lomustine at a glance
Medicine class
Cytotoxic nitrosourea alkylating agent
How it is taken
By mouth as a hard capsule, swallowed whole
Key safety issue
Blood-cell counts can fall late and progressively, increasing infection and bleeding risks
Handling
Avoid capsule contents and wash hands after handling
What is lomustine used for?
Licensed uses include palliative or supplementary treatment, usually within combination treatment involving surgery, radiotherapy or other anticancer agents.
Primary or metastatic brain tumours
Lung tumours, particularly small-cell disease
Hodgkin lymphoma resistant to conventional combination chemotherapy
Metastatic malignant melanoma
Second-line treatment where appropriate for non-Hodgkin lymphoma, myeloma, gastrointestinal tumours, and cancers of the kidney, testis, ovary, cervix or breast
How does lomustine work?
Lomustine is converted into reactive substances that damage and cross-link DNA and interfere with DNA repair. This limits cancer-cell division but can also affect healthy rapidly dividing cells, particularly bone-marrow cells. Its fat-soluble properties allow active material to reach the central nervous system.
How to take lomustine
Follow your oncology team's written instructions exactly. Swallow capsules whole with water; do not open, chew or crush them. Taking lomustine on an empty stomach and using prescribed anti-sickness treatment beforehand may reduce nausea. Avoid damaged capsules and their contents; wash exposed skin thoroughly and contact your treatment team for advice.
Check that you understand which capsules to take before leaving the hospital or pharmacy.
Do not take additional capsules unless your oncology team instructs you to.
If you vomit after taking lomustine, contact the cancer team and do not repeat it without their advice.
Store in the original container below 25°C, protected from light and moisture.
lomustine side effects
Common or expected effects
- Nausea, vomiting and reduced appetite
- Reduced white cells, platelets or red cells
- Infection or reduced immune response
- Tiredness, poor coordination or disorientation
- Sore mouth or mouth ulcers
- Diarrhoea
- Temporary liver-test abnormalities
- Fever, chills or swelling
Get urgent medical advice
- Fever, chills or other signs of infection
- Unusual bruising, prolonged bleeding or blood spots
- Severe weakness or breathlessness from anaemia
- New dry cough or breathlessness
- Yellow skin or eyes
- Markedly reduced urine or swelling
- Severe confusion, coordination problems or other significant neurological changes
lomustine in pregnancy
Lomustine is contraindicated during pregnancy because it can damage genetic material and animal studies show reproductive toxicity. Discuss pregnancy with the oncology team before treatment. If pregnancy occurs or is possible during treatment, contact the specialist promptly rather than changing treatment independently. Effective contraception is required during treatment and afterwards for the product-specified period.
lomustine while breastfeeding
Breastfeeding is contraindicated during lomustine treatment. Its fat-soluble nature means transfer into breast milk is considered likely, with potential risk to the infant. Discuss feeding options with the oncology and maternity teams.
lomustine interactions
Interaction studies are limited. The oncology team should review prescribed, pharmacy-bought and complementary products before treatment.
Theophylline
May increase lomustine-related bone-marrow toxicity.
Cimetidine
May increase lomustine-related bone-marrow toxicity.
Phenobarbital and other enzyme-inducing antiepileptics
May speed lomustine elimination and reduce its anticancer effect; specialist review is needed.
Other cytotoxic treatments or radiotherapy
Can increase bone-marrow suppression and associated infection or bleeding risks.
Common questions about lomustine
Answers are fully visible for fast scanning and source review.
Why are blood tests needed after taking lomustine?
Lomustine can cause delayed and prolonged falls in white cells, platelets and red cells. Tests identify infection, bleeding or anaemia risks before symptoms become severe.
Can lomustine capsules be opened or crushed?
No. Swallow them whole because the contents are cytotoxic and direct exposure should be avoided.
What should I do if I vomit after taking lomustine?
Contact your cancer team promptly. Do not take replacement capsules unless the specialist team explicitly instructs you to do so.
Can lomustine be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.