Chemotherapy Patient Resource Area

Lomustine/CeeNu^®

Drug
Lomustine (generic name) is manufactured as CeeNu^® (trade name) (Bristol-Myers Squibb, Princeton, NJ).

Action
Lomustine is an anticancer drug that stops cell growth and division. It is a type of drug called an alkylating agent and is used to treat brain tumors, Hodgkin's disease, non-Hodgkin lymphoma, bronchiogenic carcinoma, malignant melanoma, and cancers of the kidney, breast, and gastrointestinal tract. Lomustine also has been applied to the skin to treat psoriasis and a skin disorder called mycosis fungoides.

What does the drug look like?
Lomustine is supplied in film-coated capsules in various strengths (10-mg capsules are all white, 40-mg capsules are white and green, and 100-mg capsules are all green).

How long will I take the drug?
The length of treatment varies and depends on your diagnosis and how well your body responds to treatment.

How do I take the drug?
Lomustine is taken by mouth, once every six weeks. Lomustine may cause nausea. Taking the drug on an empty stomach after fasting for 8-12 hours generally reduces this. The dose of lomustine is based on your body size and is determined by your doctor. Your doctor and pharmacist will tell you how many capsules to take. Your full dose may contain two or more different strengths of capsules, so your pill bottle will likely contain different colored capsules. Be sure to read the label on your medicine closely so that you take the dose you need. Take all of the capsules at the same time. Swallow each capsule whole; do not chew them.

Storage
Store this medicine at room temperature, away from excess heat and moisture (do not store on a windowsill or in a bathroom). Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Lomustine temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination.
• Lomustine temporarily lowers the number of red blood cells in your blood, which carry oxygen, and may cause you to feel tired and lack energy. Conserve your energy, get adequate rest, and enlist help in carrying out daily activities (such as meal preparation) as needed. If you feel unusually tired, if your skin and mucous membranes (lining of eyes and mouth) appear unusually pale, or if you experience unusual or heavy bleeding, contact your doctor immediately, as these may be signs of anemia (low red blood cell count).
• Lomustine also lowers the number of platelets in your blood, which are necessary for proper blood clotting. DO NOT take aspirin or aspirin-containing products. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing. Your healthcare providers may give you suggestions on how to care for your mouth, and these directions should be followed carefully.
• Lomustine may cause nausea and vomiting. Generally, the onset of nausea occurs about 3-6 hours after taking the drug and lasts up to about 24 hours. However, loss of appetite may last for several days. Eat small frequent meals and bland foods, and report moderate to severe vomiting to your doctor. Medications for nausea can be prescribed to help with this side effect.
• You should not become pregnant while taking lomustine. If you get pregnant, lomustine may harm the fetus or cause fetal death. Use a reliable method of birth control. If you are thinking about having children in the future, be sure to discuss this with your doctor. Lomustine may cause sterility.

Drug interactions
Let your doctor know what medications you are taking. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills or cough
• Painful urination
• Moderate to severe nausea and vomiting
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stools