II. Indications

III. Mechanism

  1. See Alkylating Agent
  2. Antineoplastic nitrosourea
    1. Alkylating Agent that cross-links DNA during all Cell Cycle phases
    2. Carbamoylates Proteins, including DNA repair Proteins, resulting in further cytotoxic effects

IV. Medications

  1. Oral Lomustine: 5, 10, 40 and 100 mg capsules
    1. Dispensed as single doses

V. Dosing

  1. See other references for disease specific dosing protocols
  2. Typically taken every 6 weeks during treatment

VI. Pharmacokinetics

  1. Lipophilic
  2. Easily crosses the blood brain barrier
  3. Narrow therapeutic range
    1. Fatalities have occurred with overdosage (dispense one dose at a time)

VII. Adverse Effects

  1. Alopecia
  2. Severe Bone Marror Suppression
  3. Hepatotoxicity
  4. Impaired future fertility
  5. Nephrotoxicity
  6. Pulmonary Fibrosis
  7. Secondary Malignancy

VIII. Safety

  1. Avoid in Lactation
  2. Pregnancy Category D
    1. Avoid in Pregnancy (all trimesters)
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count (CBC)
    2. Liver Function Tests
    3. Renal Function tests
    4. Pulmonary Function Tests

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Related Studies

Ontology: Lomustine (C0023972)

Definition (NCI) A nitrosourea with antineoplastic activity. Lomustine alkylates and crosslinks DNA, thereby inhibiting DNA and RNA synthesis. This agent also carbamoylates DNA and proteins, resulting in inhibition of DNA and RNA synthesis and disruption of RNA processing. Lomustine is lipophilic and crosses the blood-brain barrier. (NCI04)
Definition (NCI_NCI-GLOSS) An anticancer drug that belongs to the family of drugs called alkylating agents.
Definition (MSH) An alkylating agent of value against both hematologic malignancies and solid tumors.
Definition (CSP) cytotoxic alkylating agent of the nitrosourea group used as an antineoplastic.
Definition (PDQ) A nitrosourea with antineoplastic activity. Lomustine alkylates and crosslinks DNA, thereby inhibiting DNA and RNA synthesis. This agent also carbamoylates DNA and proteins, resulting in inhibition of DNA and RNA synthesis and disruption of RNA processing. Lomustine is lipophilic and crosses the blood-brain barrier. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43065&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=43065&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C617" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008130
SnomedCT 387227009, 40999006
English Lomustine, Urea, N-(2-chloroethyl)-N'-cyclohexyl-N-nitroso-, Chloroethylcyclo- hexylnitrosourea, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, N-(2-chloroethyl)-N'-cyclohexyl-N-nitrosourea, lomustine, Chloroethylcyclo-hexylnitrosourea, chloroethylcyclohexylnitrosourea, Lomustinum, lomustine (medication), Lomustine [Chemical/Ingredient], cyclohexylchloroethylnitrosourea, 1-Nitrosourea, 1-(2-chloroethyl)-3-cyclohexyl-, N-(2-Chloroethyl)-N'-cyclohexyl-N-nitrosourea, 1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea, Lomustine (product), Lomustine (substance), Chloroethylcyclohexylnitrosourea, LOMUSTINE
Swedish Lomustin
Czech lomustin
Finnish Lomustiini
Russian LOMUSTIN, CCNU, ЛОМУСТИН
Japanese ロムスチン
Polish Lomustyna
Spanish lomustina (producto), lomustina (sustancia), lomustina, Lomustina
French Lomustine
German Lomustin
Italian Lomustina
Portuguese Lomustina