Lomustine, Oral

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KEY POINTS

• This medicine is taken by mouth to certain kinds of tumors or cancers. Take it exactly as directed.
• You will need frequent blood tests during treatment. Keep all your appointments for tests.
• You may get infections or bleed more easily when you are taking this medicine.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: lomustine, oral; Gleostine

What is this medicine used for?

This medicine is taken by mouth to treat brain tumors, Hodgkin's disease, and other types of cancer. It may be used with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Bleeding problems, bone marrow problems, or a blood disorder
• Breathing problems or a lung disorder
• Kidney or liver disease

This medicine may make men sterile (unable to have children). If you plan to have children someday, talk with your healthcare provider before you start treatment.

Females of childbearing age: This medicine is usually not given during pregnancy because it can harm the baby. Do not become pregnant while you are taking this medicine. Contact your healthcare provider right away if you become pregnant. Use an effective method of birth control while you are receiving this medicine and for at least 6 months after your therapy is completed. Do not breast-feed while taking this medicine.

Males: Men who receive this medicine should always use a condom when having sex with a woman who may become pregnant. Do this during treatment with this medicine or for 6 months after stopping treatment.

How do I take it?

This medicine is taken by mouth.

Check the label on the medicine for directions about your specific dose. You may need to take 2 or more different capsules that make up 1 dose. The capsules may be of different colors. Different strengths of the capsules will come in separate bottles. Wear gloves when you handle the capsules. Take all of the capsules that make up your dose at the same time. Follow directions carefully. If you do not understand the directions or the number or types of capsules you should take, ask your pharmacist to explain.

Doses are usually taken once every 6 weeks. Do not take larger or smaller doses or take the medicine more often than directed by your healthcare provider. An overdose of this medicine can be fatal. Do not stop taking this medicine without your healthcare provider's approval.

Check with your healthcare provider before using this medicine in children.

Swallow the capsules whole, taking it with liquids on an empty stomach (1 hour before or 2 hours after meals) may help to reduce the nausea and vomiting caused by the medicine.

Do not break, crush, or open the capsules. If you touch broken capsules, wash the area with soap and water right away. If the medicine gets in your eyes, wash them with water right away and contact your healthcare provider.

What if I miss a dose?

If you miss a dose or vomit right after taking your dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: Severe nausea and vomiting, diarrhea, stomach pain, confusion, tiredness, dizziness, cough, shortness of breath, death.

What should I watch out for?

This is a very strong medicine. Only healthcare providers experienced with this medicine should prescribe it. Make sure you understand what the risks and benefits of treatment are.

If you are receiving other medicines by injection for your condition, keep all your appointments. You will need frequent blood tests during treatment. Keep all your appointments for tests. Depending on the results of the tests, your dosage may be changed. It is important that you follow instructions exactly.

This medicine may lower the number of certain types of blood cells in your body. You may get infections or bleed more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Do not have any vaccines without getting your healthcare provider's approval first. If you develop a fever or other signs of infection, or have any unusual bruising or bleeding, contact your healthcare provider right away.

Nausea and vomiting usually last less than 24 hours. If they continue, contact your healthcare provider.

This medicine may make your mouth sore. Use a soft bristle brush or mouth swab to brush your teeth.

Do not drink alcohol, or take aspirin while receiving this medicine. It may increase the risk of bleeding. Report any unusual bruising or bleeding to your healthcare provider.

Do not take any other medicines without your healthcare provider’s approval

Long-term use of this medicine may increase your risk of other cancers. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Fever; sore throat; unusual bruising or bleeding; blood in the urine; black or blood bowel movements; trouble swallowing or severe mouth sores; shortness of breath; new or worsening cough; swelling in your feet or lower legs; confusion; yellowing of your skin or eyes; severe nausea, vomiting, or stomach pain; decreased urination; nausea and vomiting that continue; severe diarrhea; unusual tiredness or weakness; vision changes.

Other: Hair loss, loss of appetite, weakness, tiredness, nausea, vomiting.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Other cancer medicines
• Vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.