Lomustine

Lomustine is an alkylating drug indicated for the treatment of patients with:

• Brain tumors, primary and metastatic, following appropriate surgical and/or radiotherapeutic procedures.
• Hodgkin’s lymphoma in combination with other chemotherapies, following disease progression with initial chemotherapy.

Lomustine inhibits the synthesis of DNA and RNA via alkylation although carbamoylation and modification of cellular proteins may also be involved.

Adult: 100-130 mg/m2 as a single dose every 6 wk. Adjust dose according to platelet and leukocyte counts. Compromised marrow function: 100 mg/m2 as a single dose every 6 wk.

Child: 75-150 mg/m2 as a single dose every 6 wk. Readjust dose according to platelet and leukocyte counts.

Increased levels/ effects with CYP2D6 inhibitors.

Pregnancy and lactation.

Pulmonary infiltrates, pulmonary fibrosis, nausea, vomiting, hepatotoxicity, nephrotoxicity, stomatitis, alopecia, disorientation, lethargy, dysarthria, ataxia, visual disturbances.

Pregnancy category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Symptoms: Pancytopenia, hepatic dysfunction, abdominal pain, pulmonary toxicity with tachypnoea and hypoxaemia, confusion and disorientation. Severe myelosuppression.

Management: Symptomatic and supportive.

Store at 15-30° C

Lomustine 10mg