Lomustine

Drug Class:	Commonly Known As:	Category:
Antineoplastic Agent	CeeNU®	Adult, Cancer-related, Children

Lomustine - Side Effects, Precautions, and Contraindications

What side effects can Lomustine cause?

Side Effects	Management
Nausea and vomiting may occur within 45 minutes to 6 hours. May last for 24 hours.	Take anti-nausea/vomitng medicines if prescribed. Eat small but frequent meals. Avoid drinking too much water during meals. Stay in an up-right position for at least two hours after each meal. Seek medical attention immediately if you experience persistent vomiting.
Low white blood cell count. May occur 4-5 weeks after the dose and persist for 1-2 weeks. White blood cells protect the body by fighting bacteria (germs) that cause infection. When the number of white blood cells is low, you will be more susceptible to infections and may become very ill from these infections.	To help prevent infection: Wash hands regularly, especially before eating and after using the bathroom. Avoid crowded places and avoid contact with people who are sick. Do not eat raw or half-cooked food.	Seek medical help immediately if you experience any of the following: Fever(temperature of 38˚C twice or ≥38.5˚C once) Blood in stools or urine Any uncontrollable or persistent bleeding or bruising.
Low platelet counts. May occur 4 weeks after the dose and persist for 1-2 weeks. Platelets are important for blood clotting. With low platelets, you may bruise or bleed (e.g. gums or nose) more easily than usual.	Be safety conscious. Brush teeth gently with a soft-bristled toothbrush. Clean your nose by blowing gently. Avoid constipation by increasing fluid and fiber intake.
Loss of appetite may occur and may last for 2 to 3 days.	Eat small but frequent meals. Eat whenever hungry, even if it is not meal time yet. If you are not eating well, try some nutritional supplements such as Pediasure, Ensure and Enercal Plus.
Pulmonary toxicity is rare but can be serious. Effects may be delayed. Onset can occur as early as 6 months from the start of therapy or as late as 17 years after treatment.	Seek medical help immediately if you have any shortness of breath, wheezing or prolonged coughing.

Before taking Lomustine, what precautions must I follow?

Do not take this medication, if you are allergic to Lomustine or any component of this formulation.

Before starting Lomustine, inform your doctor of any other medications that you are already on. Check with the doctor or pharmacist before taking any other medications including vitamins and herbal medications. Talk to your doctor before getting flu shots or other vaccines.

Report to your doctor if you have yellowing of eyes/skin, mental confusion or swelling of feet or lower legs accompanied with lower back or side pain.