CCNU 10'S (LOMUSTINE CAP)

Lomustine, a cytotoxic alkylating agent, exerts its anti-cancer effects through several mechanisms. Its primary mode of action involves the alkylation of DNA, leading to the formation of both intra• and inter-strand crosslinks. This alkylation occurs mainly at the O6 position of guanine residues, resulting in DNA damage and subsequent inhibition of DNA replication and RNA transcription. Moreover, lomustine can induce the mispairing of DNA bases during replication, further contributing to its cytotoxicity. These actions collectively disrupt the normal cell cycle, triggering cell death in rapidly dividing cancer cells. The drug's ability to damage DNA and interfere with vital cellular processes underlies its therapeutic efficacy in treating various types of cancer.

Lomustine

Alkylating agent

Capsule

The following are the uses of Lomustine Capsule:

• Used for treating brain tumors, both primary and metastatic, that have not responded to other treatments.
• Used for slowing or stopping the growth of cancer cells in the brain.
• Used for managing certain types of lung cancer, particularly small cell lung cancer.
• Used for treating Hodgkin's disease and other types of lymphomas.
• Used for shrinking tumors in various cancers, improving symptoms and quality of life.
• Used for extending survival rates in patients with advanced or recurrent cancers.
• Used for managing certain types of melanoma and gastrointestinal tumors.

In the case of an overdose of Lomustine Capsules, individuals may experience severe side effects such as nausea, vomiting, and suppression of bone marrow function. It is crucial to seek medical assistance promptly if an overdose is suspected. The healthcare provider will determine the appropriate course of action, which may include supportive care and monitoring of vital signs. Timely intervention can help manage the adverse effects and ensure the patient's well-being.

In the case of a missed dose of Lomustine Capsule, it is important to contact your healthcare provider for guidance. They will advise you on whether to take the missed dose as soon as possible or simply skip it and continue with the next scheduled dose. Never take a double dose to make up for a missed one without consulting your doctor, as this may increase the risk of side effects. Your healthcare provider will determine the best course of action based on your individual treatment plan.

To take Lomustine Capsules, swallow the prescribed number of capsules whole with a full glass of water, preferably at the same time each day, following the dosage instructions provided by your healthcare professional, without opening or crushing the capsules.

Following are the conditions/situations when Lomustine Capsule should not be used:

• Must not be used in patients with a known hypersensitivity or severe allergic reaction to Lomustine or similar medications.
• Contraindicated in patients with severe bone marrow depression or those who have a low white blood cell count.
• Should not be used in patients with liver disease or impaired liver function.
• Not recommended for pregnant women as it may cause harm to the developing fetus.
• Should be avoided during breastfeeding as it can pass into breast milk and harm the nursing infant.
• Must not be used in patients with active infections, as it can further suppress the immune system.
• Contraindicated in patients with severe kidney disease or kidney failure.
• Not suitable for patients with a history of severe lung disease or respiratory distress.

The side effects of Lomustine Capsule may include:

• Nausea and vomiting
• Loss of appetite
• Diarrhea or constipation
• Mouth sores
• Skin rash or itching
• Hair loss
• Fatigue and weakness
• Low blood cell counts, which can increase the risk of infections, bleeding, and anemia.

Following are the precautions and warnings for Lomustine Capsule:

• This medication is a potent chemotherapy drug and should be handled with extreme care by healthcare professionals only.
• Patients should be closely monitored for blood disorders, as Lomustine can cause a significant decrease in white blood cells, red blood cells, and platelets. Regular blood tests are essential.
• Liver function tests should be conducted periodically during treatment to monitor liver health.
• Patients with pre-existing liver or kidney disease may require dosage adjustments and should be closely monitored.
• It is important to avoid pregnancy during and after treatment with Lomustine, as it may cause harm to the fetus. Effective contraception is necessary.
• Lomustine can cause severe nausea and vomiting. Antiemetic medications may be prescribed to manage these side effects.
• Patients should inform their doctor about all medications they are taking to avoid potential drug interactions.
• Lomustine is potentially carcinogenic and may increase the risk of developing secondary cancers. Long-term monitoring is recommended.

Following are the drug interactions for Lomustine Capsule:

• Lomustine may interact with other chemotherapy drugs, such as cisplatin and doxorubicin, increasing the risk of bone marrow suppression and other toxicities.
• It can enhance the effects of immunosuppressants like cyclosporine, leading to increased immunosuppression.
• The effectiveness of vaccines may be reduced when administered concurrently with Lomustine, as it can suppress the immune response.
• Combining Lomustine with phenytoin or carbamazepine may result in decreased levels of these anticonvulsants, potentially reducing their seizure control.
• Antacids containing aluminum or magnesium should be avoided as they can decrease the absorption of Lomustine.
• Caution is advised when using Lomustine with other myelosuppressive agents, as it may increase the risk of bone marrow toxicity.
• The metabolism of Lomustine can be affected by drugs that induce or inhibit liver enzymes, potentially altering its effectiveness and side effect profile.

Following are the food interactions for Lomustine Capsule:

• Avoid consuming grapefruit and grapefruit juice, as they can interfere with the metabolism of Lomustine, leading to increased drug levels and potential toxicity.
• Alcohol consumption should be limited or avoided as it may increase the risk of liver damage and enhance the sedative effects of Lomustine.
• Foods high in tyramine, such as aged cheeses, cured meats, and certain types of beer, should be avoided. Lomustine can interact with tyramine, leading to a sudden increase in blood pressure.
• Vitamin C-rich foods like citrus fruits and supplements should be consumed with caution, as high doses of vitamin C may reduce the effectiveness of Lomustine.
• Avoid consuming high-fat meals, as they can increase the absorption of Lomustine, potentially leading to higher drug levels in the body.
• Limit the intake of foods containing live bacteria, such as yogurt and fermented foods, as they may alter the gut flora and potentially affect drug absorption.
• Be cautious with black pepper and herbal supplements containing piperine, as they can increase the absorption and concentration of Lomustine.
• Consult your healthcare provider for specific dietary guidelines, as they may recommend a balanced diet to support overall health during Lomustine treatment.

Lomustine capsules should be stored in a secure and dry location, specifically at room temperature, ensuring protection from light and moisture. Maintain the capsules in their original container, tightly sealed, to prevent contamination. Avoid storing them in bathrooms or near heat-emitting appliances like stoves or heaters, as temperature fluctuations can compromise the medication's integrity. Dispose of any unused or expired capsules responsibly; refrain from flushing them down the toilet or pouring them into drains. Consult your pharmacist or healthcare provider for appropriate disposal methods, and keep the medication out of children's reach to prevent accidental ingestion. Proper storage and disposal practices ensure the effectiveness of Lomustine capsules and contribute to overall medication safety.

Following are the quick tips for Lomustine Capsules:

• Take the medication exactly as prescribed by your doctor; do not adjust the dosage without medical advice.
• Swallow the capsules whole with a full glass of water; do not open, chew, or crush them.
• Take Lomustine with food to minimize stomach irritation.
• Ensure you are well-hydrated before and after taking the medication.
• Avoid activities that may cause injury or bruising, as Lomustine can lower your blood cell count.
• Regular blood tests are necessary to monitor your blood cell levels while on this medication.
• Store Lomustine capsules in a secure place, away from children and pets.