon cancer.

lomustine

cyclohexylchloroethylnitrosurea (CCNU); a nitrosourea used as an antineoplastic.
References in periodicals archive ?
Due to these results, lomustine treatment was delayed and anaemia was suspected to be associated with Mycoplasma haemofelis infection.
A single dose of L-asparaginase (400 IU/kg SQ; 3000 ILF total dose) was administered while the bird was hospitalized, and the bird was discharged with instructions to initiate lomustine (60 mg/[m.
The patient's second round of lomustine was postponed for 2 weeks until her blood cell counts recovered.
But this oncology empire is built on a number of other drugs that were also invented through taxpayer-funded research, including cisplatin, carboplatin, carmustine, and lomustine, to mention a few.
MDxHealth's epigenetic MGMT test (PredictMDx(TM) for Glioblastoma) will be used to select patients to enroll in a randomized, multicenter phase III clinical study examining the addition of lomustine (also known as CCNU) to the current therapy of temozolomide/radiotherapy in MGMT methylated, newly diagnosed glioblastoma multiforme (GBM) patients, a severe form of brain cancer.
Combination chemotherapy with L-asparaginase, lomustine, and prednisone for relapsed or refractory canine lymphoma.
NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide.
It emerged Yarnell had been given one week's worth of Lomustine tablets, instead of just one day's worth and eight days' worth of Etoposide, rather than three days' worth.
The most commonly used chemotherapy drugs have been alkylating agents, such as procarbazine (Matulane), temozolomide (Temodar), and the nitrosureas, carmustine (BCNU) and lomustine (CCNU).
MDxHealth's epigenetic MGMT test (PredictMDx for Glioblastoma) will be used to select patients to enrol in a randomised, multicenter Phase III clinical trial assessing the effects of adding lomustine (also known as CCNU) to the current therapy of temozolomide/radiotherapy in MGMT methylated, newly diagnosed glioblastoma multiforme (GBM) patients.
In December 1997, she was diagnosed with glioblastoma multiforme in the right frontoparietal lobe, treated with excision and radiation therapy, followed by 10 months of chemotherapy (procarbazine, lomustine, and vincristine), which was completed in February 1999.