Lomustine (CCNU)
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General information
Class/mechanism: Nitrosourea, alkylates DNA and RNA and may inhibit certain key enzymatic reactions by carbamoylation of amino acids in proteins.[1][2]
Route: PO
Extravasation: n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.[1]
Diseases for which it is used
- Acute myeloid leukemia
- Anaplastic glioma
- CNS lymphoma
- Glioblastoma
- High-grade glioma, pediatric
- Low-grade glioma
- Medulloblastoma
Diseases for which it was used
Patient drug information
- Lomustine (Ceenu) package insert[1]
- Lomustine (Ceenu) patient drug information (Chemocare)[3]
- Lomustine (Ceenu) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 1976-08-04: Initial approval
- 2009-04-30: (oldest available label) has been shown to be useful as a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in brain tumors - both primary and metastatic, in patients who have already received appropriate surgical and/or radiotherapeutic procedures. (No supporting studies are cited)
- 2009-04-30: (oldest available label) has been shown to be useful as a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in Hodgkin’s Disease-secondary therapy in combination with other approved drugs in patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy. (No supporting studies are cited)
History of changes in EMA indication
- 1976-01-26: EURD
Also known as
- Generic names: CCNU
- Brand names: CeeNu, Gleostine
COG ACNS0331 Lomustine Dosing Nomogram
Available Capsule Sizes
- 10 mg
- 40 mg
- 100 mg
Body Surface Area (m2) | Ideal Dose (75 mg/m2/day once daily) | Actual Dose to be Given |
---|---|---|
2.0 | 150 mg, | 150 mg |
1.9 | 143 | 140 |
1.8 | 135 | 130 |
1.7 | 128 | 130 |
1.6 | 120 | 120 |
1.5 | 112 | 110 |
1.4 | 105 | 100 |
1.3 | 98 | 100 |
1.2 | 90 | 90 |
1.1 | 82 | 80 |
1.0 | 75 | 80 |
0.95 | 71 | 70 |
0.9 | 68 | 70 |
0.85 | 64 | 60 |
0.8 | 60 | 60 |
0.75 | 56 | 60 |
0.7 | 53 | 50 |
0.65 | 49 | 50 |
0.6 | 45 | 40 |
0.55 | 41 | 40 |
0.5 | 38 | 40 |
0.45 | 34 | 30 |
0.4 | 30 | 30 |
0.35 | 26 | 30 |
0.3 | 23 | 20 |
References
- ↑ 1.0 1.1 1.2 Lomustine (Ceenu) package insert
- ↑ Lomustine (Ceenu) package insert (locally hosted backup)
- ↑ Lomustine (Ceenu) patient drug information (Chemocare)
- ↑ Lomustine (Ceenu) patient drug information (UpToDate)
- ↑ Discontinued drug bulletin: Lomustine capsules (American Society of Health-System Pharmacists)
- ↑ NextSource Biotechnology Lomustine (CCNU) update
Categories:
- Drugs
- Oral medications
- Nitrosoureas
- Acute myeloid leukemia medications
- Anaplastic glioma medications
- CNS lymphoma medications
- Glioblastoma medications
- High-grade glioma, pediatric medications
- Low-grade glioma medications
- Medulloblastoma medications
- Classical Hodgkin lymphoma medications (historic)
- Non-small cell lung cancer medications (historic)
- Ovarian cancer medications (historic)
- Small cell lung cancer medications (historic)
- FDA approved in 1976
- EMA approved in 1976