Lomustine

Uses

Precaution

Side Effects

Handling

Uses

What is Lomustine for?

Lomustine is a cytotoxic medication used for the treatment of brain tumours and Hodgkin’s lymphoma. It exerts its action by interfering with deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) synthesis.

How should I take or use Lomustine?

A blood test may be done before each treatment. The dose of your chemotherapy may be changed based on the test results and/or other side effects.

It is usually taken as a single dose ONCE every 6 weeks.

Swallow the capsules in whole with a glass of water on an empty stomach.

No food or drink for 2 hours after administration to reduce incidence of nausea and vomiting. Do not open, crush or chew the capsules. You may be given capsules of different strength to make the right dose. It is important to take Lomustine exactly as directed by your doctor.

Take precautions to avoid cytotoxic exposure. (Please refer to patient information leaflet (PIL) on “Safe Handling of Oral Cytotoxic Medications” for details).

What should I do if I forget to take or use Lomustine?

If you or your child miss a dose, take it as soon as you remember and inform your doctor. If it is nearer to the time of your next dose, skip the missed dose. Do not take two doses at the same time.

Do not repeat dose if vomiting occurs after dose has been administered, wait until the next scheduled dose. Contact the pharmacist or doctor if you or your child repeatedly miss doses due to vomiting, even with the administration of anti-vomiting medicine.

Precaution

What precautions should I take when taking or using Lomustine?

Do not take this medication, if you are allergic to Lomustine or any component of this formulation.

Before starting Lomustine, inform your doctor of any other medications that you or your child is already on. Check with the doctor or pharmacist before taking any other medications including vitamins and herbal medications. Talk to your doctor before getting flu shots or other vaccines.

Report to your doctor if you or your child has yellowing of eyes/skin, mental confusion or swelling of feet or lower legs accompanied with lower back or side pain.

Side Effects

What are some common side effects of Lomustine?

Side Effects	Management
Nausea and vomiting may occur within 45 minutes to 6 hours. May last for 24 hours.	Take anti-nausea/vomitng medicines if prescribed. Eat small but frequent meals. Avoid drinking too much water during meals. Stay in an up-right position for at least two hours after each meal. Seek medical attention immediately if you or your child experience persistent vomiting.
Low white blood cell count. May occur 4-5 weeks after the dose and persist for 1-2 weeks. White blood cells protect the body by fighting bacteria (germs) that cause infection. When the number of white blood cells is low, you or your child will be more susceptible to infections and may become very ill from these infections.	To help prevent infection: Wash hands regularly, especially before eating and after using the bathroom. Avoid crowded places and avoid contact with people who are sick. Do not eat raw or half-cooked food.	Seek medical help immediately if you or your child experience any of the following: Fever (temperature of 38ËšC twice or â‰¥38.5ËšC once) Blood in stools or urine Any uncontrollable or persistent bleeding or bruising.
Low platelet counts. May occur 4 weeks after the dose and persist for 1-2 weeks. Platelets are important for blood clotting. With low platelets, you or your child may bruise or bleed (e.g. gums or nose) more easily than usual.	Be safety conscious. Brush teeth gently with a soft-bristled toothbrush. Clean your nose by blowing gently. Avoid constipation by increasing fluid and fiber intake.
Loss of appetite may occur and may last for 2 to 3 days.	Eat small but frequent meals. Eat whenever hungry, even if it is not meal time yet. If you or your child is not eating well, try some nutritional supplements such as Pediasure, Ensure and Enercal Plus.
Pulmonary toxicity is rare but can be serious. Effects may be delayed. Onset can occur as early as 6 months from the start of therapy or as late as 17 years after treatment.	Seek medical help immediately if you or your child has any shortness of breath, wheezing or prolonged coughing.

Handling

How should I store Lomustine?

Keep away from children
Keep in a cool, dry place, away from direct sunlight
Store at room temperature
Keep Lomustine capsules in a closed container.

How should I handle Lomustine safely?

Take precautions to avoid cytotoxic exposure: wear gloves and mask when handling the capsules. Please refer to Patient's Information Leaflet on "Safe Handling of Oral Cytotoxic Medications" for details.

Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System, and SingHealth), community pharmacies (Guardian, Unity, and Watsons), and the Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.