Ceenu-Lomustine

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

WARNING Blood related problems: Lomustine may cause serious decreases in your red blood cell, white blood cell and platelet levels which can cause infections, anemia, bruising and bleeding. These problems may be worse and/or last longer as the total amount of lomustine used over time increases (see Precautions To Be Aware Of Before Taking This Medication). Treatment courses should not be given more frequently than every 6 weeks. Uses For This Medication
  • Lomustine is used in combination with other chemotherapy medications to treat brain tumors and Hodgkin’s lymphoma.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Lomustine is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death. Benefits of This Medication Lomustine, alone or together with other chemotherapy medications, may slow down the growth of the tumor, or cancer. In addition, for some cancers, lomustine, in combination with other chemotherapy medications, may lengthen how long a person lives. Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to lomustine or any of its components
  Precautions to be Aware of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example, ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.
  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands with soap and water well and often, and brush and floss your teeth daily.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
 

Organ related precautions

  • This medication can cause changes in the ability of your liver and/or kidneys to work normally. Your doctor or healthcare provider will check your liver and kidneys regularly, usually through blood tests, while you are on this medication to make sure that they are both working properly. If you have any liver or kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  • A serious lung problem known as pulmonary fibrosis (scarring of the lungs) has been reported in people taking this medication. The risk of developing this problem increases as the total amount of lomustine used over time increases. Your doctor or healthcare provider will monitor you carefully while you are receiving lomustine to make sure that you do not develop this condition. In addition, contact your doctor or healthcare provider immediately if you experience cough, difficulty breathing, or wheezing.
 

Miscellaneous precautions

  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent. Patient specific precautions Lomustine is used to treat certain types of cancer in children. However, children younger than 17 years of age who receive lomustine in combination with radiation therapy to treat brain tumors may be at risk for developing pulmonary fibrosis (scarring of the lungs) months to years after their treatment is completed.
  Pregnancy and Breastfeeding Precautions
  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
  Medication and Food Interactions Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Notify your health care provider if you are taking any of these medicines as Lomustine can increase their effects:
  • Amphotericin B (Fungizone)
  • Flucytosine (Ancobon)
  • Antithyroid medications for overactive thyroid
  • Ganciclovir (Cytovene)
  • Azathioprine- (Imuran)
  • Interferon (Intron A, Roferon A)
  • Chloramphenicol (Chloromycetin)
  • Zidovudine (AZT, Retrovir)
  • Colchicine
  Side Effects
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when lomustine is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with lomustine alone.
 

More common side effects

  • Decreased platelet, red blood cell, and/or white blood cell levels – usually occurs 4-6 weeks after drug administration (see Warning and Precautions To Be Aware Of Before Taking This Medication)
  • Nausea, vomiting (which may last for up to 24 hours and can usually be reduced if this medication is taken in a fasting state)
 

Less common side effects

  • Loss of appetite
  • Weakness
 

Rare side effects

This is not a complete list of the rare side effects reported with lomustine. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Development of another cancer (leukemia or bone marrow dysplasia)
  • Inflammation and/or scarring of the lungs (pulmonary fibrosis)
  • Kidney or liver problems (see Precautions To Be Aware Of Before Taking This Medication)
  • Sores in the mouth or on the lips
  • Hair loss
  • Vision changes
  • Swelling in the legs and feet
  • Confusion, lethargy, slurred speech, difficulty walking
  How To Take This Medication  
  • This medication is taken by mouth (orally) and may only be taken once every 6 weeks. Take this medication exactly as directed by your doctor or healthcare provider. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you. This medication can be given in different doses depending on your weight and the type of condition being treated.
  • Antiemetics, which are medications to help prevent and control nausea and vomiting, may be given before lomustine either by mouth (orally) or by injection into a vein (IV).
  • It is important that you only use this medication when it’s been prescribed for you. Sharing this medication with someone for whom it is not prescribed could cause harm.
  • If you accidentally take too many pills or someone else accidentally takes your medication, contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • Store this medication at room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.