Lomustine
About Lomustine
Lomustine is a prescription medication used to treat certain types of brain tumours and Hodgkin's lymphoma. It is primarily prescribed when other therapies have not worked or as part of a combined chemotherapy plan to help stop cancer cells from growing.
Unlike daily medications, you typically take Lomustine as a single oral dose once every 6 weeks. It is best to take this medication on an empty stomach or at bedtime to help prevent nausea and vomiting. Making simple adjustments, such as getting plenty of rest and staying well-hydrated, can help support your body during this treatment cycle.
Common side effects include temporary hair loss, nausea, and a decreased appetite. Because this medication can lower your body's ability to fight infections, you must consult your doctor immediately if you experience serious symptoms like a high fever, severe chills, or unusual bleeding.
Talk to your doctor before starting Lomustine if you have a history of liver damage, kidney disease, or lung problems. Do not take this if you are pregnant, planning to become pregnant, or currently have severely weakened bone marrow.
This medication can interact with other drugs, alcohol, and vaccines, which can increase your risk of severe complications. Specific groups, including pregnant women, breastfeeding mothers, and older adults, must consult their doctor to discuss the risks and benefits before taking Lomustine.
Uses of Lomustine
Medicinal Benefits
Lomustine helps treat certain types of cancer by slowing the growth and spread of cancer cells. With regular use as prescribed, it helps control tumour progression, relieve cancer-related symptoms, and support effective long-term treatment.
- Targets Cancer Cells Effectively: By interfering with the growth and division of rapidly multiplying cancer cells, this medicine helps slow tumour growth and limit the spread of cancer.
- Treats Tumours in the Brain: Because this medicine can cross the blood-brain barrier, it is able to reach and treat certain brain tumours and cancers that have spread to the brain, where many chemotherapy medicines have limited access.
- Supports Symptom Relief and Disease Control: By helping shrink tumours and reduce their growth, this medicine may relieve tumour-related symptoms, improve daily comfort, and support better overall treatment outcomes.
Directions for Use
- Lomustine can be taken 1 hour before a meal or 2 hours after a meal, or as advised by your doctor.
- It is taken as a single dose every 6 weeks; however, follow your doctor’s advice regarding the dosage and duration.
- Swallow the medicine as a whole with a glass of water.
- Do not break, chew or crush Lomustine.
Storage
Side Effects of Lomustine
Common Side Effects (Usually mild):
- Nausea and vomiting (usually occurring within the first 24 hours after taking the dose)
- Loss of appetite or weight loss
- Mouth sores or redness on the gums and tongue
- Temporary hair thinning or loss
Serious Side Effects (Consult a doctor right away):
- Signs of infection, such as a fever over 100.4°F (38°C), body aches, or chills
- Unusual bruising, nosebleeds, or blood in your stools or urine
- Shortness of breath, persistent dry cough, or chest discomfort
- Yellowing of the skin or eyes, which may indicate liver damage
- Extreme weakness, severe dizziness, or pale skin
Medicines Containing this Salt
View AllDrug Warnings
- Monitor for delayed blood count drops: Keep in mind that Lomustine causes your blood cell counts to drop 4 to 6 weeks after you take your dose, not right away. Attend all scheduled blood test appointments so your doctor can monitor this safely.
- Handle capsules with extreme care: Always wear disposable gloves when touching the capsules. If a capsule is broken or leaking, do not touch it with bare hands; clean it up using a damp paper towel while wearing gloves and place it in a sealed plastic bag.
- Use highly effective birth control: Both men and women must use dependable birth control during treatment and for several months after the final dose, as this medicine can cause severe birth defects.
- Avoid live vaccines: Do not receive live vaccines (such as the MMR or shingles vaccine) while taking Lomustine, as your weakened immune system could allow the virus to cause a severe infection.
Drug Interactions
- Other chemotherapy drugs: Taking Lomustine with other cancer treatments can severely increase the risk of low blood cell counts, raising your risk of infection and bleeding.
- Live vaccines: Combined use can lead to serious, life-threatening infections because your immune system is less able to fight off live viruses.
- Blood thinners: Medications that prevent blood clots can greatly increase your risk of severe bleeding when taken alongside Lomustine.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeAvoid alcohol consumption while on treatment with Lomustine to prevent serious adverse effects.
Pregnancy
unsafeLomustine is not recommended for use in pregnancy as it may harm your fetus. If you are pregnant or planning pregnancy, inform your doctor before taking Lomustine.
Breast Feeding
unsafeAvoid breastfeeding your child while on treatment with Lomustine as it causes serious side effects to the baby.
Driving
unsafeLomustine may cause visual disturbances as a side effect. Avoid driving vehicles or operating machines until you are alert.
Liver
cautionLomustine may cause hepatotoxicity. If you have a pre-existing or a history of liver disease, inform your doctor before taking Lomustine. Your liver function should be monitored carefully before, during and after the treatment with Lomustine.
Kidney
cautionLomustine and its metabolites are known to be largely eliminated via the kidney, and the risk of adverse responses to this medicine may be higher in patients with impaired renal function. It may cause nephrotoxicity with progressive renal failure and a decrease in kidney size. Hence, if you have a pre-existing or a history of kidney disease, inform your doctor before taking Lomustine.
Children
cautionPlease consult a doctor. Your child's doctor may recommend this medicine based on the age, body weight and disease condition of your child.
Habit Forming
Diet & Lifestyle Advise
- Avoid crowds and sick contacts: Your white blood cell counts will drop significantly a few weeks after your dose, making you highly vulnerable to infections. Stay away from crowded public spaces and anyone with a cold or flu.
