Classes
DEA Class; Rx
Common Brand Names; Ifex
- Antineoplastics, Alkylating
Description
Nitrosourea alkylating agent
Used for the treatment of Hodgkin lymphoma and brain cancers
Fatal myelosuppression has been reported; give only 1 lomustine dose at a time with a minimum interval of 6-weeks between doses
Indications
Contraindications
Hypersensitivity
Adverse Effects
- Nausea (54%)
- Vomiting (54%)
- Neurotoxicity
- Myelosuppression (delayed 4-5 weeks)
- Ataxia
- Lethargy
- Disorientation
- Stomatitis
- Mucositis
- Pulmonary fibrosis (rare)
- Pulmonary toxicity
- Elevated LFTs
- Leukemia
- Renal toxicity
- Hepatic toxicity
- Infertility
- Alopecia
- Optic atrophy (rare)
Warnings
Causes myelosuppression that can result in fatal infections and bleeding; monitor blood counts for at least 6 weeks after each dose; do not give more frequently than q6wk due to delayed myelosuppression
Avoid pregnancy; can cause fetal harm; advise males and females of reproductive potential of potential risk to fetus and to use effective contraception; advise males with female partners of reproductive potential to use effective contraception during treatment and for 3.5 months after the final dose; therapy may result in reduced fertility in males and females of reproductive potential
Hepatotoxicity reported; increased levels of transaminases, alkaline phosphatase and bilirubin can occur; monitor liver function
Can cause renal failure; monitor renal function
Delayed pulmonary toxicity may occur; pulmonary infiltrates and/or fibrosis may occur; perform pulmonary function tests prior to treatment and repeat frequently; permanently discontinue therapy in patients diagnosed with pulmonary fibrosis
Secondary malignancies reported; acute leukemia and myelodysplasia can occur with long-term use
Pregnancy and Lactation
Pregnancy Category: D
Lactation: Unknown if metabolites present in breast milk; avoid nursing during treatment and for 2 weeks after final dose
Maximum Dosage
130 mg/m2 PO (repeated no sooner than every 6 weeks) is FDA approved; 200 mg/m2 PO has been studied off-label as induction therapy in AML patients 60 years and older in combination with other chemotherapy.
130 mg/m2 PO (repeated no sooner than every 6 weeks) is FDA approved; 200 mg/m2 PO has been studied off-label as induction therapy in AML patients 60 years and older in combination with other chemotherapy.
130 mg/m2 PO (repeated no sooner than every 6 weeks).
130 mg/m2 PO (repeated no sooner than every 6 weeks).
130 mg/m2 PO (repeated no sooner than every 6 weeks).
How supplied
Lomustine
capsule
- 5mg
- 10mg
- 40mg
- 100mg
