Lomustine | Side Effects, Dosage, Uses & More
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Generic Name:

lomustine, Oral capsule

All Brands

  • CeeNU (Discontinued)
  • Gleostine
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 5

Highlights for lomustine

Oral capsule
1

Lomustine is used to treat cancerous brain tumors. It’s also used to treat Hodgkin’s disease. This is a type of lymphoma (blood cancer that starts in the lymphatic system).

2

This drug comes in the form of a capsule you take by mouth.

3

Lomustine is available as the brand-name drug Gleostine. It’s also available as a generic drug.

4

The more common side effects of this drug include nausea, vomiting, or loss of appetite.

5

Lomustine can cause serious side effects. These can include serious infections, bleeding, lung disease, or kidney or liver problems.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Low blood cell count warning. This drug can lower the amount of platelets and white blood cells in your body. Low platelet counts put you at risk of bleeding. Low white blood cell counts put you at risk for serious infections. Your doctor should check your blood count every week for 6 weeks after each dose of this drug.

Lung disease

This drug can damage the cells of your lungs. This damage may appear after you’ve been taking this drug for 6 months or longer.

Liver disease

This drug can cause liver problems. Your doctor should check your liver enzyme levels regularly during your treatment.

Kidney disease

Lomustine can affect your kidneys. Your doctor may do blood tests regularly during your treatment to check your kidney function.

What is lomustine?

Lomustine is a prescription drug. It’s available as an oral capsule.

Lomustine is available as the brand-name drug Gleostine. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Lomustine is used to treat cancerous brain tumors. It’s also used to treat Hodgkin’s disease. This is a type of lymphoma (blood cancer that starts in the lymphatic system).

How it works

Lomustine belongs to a class of drugs called nitrosoureas. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

See Details

How it works

Lomustine belongs to a class of drugs called nitrosoureas. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Lomustine works by stopping cancer cells from spreading and forming. It does this by interfering with the process that controls their growth.

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lomustine Side Effects

Oral capsule

More common side effects

The more common side effects of lomustine can include:

  • nausea

  • vomiting

  • loss of appetite

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Infection. Symptoms can include:

    • fever
    • chills
    • sore throat
  • Bleeding. Symptoms can include:

    • unusual bruising
    • dark-colored stools
    • blood in your urine
  • Liver disease. Symptoms can include:

    • severe stomach pain
    • yellowing of your skin and the whites of your eyes
  • Lung disease. Symptoms can include:

    • cough
    • trouble breathing
  • Confusion

  • Swelling of your feet or legs

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Lomustine doesn’t cause drowsiness. However, it may make you have less energy.

This drug may cause you to lose your appetite. This reduced appetite may last for several days after you take the drug. You may also have nausea and vomiting that starts 3–6 hours after you take lomustine. This effect usually lasts fewer than 24 hours.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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lomustine May Interact with Other Medications

Oral capsule

Lomustine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Interactions that increase your risk of side effects
  • Increased side effects from other drugs: Taking lomustine with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:
    • Live vaccines, such as the live flu vaccine and the herpes zoster (shingles) vaccine.
      • You shouldn’t receive live vaccines while you’re taking this drug. Lomustine raises your risk of getting an infection from the vaccine.
  • Increased side effects from both drugs: Taking lomustine with certain medications raises your risk of side effects. This is because lomustine and these other medications can cause the same side effects. As a result, these side effects can be increased. Examples of these drugs include:
    • Immunosuppressant drugs, such as methotrexate, azathioprine, and fluorouracil.
      • Medications that can reduce your ability to fight infection can interact with lomustine and put you at higher risk of infection. Your doctor may lower your dose of lomustine if you take other drugs that weaken your immune system.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Lomustine warnings
pregnancy warning
Pregnant women

Lomustine is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

breast feeding warning
Women who are breast-feeding

Lomustine may pass into breast milk and may cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

senior warning
For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you’re older than 65 years, you may be at higher risk of serious side effects from this drug, including infections and bleeding.

childrens warning
For children

Studies show that some children who have taken this drug for brain tumors have developed severe lung disease. In some cases, the lung disease didn’t appear until years after treatment ended. For all children younger than 5 years old who received this drug, the lung disease was fatal (caused death). Talk to your doctor to learn more about treating your child with lomustine.

drug transfer warning
Contact with drug

This drug can harm your skin. To protect your hands, you or your caregiver should wear rubber or latex gloves when you handle this medication.

call the doctor
When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

allergy warning
Allergies

Lomustine can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take lomustine (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Brain tumors

