| Recommended Dose and Dosage Regimen | The recommended dose of lomustine varies depending on the specific indication and patient characteristics. For adults with brain tumors, the typical initial dose is 130 mg/m² taken orally as a single dose every 6 weeks. The dosage may be adjusted based on individual response and tolerance. For other malignancies, such as Hodgkin’s disease and non-Hodgkin’s lymphoma, lomustine may be administered at doses ranging from 40 to 110 mg/m² once every 6 weeks or in divided doses. Pediatric dosing may differ based on body surface area and age. Follow your healthcare provider’s instructions regarding dosing. |
| Frequency of Administration | Lomustine is usually administered as a single oral dose once every 6 weeks for the treatment of brain tumors and other malignancies. |
| Route of Administration | Lomustine is administered orally in the form of capsules. |
| Mechanism of Action (MOA) | Lomustine, a nitrosourea alkylating agent, exerts its antineoplastic effects by alkylating DNA and interfering with DNA replication and transcription. It inhibits DNA synthesis by forming cross-links between DNA strands, leading to strand breaks and cell death. Lomustine also exhibits cytotoxic activity against rapidly dividing tumor cells. |
| Pharmacokinetics (PK) | Lomustine is well absorbed after oral administration, with peak plasma concentrations achieved within 1-6 hours. It undergoes extensive hepatic metabolism to active metabolites. The elimination half-life of lomustine ranges from 16 to 48 hours. Metabolites are excreted mainly in the urine. |
| Pharmacodynamics (PD) | Lomustine’s pharmacodynamic effects include inhibition of DNA synthesis, DNA damage, and cell death in rapidly proliferating tumor cells. It exhibits dose-dependent cytotoxicity and may induce apoptosis in cancer cells. |
| Pathophysiology | Lomustine is indicated for the treatment of various malignancies, including brain tumors (e.g., glioblastoma multiforme, anaplastic astrocytoma), Hodgkin’s disease, non-Hodgkin’s lymphoma, and melanoma. It may be used alone or in combination with other antineoplastic agents or radiation therapy. |
| Primary Indications | Brain tumors (glioblastoma multiforme, anaplastic astrocytoma), Hodgkin’s disease, non-Hodgkin’s lymphoma, melanoma, other malignancies. |
| Contraindications | Contraindications to lomustine use include hypersensitivity to lomustine or its components, severe bone marrow suppression, severe hepatic impairment, and pre-existing severe renal impairment. Lomustine should not be used in patients with inadequate bone marrow reserve due to previous cytotoxic therapy or bone marrow involvement by tumor. |
| Purpose of Taking Medication | The purpose of lomustine therapy is to treat various malignancies by inhibiting tumor growth and inducing cancer cell death. Lomustine is used as part of a comprehensive treatment regimen for brain tumors, lymphomas, Hodgkin’s disease, melanoma, and other cancers. |
| Usage Instructions | Take lomustine capsules orally as directed by your healthcare provider. Swallow the capsules whole with a full glass of water, with or without food, depending on your healthcare provider’s instructions. Do not open, crush, or chew the capsules. |
| Precautions and Care | Patients receiving lomustine should be closely monitored for signs of bone marrow suppression (e.g., leukopenia, thrombocytopenia, anemia), hepatic toxicity, and pulmonary toxicity. Regular blood tests and liver function tests may be necessary during treatment. Avoid contact with lomustine capsules if pregnant or breastfeeding. |
| Dietary Considerations | There are no specific dietary considerations associated with lomustine use. Maintain a balanced diet and adequate hydration to support overall health and immune function during cancer treatment. |
| Missed Dose | If a dose of lomustine is missed, take it as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. |
| Possible Side Effects | Common side effects of lomustine may include bone marrow suppression (e.g., leukopenia, thrombocytopenia, anemia), nausea, vomiting, diarrhea, alopecia (hair loss), and hepatic toxicity. Serious adverse effects may include pulmonary toxicity, renal toxicity, and secondary malignancies. |
| Storage and Disposal | Store lomustine capsules at room temperature away from moisture, heat, and light. Keep the medication out of reach of children and pets. Unused or expired medication should be disposed of properly according to local regulations. |
| Overdose or Emergency | In case of lomustine overdose or emergency, seek medical attention immediately. Overdose may lead to severe bone marrow suppression, hepatic toxicity, and other adverse effects. Treatment is supportive and may include hematopoietic growth factors, blood transfusions, and symptomatic care. |
| Monitoring and Laboratory Tests | Patients receiving lomustine therapy require regular monitoring of blood counts (e.g., complete blood count with differential), liver function tests (e.g., serum transaminases, bilirubin), renal function, and pulmonary function. Imaging studies may be performed to assess tumor response to treatment. |
