Lomustine may cause serious blood disorders (decreased bone marrow function leading to low number of white blood cells/platelets and anemia). It can lower your body's ability to fight an infection and increase your risk of bleeding. These side effects usually occur 4-6 weeks after your dose. Higher doses and more doses increase the chance of these side effects.
Seek immediate medical attention if you develop symptoms of infection (fever, chills, persistent sore throat) or unusually easy bruising/ bleeding. (See also Side Effects section.)
Your doctor will monitor you and perform blood tests weekly for at least 6 weeks after each dose. Your dose and any further treatment will be based on your blood tests. You will have to wait at least 6 weeks between doses.Who should not take lomustine?
Take this medication by mouth as a single dose as directed by your doctor. (See also Warning section.) Your dose may consist of 2 or more different strengths/colors of capsules. Taking this medication on an empty stomach with a full glass of water may decrease nausea and vomiting. Unless your doctor instructs you otherwise, drink plenty of fluids to avoid a serious loss of body water (dehydration).
Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.
Wear rubber or latex gloves when you handle the capsules.
Nausea, vomiting, loss of appetite, diarrhea, and mouth/lip sores may occur. Nausea and vomiting usually last for less than 24 hours, though loss of appetite can last for several days. Nausea and vomiting can be quite severe. In some cases, your doctor may prescribe medication to prevent/treat nausea and vomiting. Changes in diet such as eating several small meals or limiting activity may help decrease some of these effects. If these effects persist or worsen, notify your doctor or pharmacist promptly.
Temporary hair loss may occur. Normal hair growth should return after treatment has ended.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. (See also Warning section.)
Tell your doctor immediately if any of these rare but very serious side effects occur: coughing up blood, persistent nausea/vomiting, stomach/abdominal pain, black tarry stools, unusual tiredness, change in the amount of urine, dark or pink urine, yellow eyes/skin.
A severe (sometimes fatal) lung problem (pulmonary fibrosis) has occurred in patients using this drug. This condition can occur months to years after you start taking this medication. Tell your doctor immediately if you experience any of these serious side effects: cough, chest pain, difficult/painful breathing.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
In the US -
Before taking lomustine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current infection.
Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose. To prevent the spread of infections, wash your hands well, and avoid touching your eyes or the inside of your nose without first washing your hands.
To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.
This medication is not recommended for use during pregnancy. It may harm an unborn baby. Therefore, it is important to prevent pregnancy while using this medication. Consult your doctor for more details and to discuss the use of reliable forms of birth control (such as condoms, birth control pills) while using this medication. If you become pregnant or think you may be pregnant, tell your doctor immediately.
It is not known whether this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
This drug should not be used with the following medications because very serious interactions may occur: nalidixic acid, live vaccines.
If you are currently using either of the medications listed above, or have received or plan to receive any vaccines, tell your doctor or pharmacist before starting lomustine.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g., heparin, warfarin), other drugs that can affect the immune system (e.g., chemotherapy, cyclosporine).
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Do not share this medication with others.
Laboratory and/or medical tests (e.g., complete blood count, kidney/liver/lung tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
It is important that you take lomustine as scheduled by your doctor. If you miss a dose, contact your doctor immediately to obtain a new dosing schedule.
Store in a tightly closed container at room temperature below 104 degrees F (40 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised April 2013. Copyright(c) 2013 First Databank, Inc.
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