Uses of Lomustine

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Lomustine belongs to the group of alkylating agents, whose main active ingredient is Lomustine. The drug has an anti-cancer effect. To learn more about the drug Lomustine, read through the article below.

1. What is Lomustine?

The drug Lomustine has the main ingredient Lomustine, with the strength of 10mg, 40mg and 100mg, made in the form of capsules.
Mechanism of drug:
Lomustine is a nitrosoure derivative, is an alkylated drug. Lomustine is lipid soluble, readily absorbed orally and converted to substances with alkylating effects. Lomustine also carbamylates DNA polymerase, altering cellular proteins and enzymes. Leads to inhibition of DNA and RNA synthesis. Lomustine can act on any stage of cell division, including the resting phase.

2. What does Lomustine do?

The drug Lomustine is used in the following cases:
Used in combination with other anti-cancer drugs after brain tumor surgery: Myeloblastoma, astrocytoma, oligodendroglioma. In combination with second-line therapy for drug-resistant or recurrent Hodgkin's disease.

3. Dosage and usage of the drug Lomustine

3.1. Dosage

Commonly used with adults and adolescents: Initial dose when taking a lomustine drug: Oral 100 - 130mg/m2 x 6 weeks 1 time. Repeat Lomustine only when blood cells have returned to normal (leukocytes > 4000/mm3, platelets > 100000/mm3) In patients with impaired marrow function: Reduce dose to 100mg/m2 x 6 weeks 1 times. When used with other myelosuppressive agents, the dose of Lomustine must be reduced. Adjust dose for next cycle: WBC > 3000/mm3, platelets > 75000/mm3: No need to adjust dose Lomustine WBC 2000 - 2999/mm3, platelets 25000 - 74999/mm3: Reduce to 70% of previous dose WBC < 2000/mm3, platelets < 25000/mm3: Reduce to 50% of previous dose Renal failure: According to Aronoff Clcr 10 - 50ml/min: Use 75% of Lomustine dose. Clcr < 10ml/min: Use 25-50% of Lomustine dose. Renal dialysis: No additional dose required. According to Kintzel Clcr 46 - 60ml/min: Use the usual dose of Lomustine. Clcr 31 - 45ml/min: Use 70% of the dose. Clcr ≤ 30ml/min: Do not use Lomustine.

3.2. How to use

Lomustine capsules are taken orally. Take the tablet with water, do not chew or break the capsule. Drink on an empty stomach. After taking the drug, you must fast for 2 hours to avoid nausea and vomiting. Gloves must be used to handle the capsule to avoid breaking the capsule into the body. Lomustine is often used in combination with other drugs according to different regimens. Such as: Lomustine, doxorubicin and vinblastin. Cyclophosphamide, methotrexate and lomustine. Methotrexate, doxorubicin, cyclophosphamide, and Lomustine. Procarbazine, vincristine and lomustine

4. Contraindications of the drug Lomustine

Do not use for people with a history of allergy to Lomustine or to any of its ingredients.

5. Lomustine side effects

Common:
Nausea, vomiting. Myelosuppression, thrombocytopenia, leukopenia. Kidney toxicity. Uncommon:
Dermatitis, itching, skin pain. Transient hepatotoxicity with increased transaminases, bilirubin, alkaline phosphatase, bacterial infection. Rare:
Hair loss, pharyngitis. Contact dermatitis, transient hyperpigmentation, capillary dilation. Epidermal detachment dermatitis. Easy to bleed. Loss of coordination, lethargy, disorientation, dysarthria. Visual disturbances, optic nerve atrophy, blindness. Pulmonary infiltrates, pulmonary fibrosis. Reduced kidney size, increased blood nitrogen, kidney failure.

6. Notes when using Lomustine

Lomustine is highly toxic but has a low therapeutic index, so it must be used under the regular supervision of a doctor. Caution should be exercised when lomustine is used in patients with liver dysfunction. It is necessary to check the indicators of liver and kidney function periodically. Complete blood count should be regularly monitored. Respiratory function should be checked before and after treatment. Caution should be exercised when using Lomustine in patients with reduced red blood cells, platelets or white blood cells. Do not use Lomustine for pregnant women because it can affect the fetus. Lomustine should not be used by women who are breast-feeding because the drug can pass into breast milk and harm the baby. There are no studies on the effects of Lomustine on the ability to drive and use machines.

7. Overdose, missed dose of Lomustine

Overdose: Lomustine causes chronic nephrotoxicity of varying degrees. Overdosage can lead to a decrease in the total number of blood cells. In case of an overdose of Lomustine, call 911 immediately for supportive measures. If you forget a dose of Lomustine, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose of Lomustine and take your next dose as usual. Do not double the prescribed dose of Lomustine.

8. Lomustine drug interactions

Concomitant administration of Theophylline and Lomustine often results in a rapid increase in leukopenia and thrombocytopenia. Do not use Lomustine concomitantly with BCG, natalizumab, clozapine, pimozide, pimecrolimus, tacrolimus, live vaccines. Lomustine potentiates the effects of aripiprazole, leflunomide, clozapine, pimozide, live vaccines, natalizumab. Lomustine reduces the effect of BCG, sipuleucel-T, inactivated vaccines, coccidioides skin test. Denosumab, roflumilast, trastuzumab, pimecrolimus, tacrolimus increase the effect of Lomustine. Peginterferon alpha-2b, Echinacea reduce the effects of Lomustine. Lomustine is used to treat cancer. However, the drug has many side effects and toxicity, so it must be used under the strict control of a doctor. Contact your doctor right away if you have any questions about Lomustine.