Lomustine

Lomustine is a prescription medicine used for the treatment of brain tumors and Hodgkin Lymphoma.

• Lomustine is available under the following different brand names: Gleostine, Ceenu

Common side effects of Lomustine include:

• nausea,
• vomiting,
• delayed infection,
• mouth sores, and
• hair loss

Serious side effects of Lomustine include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• yellowing of the skin or eyes (jaundice),
• easy bruising,
• unusual bleeding (nose, mouth, vagina, or rectum),
• purple or red pinpoint spots under your skin,
• little or no urination,
• swelling in the feet or ankles,
• tiredness,
• shortness of breath (may develop as long as 6 months or later after taking the medication),
• fever,
• chills,
• sore throat,
• blisters or ulcers in the mouth,
• red or swollen gums,
• trouble swallowing,
• new or worsening cough, and
• chest pain

Rare side effects of Lomustine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out. 

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Capsule

• 5 mg
• 10 mg
• 40 mg
• 100 mg

Brain tumors

Adult and pediatric dosage

• 130 mg/m² orally once every 6 weeks 
• Round dose to the nearest 5 mg
• Compromised bone marrow: 100 mg/m² orally once every 6 weeks

Hodgkin Lymphoma

Adult and pediatric dosage

• 130 mg/m² orally once every 6 weeks 
• Round dose to the nearest 5 mg
• Compromised bone marrow: 100 mg/m² orally once every 6 weeks

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Lomustine has severe interactions with the following drug:
  • BCG vaccine live
  • cholera vaccine
  • influenza virus vaccine quadrivalent, intranasal
  • measles (rubeola) vaccine
  • measles mumps and rubella vaccine, live
  • measles, mumps, rubella and varicella vaccine, live
  • rotavirus oral vaccine, live
  • rubella vaccine
  • typhoid polysaccharide vaccine
  • typhoid vaccine live
  • varicella virus vaccine live
  • yellow fever vaccine
  • zoster vaccine live
• Lomustine has serious interactions with the following drugs:
  • adenovirus types 4 and 7 live, oral
  • axicabtagene ciloleucel
  • brexucabtagene autoleucel
  • ciltacabtagene autoleucel
  • deferiprone
  • fingolimod
  • idecabtagene vicleucel
  • lisocabtagene maraleucel
  • lonafarnib
  • natalizumab
  • nivolumab
  • ocrelizumab
  • ofatumumab
  • palifermin
  • pimecrolimus
  • ropeginterferon alfa 2b
  • smallpox (vaccinia) vaccine, live
  • tisagenlecleucel
  • tofacitinib
• Lomustine has moderate interactions with at least 108 other drugs.
• Lomustine has minor interactions with the following drugs:
  • digoxin
  • ruxolitinib topical
  • vitamin A
  • vitamin E

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Lomustine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Lomustine?”

Cautions

• Causes myelosuppression that can result in fatal infections and bleeding; monitor blood counts for at least 6 weeks after each dose; do not give more frequently than q6wk due to delayed myelosuppression
• Avoid pregnancy; can cause fetal harm; advise males and females of reproductive potential of the potential risk to the fetus and to use effective contraception; advise males with female partners of reproductive potential to use effective contraception during treatment and for 3.5 months after the final dose; therapy may result in reduced fertility in males and females of reproductive potential
• Hepatotoxicity reported; increased levels of transaminases, alkaline phosphatase and bilirubin can occur; monitor liver function
• Can cause renal failure; monitor renal function
• Delayed pulmonary toxicity may occur; pulmonary infiltrates and/or fibrosis may occur; perform pulmonary function tests prior to treatment and repeat frequently; permanently discontinue therapy in patients diagnosed with pulmonary fibrosis
• Secondary malignancies reported; acute leukemia and myelodysplasia can occur with long-term use

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available
• Lactation
  • Unknown if metabolites present in breast milk; avoid nursing during treatment and for 2 weeks after the final dose