Generic: Lomustine

Form: Oral capsule
Strengths: 10 mg, 40 mg, 100 mg

Brand: Gleostine

Form: Oral capsule
Strengths: 5 mg, 10 mg, 40 mg, 100 mg
Adult dosage (ages 18–64 years)
  • Typical first dose:
    • If you’ve been treated for this condition before, your doctor will decide your first dose based on your body surface area (BSA). This is calculated from your height and weight. You may need to take two or more capsules to make up the total single dose. The capsules may be different strengths or colors. Your next dose will be 6 or more weeks later.
    • If you haven’t been treated for this condition before, the starting dose is 130 mg/m2 taken once every 6 weeks. Your doctor may reduce your dose if you have bone marrow damage or if you’re taking other medications.
  • Dosage changes: Your doctor will do blood tests to figure out your next dose of lomustine. Your next dose will often be 6 weeks after your first dose, but it may be longer. If your blood counts haven’t returned to safe levels, your doctor may delay your dose until they do. Your next dose may or may not be the same as your first dose.
Child dosage (ages 0–17 years)
  • Typical first dose: Your doctor will decide your child’s dose based on their body surface area (BSA). This is calculated from your child’s height and weight. Your child may need to take two or more capsules to make up the total single dose. The capsules may be different strengths or colors. Your child’s next dose will be 6 or more weeks later.
  • Dosage changes: Your doctor will do blood tests to figure out your child’s next dose of lomustine. The next dose will often be 6 weeks after the first dose, but it may be longer. If your child’s blood counts haven’t returned to safe levels, your doctor may delay your child’s dose until they do. Your child’s next dose may or may not be the same as their first dose.
Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects, including infections and bleeding.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Hodgkin’s disease

Generic: Lomustine

Form: Oral capsule
Strengths: 10 mg, 40 mg, 100 mg

Brand: Gleostine

Form: Oral capsule
Strengths: 5 mg, 10 mg, 40 mg, 100 mg
Adult dosage (ages 18–64 years)
  • Typical first dose:
    • If you’ve been treated for this condition before, your doctor will decide your first dose based on your body surface area (BSA). This is calculated from your height and weight. You may need to take two or more capsules to make up the total single dose. The capsules may be different strengths or colors. Your next dose will be 6 or more weeks later.
    • If you haven’t been treated for this condition before, the starting dose is 130 mg/m2 taken once every 6 weeks. Your doctor may reduce your dose if you have bone marrow damage or if you’re taking other medications.
  • Dosage changes: Your doctor will do blood tests to figure out your next dose of lomustine. Your next dose will often be 6 weeks after your first dose, but it may be longer. If your blood counts haven’t returned to safe levels, your doctor may delay your dose until they do. Your next dose may or may not be the same as your first dose.
Child dosage (ages 0–17 years)
  • Typical first dose: Your doctor will decide your child’s dose based on their body surface area (BSA). This is calculated from your child’s height and weight. Your child may need to take two or more capsules to make up the total single dose. The capsules may be different strengths or colors. Your child’s next dose will be 6 or more weeks later.
  • Dosage changes: Your doctor will do blood tests to figure out your child’s next dose of lomustine. The next dose will often be 6 weeks after the first dose, but it may be longer. If your child’s blood counts haven’t returned to safe levels, your doctor may delay your child’s dose until they do. Your child’s next dose may or may not be the same as their first dose.
Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects, including infections and bleeding.

Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Lomustine comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your condition won’t improve. It may even get worse.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. However, your doctor may decide to delay when you take this drug based on how your body responds to the medication and your results of certain laboratory tests. These temporary stops in your treatment are okay when managed by your doctor.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • stomach pain
  • diarrhea
  • vomiting
  • fatigue
  • dizziness
  • cough
  • trouble breathing

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your doctor can do certain tests to check if this drug is working. Your brain tumor or Hodgkin’s disease symptoms may also start to improve.

Lomustine may be used for long-term or short-term treatment.

Your length of treatment with this drug will depend on how your body responds to it.

Take this drug with food

This may help reduce upset stomach.

Store this drug carefully

  • Store lomustine at room temperature. Keep it between 59°F and 86°F (15°C and 30°C).
  • Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Keep the medication container closed tightly.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor should monitor certain health issues during your treatment. This can help make sure you stay safe while you take this drug. These issues include:

  • Kidney function. Your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may change your treatment.
  • Liver function. Your doctor may do blood tests to check how well your liver is working. If your liver isn’t working well, your doctor may change your treatment
  • Blood cell counts. This drug can lower the amount of platelets and white blood cells in your body. If the amount of these cells in your body gets too low, your doctor may delay or lower your dose of lomustine. Your doctor should check your blood cell counts every week for 6 weeks after you take a dose of lomustine.
  • Lung function. Your doctor may do breathing tests to check how well your lungs are working. They’ll check your lung function before and during your treatment with this drug.

Not every pharmacy stocks this drug

When filling your prescription, be sure to call ahead.

Hidden costs

You’ll need to purchase rubber or latex gloves. Anyone who handles this drug should wear them to protect their skin.

Also, you may need to have blood tests during your treatment with lomustine. The cost of these tests will depend on your insurance coverage.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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How Much Does lomustine Cost?

Oral capsule

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Lowest price for lomustine

Walmart $42.30
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Publix $46.22
These prices represent the lowest priced national pharmacies for lomustine on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for lomustine on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Darren Hein on January 25, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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