ISSN 2398-2950      

Lomustine

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Synonym(s): CeeNU, CCNU


Introduction

Name

  • Lomustine.

Class of drug

  • Alkylating agent in the nitrosurea family.

Description

Chemical name

  • 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosurea.

Molecular formula

  • C9H16C1N3O2

Molecular weight

  • 233.71

Physical properties

  • Yellow powder.

Storage requirements

  • Stable if stored in well closed containers at room temperature until expiration date indicated on package. Avoid excessive heat over 40°C.

Uses

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Indications

  • Indicated as a single agent or as part of combination therapy in the treatment of high grade or metastatic mast cell tumors Mastocytoma, epitheliotropic or refractory lymphoma Lymphoma and multiple myeloma Multiple myeloma.

Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs 

Cimetidine 

  • In humans, cimetidine may enhance the toxicity of lomustine. Cimetidine Cimetidine should be avoided in patients on all chemotherapeutics due to induction of cytochrome p450.  

Barbiturates 

  • May increase lomustine toxicity (increases rate of conversion to metabolites Phenobarbital). 

with diagnostic tests

  • Monitoring ALT prior to every dose is essential to detect idiosyncratic hepatotoxicity. 

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rau S E, Burgess K E (2017) A retrospective evaluation of lomustine (CeeNU) in 32 treatment naïve cats with intermediate to large cell gastrointestinal lymphoma (2006-2013). Vet Comp Oncol 15(3), 1019-1028 PubMed.
  • Dutelle A L, Bulman‐Fleming J C, Lewis C A & Rosenberg M P (2012) Evaluation of lomustine as a rescue agent for cats with resistant lymphoma. J Feline Med Surg 14, 694-700 PubMed
  • Musser M L, Quinn H T, Chretin J D (2012) Low apparent risk of CCNU (lomustine)-associated clinical hepatotoxicity in cats. J Feline Med Surg 14(12), 871-875 PubMed.  
  • Rassnick K M et al (2008) Lomustine for treatment of mast cell tumors in cats: 38 cases (1999-2005). JAVMA 232 (8), 1200-1205 PubMed.
  • Rassnick K M, Gieger T L, Williams L E, Ruslander D M, Northrup N C, Kristal O, Myers N C, Moore A S (2001) Phase I evaluation of CCNU (lomustine) in tumor-bearing cats. J Vet Intern Med 15(3), 196-199 PubMed.  

Other sources of information

  • Ramsey I (2016) BSAVA Small Animal Formulary. 8th edn. Quedgeley, UK.
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