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Lomustine (CeeNU®)

By: Dr. Dawn Ruben

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Overview

  • Lomustine belongs to a class of drugs known as nitrosourea anti-tumor alkylating agents. Unlike the more common nitrogen mustard alkylating agents, lomustine readily crosses from the blood into the brain and is used in the treatment of brain tumors in people.
  • Other anti-tumor alkylating agents similar to lomustine include carmustine and streptozotocin.
  • Lomustine works by bonding with DNA of rapidly dividing cells to cause genetic defects, resulting in cell death. Since malignant cancer cells typically divide rapidly, these cells are most likely attacked by the drug. Other normal rapidly dividing body cells such as hair and gastrointestinal lining cells may also be affected, resulting in side effects.
  • In veterinary medicine, lomustine has been primarily used in dogs. Recent studies have indicated that the drug may also be effective in cats.
  • Lomustine is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other names

  • This drug is registered for use in humans only.
  • Human formulations: CeeNU® (Bristol-Myers Squibb)
  • Veterinary formulations: None

    Uses of Lomustine

  • Lomustine has been used in the treatment of lymphosarcoma and mast cell tumors. The drug may show promise in the treatment of brain tumors of dogs, which is the primary use in humans.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, lomustine can cause side effects in some animals.
  • Lomustine should not be used in animals with known hypersensitivity or allergy to the drug.
  • This drug should be used with extreme caution in animals with kidney disease and liver abnormalities since it can cause liver damage and kidney damage.
  • Lomustine may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with lomustine. Such drugs include azathioprine, cyclophosphamide, amphotericin B and chloramphenicol.
  • The most significant adverse effect of lomustine is associated with the bone marrow and lymphoid tissue. Anemia, low white blood cell counts and low platelets can occur.
  • Other adverse effects of lomustine include hair loss, severe vomiting, diarrhea and lack of appetite.

    How Lomustine is Supplied

  • Lomustine is available in 10 mg, 40 mg and 100 mg capsules.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • In dogs, lomustine is administered at a dose of 50 to 90 mg/square meter of body surface area by mouth every 21 days.
  • Recent reports in cats have shown that a dose of 60 mg/square meter of body surface area by mouth every 21 days may be safe.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.





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