- Prevent bleeding and bruising: Use a soft-bristled toothbrush and an electric razor to prevent cuts. Avoid contact sports, heavy lifting, or activities that could lead to falls or injuries.
- Manage nausea proactively: Eat small, frequent meals rather than large ones. If your doctor prescribes anti-nausea medication, take it exactly as directed before your Lomustine dose.
- Stay well-hydrated: Drink plenty of water, clear broths, or herbal teas in the days following your dose to help support your kidneys and prevent dehydration.
Special Advise
- A blood test should be performed, such as LFT, RFT, and PFT, to check for liver/kidney function and pulmonary function.
- Weekly blood tests should be done during the treatment course to check for CBC (Complete blood count).
- Lomustine should not be taken more than the prescribed dose as it can lead to fatal toxicities and death.
- Lomustine should always be taken on an empty stomach only to avoid nausea.
- The patient's stool, urine and vomit should be discarded carefully by the caregiver. Gloves should be worn to avoid any contamination.
Patients Concern
Disease/Condition Glossary
Brain Tumors: A tumor is defined as the formation of solid mass tissue due to the abnormal growth of cells. A brain tumor is a serious condition where the cells (cancerous or non-cancerous) grow abnormally in the brain. There are different types of brain tumors which can be either benign (non-cancerous) or malignant (cancerous). Lomustine is used in the treatment of primary (a tumor that starts in any part of the brain) and metastatic (cancer cells which spread to other organs of the body) brain tumors.
Hodgkin’s Disease: Hodgkin’s disease or lymphoma is a blood cancer of a certain type of cells called WBCs, specifically lymphocytes. Lymphocytes normally help control infection and maintain the body's normal immunity. However, in a cancerous state, there is an abnormal multiplication of these blood cells, causing many problems such as fatigue, fever, loss of appetite, itching, night sweats and lymph node swelling.
FAQs
Lomustine is used to treat Brain Tumors and Hodgkin's Disease.
Lomustine contains Lomustine, which belongs to the alkylating agents class. It works by inhibiting the DNA and RNA transcription that is essential for protein synthesis.
Lomustine is effective in treating brain tumours and Hodgkin's lymphoma (a rare type of blood cancer that affects the lymphatic system). However, its effectiveness can vary depending on the type and stage of cancer, how the body responds to the medication, and whether it is used alone or in combination with other anti-cancer drugs. Always follow your doctor's instructions, as proper dosing and monitoring are crucial for maximizing its effectiveness.
Lomustine has a long half-life, typically 16 to 48 hours, meaning it can remain in your body for several days. However, its effects can last longer, as it works in the body for weeks.
If you miss a dose of Lomustine, take it as soon as you remember unless it is almost time for your next dose. In that case, skip the missed dose and take your next dose at the usual time. Do not take two doses at once to make up for a missed dose. Always follow your doctor's instructions for dosing.
Lomustine may cause common side effects, such as nausea, vomiting, headache, visual disturbances, blindness, disorientation, lack of energy, loss of control, and difficulty talking in some individuals. These side effects do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.
Before taking Lomustine, it's important to share your medical history and current medications with your doctor. If you have any allergies, liver or kidney problems, or breathing issues, be sure to let them know. Lomustine can lower your blood count, making you more prone to infections or bleeding, and may cause vision problems, so be careful when driving or operating machinery. Additionally, if you're pregnant or breastfeeding, inform your doctor, and children should only take Lomustine under a paediatrician's care. Typically taken every 6 weeks, be sure to consult your doctor or pharmacist before starting treatment.
Yes, women can use Lomustine only if recommended by a doctor. Lomustine is a chemotherapy drug, and its use may require special considerations for women, particularly those who are pregnant, breastfeeding, or planning to become pregnant. This is because it can harm the developing foetus or be passed to the baby through breast milk. Always consult with your doctor before using Lomustine. Your doctor will evaluate the benefits and risks before prescribing it and may monitor you for any side effects.
Lomustine has a delayed effect on your body, particularly on your bone marrow's ability to produce new blood cells. It takes several weeks for your blood counts to drop and then safely recover, making a 6-week break necessary between doses. Talk to your doctor if you have questions about your specific treatment schedule.
No, you must swallow the capsules whole. Opening, crushing, or chewing the capsules is highly dangerous because the active powder can damage your skin, mouth, or lungs if touched or inhaled. Talk to your doctor if you have trouble swallowing capsules.
If you vomit after taking your dose, do not take an extra capsule to replace it. Contact your doctor or oncology team immediately to receive safe instructions on how to proceed. Talk to your doctor about using anti-nausea medications before your next scheduled dose.
It is highly recommended to avoid alcohol while taking this medicine. Alcohol can worsen stomach irritation, increase nausea and vomiting, and add extra stress to your liver during treatment. Talk to your doctor for personalised advice.
You can generally receive an inactive (dead) flu shot, but you must avoid the live nasal spray flu vaccine. Because Lomustine weakens your immune system, live vaccines can cause serious infections. Talk to your doctor before receiving any vaccine.
Your doctor must monitor your blood counts closely because Lomustine causes a delayed drop in white blood cells, red blood cells, and platelets about 4 to 6 weeks after your dose. These tests ensure your body is recovering safely. Talk to your doctor about your blood test schedule.
No, you should not breastfeed while taking Lomustine and for a period after your final dose, as this medication can pass into breast milk and cause severe harm to your baby. Talk to your doctor to discuss safe feeding options for your child.
Author Details
