Adult Dosing
Brain tumors, Hodgkin's disease
- 130 mg/m2 PO as a single dose, q6 wks
- If compromised bone marrow function: 100 mg/m2 PO as a single dose, q6 wks
- Subsequent dosages should be adjusted according to hematologic response to the previous dose as follows
Table 1: Subsequent dose adjustments
Nadir after
prior dose | % of
prior dose
to be given |
|---|
leucocytes/
mm3 | Platelets/
mm3 |
|---|
| > 4000 | > 100,000 | 100% |
| 3000-3999 | 75,000-99,999 | 100% |
| 2000-2999 | 25,000-74,999 | 70% |
| 2000 | 25,000 | 50% |
- Therapy should not be repeated until circulating blood elements returns to acceptable levels. Monitor blood counts and avoid repeat course of therapy before 6 weeks because the hematologic toxicity is delayed and cumulative
Pediatric Dosing
Brain tumors, Hodgkin's disease
- 130 mg/m2 PO as a single dose, q6 wks
- If compromised bone marrow function: 100 mg/m2 PO as a single dose, q6 wks
- Subsequent dosages should be adjusted according to hematologic response to the previous dose as follows
Table 1: Subsequent dose adjustments
Nadir after
prior dose | % of
prior dose
to be given |
|---|
leucocytes/
mm3 | Platelets/
mm3 |
|---|
| > 4000 | > 100,000 | 100% |
| 3000-3999 | 75,000-99,999 | 100% |
| 2000-2999 | 25,000-74,999 | 70% |
| < 2000 | < 25,000 | 50% |
[Outline]
- Administer lomustine therapy under supervision of qualified physician experienced in the use of cancer chemotherapeutic agents [US Black Box Warning]
- Lomustine therapy may cause bleeding and overwhelming infections due to bone marrow suppression including thrombocytopenia and leukopenia [US Black Box Warning]
- Monitor blood counts weekly for at least 6 weeks after a dose due to delayed bone marrow suppression. Do not give more frequently than every 6 weeks [US Black Box Warning]
- Appropriately adjust dosage on the basis of nadir blood counts from prior dose as the bone marrow toxicity is cumulative [US Black Box Warning]
- Long term use of nitrosoureas has been reported to be associated with the development of secondary malignancies
- Monitor hematological profile qwk for at least 6 wks; hepatic and renal function at baseline and periodically during treatment
- Pulmonary toxicity characterized by pulmonary infiltrates and/or fibrosis has been reported in patients receiving lomustine; monitor pulmonary function periodically during treatment
- Pulmonary toxicity is dose related
- Reversible hepatotoxicity manifested by increased transaminase, alkaline phosphatease and bilirubin levels has been reported in some patients
- Renal abnormalities consisting of progressive azotemia, decrease in kidney size and renal failure have also been reported
Cautions: Use cautiously in
- Renal impairment
- Myelosuppression
- Myelosuppressive agent use
- Elderly population
- Long term use
Pregnancy Category:D
Breastfeeding: Most sources consider breastfeeding to be contraindicated with antineoplastic therapy. Due to the potential to cause serious adverse events, it is recommended that patients receiving lomustine should not breastfeed
Pricing data from www.DrugStore.com in U.S.A.
- CeeNU 10 MG CAPS [Bottle] (B-M SQUIBB ONCOLOGY/IMMUNOLOGY)
30 mg = $315.99
90 mg = $929.96
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
