II. Indications
III. Mechanism
- See Alkylating Agent
- Antineoplastic nitrosourea
- Alkylating Agent that cross-links DNA during all Cell Cycle phases
- Carbamoylates Proteins, including DNA repair Proteins, resulting in further cytotoxic effects
IV. Medications
- Oral Lomustine: 5, 10, 40 and 100 mg capsules
- Dispensed as single doses
V. Dosing
- See other references for disease specific dosing protocols
- Typically taken every 6 weeks during treatment
VI. Pharmacokinetics
- Lipophilic
- Easily crosses the blood brain barrier
- Narrow therapeutic range
- Fatalities have occurred with overdosage (dispense one dose at a time)
VII. Adverse Effects
- Alopecia
- Severe Bone Marror Suppression
- Hepatotoxicity
- Impaired future fertility
- Nephrotoxicity
- Pulmonary Fibrosis
- Secondary Malignancy
VIII. Safety
- Avoid in Lactation
- Pregnancy Category D
- Avoid in Pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
IX. Resources
- Lomustine Capsule (DailyMed)