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Lomustine (CeeNU®) 

Warning: This drug may cause blood disorders (e.g. anemia, low blood count of white and red blood cells/platelets). Your body’s ability to fight infection also decreases while taking Lomustine, along with your risk for bleeding. These side effects usually happen within 4-6 weeks of your dosage.  

Consult your doctor immediately if you start suffering from signs of infection such as, chills, fever and nausea. Tell your doctor if you have unusual/easy bleeding. Your doctor will monitor your blood with tests for at least 6 weeks after dosage. Keep your laboratory appointments. 

Indications:  This drug is in a class of drugs known as alkylating agents. It works by slowing or stopping the growth of cancer.

 

Lomustine is used to treat mainly 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.   

Dosage:  This medication is taken by mouth, as prescribed by your doctor. To decrease the risk for nausea and vomiting, always take it on an empty stomach with a full glass of water. You may be prescribed two different colors and strength of medication. You should drink plenty of fluids to avoid dehydration, unless directed by your doctor otherwise.

Your dosage will depend on your weight, response to therapy and medical condition. Lomustine can be inhaled through the lungs and absorbed through skin; pregnant women should not handle this medication. 

Storage:  store the medication 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:  for best results, you should take the medication as prescribed. 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: You should avoid this medication if you have any known allergies to any ingredients in it. Tell your doctor of all allergies you have. 

You shouldn’t take Lomustine if you have an infection already. You should not get any immunizations while taking this medication. Avoid people that have recently had the oral polio vaccination or the flu vaccine that is inhaled through the nose. Wash your hands thoroughly to avoid possible infections. 

Before taking this medication tell your doctor of your medical history, such as kidney disease, liver disease, blood disorders (e.g. anemia clotting problem) and lung disease.  

Limit alcohol intake as it may increase your risk for stomach and intestinal bleeding. In addition, during pregnancy, this drug should only be used when needed, as it may harm an unborn baby. Women of childbearing age should use 2 forms of birth control to avoid getting pregnant.  

Avoid contact sports as your risk for easier bruising and bleeding are increased. 

Interactions: Your doctor and pharmacist should be aware of all the potential interactions while taking this medication. 

If you have or are taking nalidixic acid or live vaccines, you should consult with your doctor before taking this medication. Your doctor should also be aware of any blood thinners (e.g. heparin, warfarin) or other drugs that can affect the immune system, such as chemotherapy and cyclosporine.   

Side effects: Althoug  beneficial combating cancer, the medication 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 
  • b lack, tarry 
  • stools 
  • daytime sleepiness (lethargy) 
  • unusual bruising or bleeding 
  • yellowing of the skin or eyes (jaundice) 
  • Shortness of breath or difficulty breathing 
  • severe depression symptoms