Lomustine

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Drug-interactions 7 Mechanism-of-action 8 More General Terms 9 Internet Database 10 References

Introduction

• Tradename: CeeNu.

Indications

• brain tumors ( astrocytoma)
• Hodgkin's disease
• non-Hodgkin's lymphoma
• advanced lung cancer
• gastrointestinal carcinomas
• multiple myeloma

Dosage

• 100-130 mg/m2 once every 6 weeks
• reduce dose 25% for creatinine clearance of 10-50 mL/min
• 50% reduction in dosage if creatinine clearance < 10 mL/min

• Capsule: 10, 40, 100 mg.

Pharmacokinetics

• well absorbed orally
• distributes to all tissues
• concentrated in the CSF
• metabolized by the liver
• eliminated in the urine
• dose reductions recommended in renal dysfunction
• 1/2life is approximately 70 hours
• not dialyzable

Adverse-effects

• common (> 10%)

• nausea/vomiting

• occurs 3-6 hours after oral administration
• emetic potential high

• 60-90% < 60 mg
• > 90% > 60 mg

• myelosuppression

• onset 14 days
• nadir 4-5 weeks
• recovery 6 weeks

• less common (1-10%)

• anemia, neurotoxicity, renal failure, stomatitis, diarrhea skin rash, alopecia

• uncommon (< 1%)

• hepatotoxicity, alopecia, renal failure, pulmonary fibrosis with cumulative doses > 600 mg, disorientation, lethargy, ataxia, dysarthria

• Toxicity:

• No known antidotes
• Treatment of toxicity is symptomatic & supportive
  
• drug adverse effects of alkylating agents

Drug-interactions

• cimetidine may increase myelosuppression
• phenobarbital

Mechanism-of-action

• alkylating agent
• interferes with DNA & RNA synthesis

More General Terms

• alkylating agent nitrosourea
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 3950

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998

lomustine (CCNU, CeeNU, Belustine)