Nitrosourea alkylating agent
Lomustine (Specialist drug)
Brand names: CCNU
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC; typically 100–130 mg/m² every 6 weeks
Route: PO
Frequency: q6w
Clinical pearls
- High-grade glioma, Hodgkin lymphoma
- Crosses blood-brain barrier
Contraindications
- Severe myelosuppression
- Severe renal/hepatic impairment
- Pregnancy/breastfeeding
Side effects
- Severe delayed myelosuppression (nadir 4–6 weeks)
- Pulmonary fibrosis (cumulative)
- Nephrotoxicity
- Hepatotoxicity
- Secondary malignancy
- Severe nausea/vomiting
Interactions
- Live vaccines
- Other myelosuppressants
Monitoring
- FBC weekly post-dose
- LFTs
- U&E
- Pulmonary function
Reference: BNF; SmPC; https://bnf.nice.org.uk/drugs/lomustine-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
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