Dangerous Drug: Lomustine (CCNU)



Dangerous Drug: Lomustine (CCNU)





(loe mus’ teen)

CeeNU

PREGNANCY CATEGORY D


Drug Classes

Alkylating drug, nitrosourea

Antineoplastic


Therapeutic Actions

Cytotoxic: Exact mechanism of action not known, but it involves alkylation of DNA, thus inhibiting DNA, RNA, and protein synthesis; cell-cycle nonspecific.


Indications



  • Treatment with other drugs for primary and metastatic brain tumors and secondary treatment of Hodgkin disease in patients who relapse following primary therapy



Contraindications and Cautions



  • Contraindicated with allergy to lomustine, myelosuppression, pregnancy (teratogenic and embryotoxic in preclinical studies), and lactation.


  • Use cautiously with impaired renal or hepatic function.


Available Forms

Capsules—10, 40, 100 mg


Dosages

Adults and pediatric patients

130 mg/m2 PO as a single dose every 6 wk. Adjustments must be made with bone marrow suppression; initially reduce the dose to 100 mg/m2PO every 6 wk; do not give a repeat dose until platelets exceed 100,000/mm2 and leukocytes exceed 4,000/mm2; adjust dosage after initial dose based on hematologic response as follows:

Minimum (nadir) count after prior dose:



























Leukocytes/mm3 Platelets/mm3 Percentage of Prior Dose to Give
More than 4,000 More than 100,000 100
3,000–3,999 75,000–99,999 100
2,000–2,999 25,000–74,999 70
Less than 2,000 Less than 25,000 50

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Jul 21, 2016 | Posted by in NURSING | Comments Off on Dangerous Drug: Lomustine (CCNU)

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