Pharm

Lomustine

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Lomustine, Gleostine, CCNU

  • See Also
  1. Chemotherapy
  2. Alkylating Agent
  • Indications
  1. Brain Tumor
  2. Hodgkin Lymphoma
  • Mechanism
  1. See Alkylating Agent
  2. Antineoplastic nitrosourea
    1. Alkylating Agent that cross-links DNA during all cell cycle phases
    2. Carbamoylates Proteins, including DNA repair Proteins, resulting in further cytotoxic effects
  • Medications
  1. Oral Lomustine: 5, 10, 40 and 100 mg capsules
    1. Dispensed as single doses
  • Dosing
  1. See other references for disease specific dosing protocols
  2. Typically taken every 6 weeks during treatment
  • Pharmacokinetics
  1. Lipophilic
  2. Easily crosses the blood brain barrier
  3. Narrow therapeutic range
    1. Fatalities have occurred with overdosage (dispense one dose at a time)
  • Adverse Effects
  1. Alopecia
  2. Severe Bone Marror Suppression
  3. Hepatotoxicity
  4. Impaired future fertility
  5. Nephrotoxicity
  6. Pulmonary Fibrosis
  7. Secondary Malignancy
  • Safety
  1. Avoid in Lactation
  2. Pregnancy Category D
    1. Avoid in Pregnancy (all trimesters)
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count (CBC)
    2. Liver Function Tests
    3. Renal Function tests
    4. Pulmonary Function Tests
  • Resources
  1. Lomustine Capsule (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7f77526b-4c40-409c-82ea-d0f934d89cc2