Drug Interaction:
Alkylating Agents Includes-
Mechlorethamine ,Chlorambucil, Melphalan, Ifosamide,Cyclophosphamide, Urasil Mustard, Lomustine, Carmustine, Streptozocin, Thiotepa, Busulfan, Pipobroman, Cisplatin, Carboplatin
Not reported.
Indication:
Alkylating Agents Includes-
Mechlorethamine ,Chlorambucil, Melphalan, Ifosamide,Cyclophosphamide, Urasil Mustard, Lomustine, Carmustine, Streptozocin, Thiotepa, Busulfan, Pipobroman, Cisplatin, Carboplatin
Brain tumors, Hodgkins disease
Adverse Reaction:
Nausea, vomiting,may occur after 3 to 6 hours after taking the drug. Use antiemetics before dosing.
Contra-Indications:
Hypersens to lomustine
Special precautions:
Found to be carcinogenic to rats and mice in approximately in clinical,quantities. Acute leukemia and bone marrow dysplasias have occured after a long nitrosourea therapy.
Pregnancy- no adequate and well controlled studies made, therefore advise patient of potential hazard to the foetus if the patient becomes pregnant while taking lomustine. Lactation- not known whether lomustine is excreted in breast milk. Because of serious adverse reactions decide whether to discontinue nursing taking into account the importance of the drug to the mother.
Dosages/ Overdosage Etc:
Indications:
Brain tumors, Hodgkins disease
Dosage:
Adults and children- 130mg/sqm as a single oral dose every 6 weeks. In compromised conditions reduce dosage to 100mg/sqm every 6 weks.
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Lomustine.
2.Pregnancy-
Tell your doctor if you are pregnant or if you intend to have children.
There is a chance that this medicine may cause birth defects if either
the male or female is taking it at the time of conception or if it is taken
during pregnancy.
3. Breast -feeding-
Tell your doctor if you are breast feeding or if you intend to breast-feed
during treatment with this medicine. Because lomustine may cause serious
side effects, breast-feeding is not recommended while you are receiving it
4.Children-
Although there is no specific information comparing lomustine in children with
use in other age groups, this medicine is not expected to cause different side
effects or problems than it does in adults.
5.Older adults-
There is no specific information comparing use of lomustine in the elderly
with use in other age groups
6. Other medicines-
Tell your doctor if you if you have ever been treated with x-rays or cancer
medicines or if you are taking any of the following-
Amphotericin B or
Antithyroid drugs or
Azithioprine or
Chloramphenicol or
Colchicine or
Flucytosine or
Gangiclovir
Pilcamycin or
Zidovudine - lomustine may increase the effects of thess medication or
radiation therapy on the blood.
7. Other medical problems-
Make sure you tell your doctor if you have any other medical problems
especially-
Chickenpox including recent exposure or
Herpes zoster - risk of severe disease affecting the other parts of the body
Infection- lomustine can decrease your bodys ability to fight infection
Kidney disease- effects of lomustine may be increased because of slower
clearance from the body
Lung disease- risk of lung problems caused by lomustine may be increased
Pharmacology/ Pharmacokinetics:
Pharmacology:
Lomustine acts as an alkylating agent but like other nitrosoureas, it may also inhibit several key enzymatic processes.
Pharmacokinetics:
The lipid soluble nitrosoureas are rapidly and completely absorbed when given orally; absorption in plasma occurs about 10 minutes postadministration and peak levels of metabolites appear in about 3 hours.Lomustine is rapidly degraded, apparently in the liver, to several cytotoxic metabolites. The metabolites are excrteted through the kidneys, 60% in 48 hours and 50% in within 12 hours
Interaction with Food:
Not available
Pregnancy and lactation:
Refer Chlorambucil- Alkylating agents
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