This page tells you about the chemotherapy drug lomustine and its possible side effects. There is information about
Lomustine is also called CCNU. It is a chemotherapy drug used to treat many kinds of cancer, including
- Brain tumours
- Hodgkin lymphoma
- Lung cancer
- Melanoma skin cancer
- Stomach cancer
- Kidney cancer
- Ovarian cancer
- Non Hodgkin lymphoma
- Testicular cancer
- Cervical cancer
- Breast cancer
Lomustine comes as blue capsules of 40mg. You should keep them in a tightly closed container and out of the reach of children. You take the capsules on an empty stomach at bedtime. They should be swallowed whole with plenty of water. You usually have lomustine as a single dose once every 6 to 8 weeks.
It is very important that you take the capsules according to the instructions your doctor or pharmacist gives you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for lomustine depends on which type of cancer you have. It may be combined with surgery, radiotherapy or other chemotherapy drugs.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells. They also check how well your liver and kidneys are working.
We've listed the side effects associated with lomustine below. You can use the links to find out more about each side effect. Where there is no link, please go to our cancer drug side effects section or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having lomustine with other drugs.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick happens in about 5 out of 10 people (50%). It can start within 4 to 6 hours of taking the capsules and last from 1 to 2 days. Tell your doctor or nurse if your anti sickness medicines aren't helping, as there are others you can try
- Loss of appetite for a few days after having the treatment
- Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment is finished
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
Fewer than 1 in 100 people have these.
- A skin rash
- Lomustine can sometimes affect the nerves and brain, causing confusion, extreme tiredness, difficulty walking or loss of balance – tell your doctor or nurse straight away if you have any of these symptoms
- Kidney changes that are mild and unlikely to cause symptoms may occur – they will almost certainly go back to normal when treatment is finished, but you will have regular blood tests to check how well your kidneys are working
- Lung changes causing a cough and breathlessness
- There is a small risk that you may get a second cancer or leukaemia some years after lomustine treatment
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Alcohol can increase the side effects of lomustine and make you feel very unwell. Don't drink alcohol while taking this medicine.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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