lomustine
Lomustine (Gleostine) is a chemotherapy medication that’s most often used to treat brain cancers in adults and children. It’s less commonly used with other therapies for Hodgkin lymphoma. This medication works as an alkylating agent to help treat the cancer. Lomustine (Gleostine) comes as capsules that are taken by mouth once every 6 weeks. Common side effects are nausea and vomiting. It can also cause low blood cell counts, which can put you at risk of bleeding and serious infections.
What is Lomustine (Gleostine)?
What is Lomustine (Gleostine) used for?
- Brain tumors; after surgery, radiation, or both
- Hodgkin lymphoma, after previous treatment no longer works well
How Lomustine (Gleostine) works
Lomustine (Gleostine) is a type of chemotherapy medication called an alkylating agent. It works by attaching to the DNA in fast-growing cells, including cancer cells. It then interferes with the way these cells grow and divide. This causes cancer cells to die, helping to stop the cancer from growing and spreading.
Drug facts
| Common Brands | Gleostine |
|---|---|
| Drug Class | Alkylating agent |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Lomustine (Gleostine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low blood cell counts
- Nausea
- Vomiting
- Mouth sores
Less Common Side Effects
- Hair loss
- Blurry vision
- Other changes in vision
Lomustine (Gleostine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Low blood cell counts: fever, chills, feeling very tired, bruising more easily, frequent nosebleeds, bleeding that’s hard to stop
- Lung problems: new or worse cough, wheezing, trouble catching your breath
- Liver problems: pain on the right side of the stomach, yellowing of the eyes or skin, dark or brown urine
- Kidney problems: making little or no urine, dark urine
- Risk of a second cancer: feeling very weak or tired all the time, bruising or bleeding easily, blood in the urine or stool, fevers, night sweats, unexplained weight loss
- Too much medication in the body: severely low blood cell counts, stomach pain, diarrhea, vomiting, low appetite, tiredness, dizziness, cough, shortness of breath
The following Lomustine (Gleostine) side effects have also been reported
Along with their needed effects, medicines like lomustine can sometimes cause unwanted effects such as blood problems, loss of hair, and other side effects; these are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bleeding gums
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
unusual bleeding or bruising
unusual tiredness or weakness
Less common
Awkwardness
black, tarry stools
blood in the urine or stools
confusion
cough or hoarseness
decrease in urination
fever or chills
lower back or side pain
painful or difficult urination
pale skin
pinpoint red spots on the skin
slurred speech
swelling of the feet or lower legs
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Blurred vision
changes in patterns and rhythms of speech
confusion about identity, place, and time
decreased vision
hair loss or thinning of the hair
shakiness and unsteady walk
swelling or inflammation of the mouth
trouble with speaking
unsteadiness, trembling, or other problems with muscle control or coordination
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
Pros and cons of Lomustine (Gleostine)
Pros
- Available as capsules taken by mouth
- Taken once every 6 weeks
- Recommended option for certain brain cancers
Cons
- Might need to take more than one capsule for each dose
- Often causes nausea and vomiting
- Can raise risk of bleeding and infections
Pharmacist tips for Lomustine (Gleostine)
- Set reminders on your calendar for when to see your oncologist and when to take your lomustine (Gleostine) dose. It’s taken just once every 6 weeks. You’re usually given enough medication for only one dose each time. This is to help prevent accidentally taking too much, which can be very dangerous.
- Be sure you know how many lomustine (Gleostine) capsules and which strengths to take to get your full dose. You might need to take more than one capsule to get your full dose. There are 10 mg (white/white), 40 mg (white/green), and 100 mg (green/green) capsules. If you’re not sure, ask your oncologist.
- Take your lomustine (Gleostine) dose all at once as a single dose. Swallow the capsules whole. Don’t break, open, chew, or crush them.
- Wear gloves when handling bottles containing lomustine (Gleostine) and the capsules. This medication, especially the powder inside the capsules, can be harmful if there’s direct contact with skin. If you touch a broken capsule or the powder inside gets on your skin, wash the area well with water right away.
- It’s common for lomustine (Gleostine) to cause upset stomach, nausea, and vomiting. Ask your oncologist about anti-nausea medications to keep at home. Take them as directed if you need them. If you need more help managing these side effects, tell your oncology care team. They can suggest other medications or tips to help prevent nausea and vomiting from chemotherapy.
- Lomustine (Gleostine) can make it easier for you to bleed or bruise. This is because the medication can lower your platelet count. Call your oncology care team if you notice easy bruising, unusual or serious bleeding, or bleeding that’s hard to stop.
- Lomustine (Gleostine) can make it easier for you to get sick with infections. Wash your hands often and try to stay away from people who are sick. Tell your oncology care team if you have a fever (100.4ºF or higher). A fever could be the only sign that you’re sick.
- Lomustine (Gleostine) can sometimes cause lung problems. Watch out for a new or worse cough, wheezing, or shortness of breath. If this happens, let your oncology care team know.
- Call your oncologist or get medical help right away if you think you’ve taken more than your full dose of lomustine (Gleostine). Taking too much can be very dangerous. It can cause severely low blood counts, vomiting, stomach pain, dizziness, cough, and shortness of breath.
- If you can become pregnant: Use effective birth control while taking lomustine (Gleostine) and for 2 weeks after stopping it. This medication can harm an unborn baby. Tell your oncologist right away if you get pregnant during treatment.
- If your partner can become pregnant: Use birth control like condoms during sex while you’re taking lomustine (Gleostine) and for 3.5 months after your last dose. This medication might cause harm to an unborn baby. If your partner becomes pregnant, let your oncologist know right away.
- Lomustine (Gleostine) might make it harder for you to have children. If you plan to start or grow your family, talk with your oncologist.
Risks and warnings for Lomustine (Gleostine)
Lomustine (Gleostine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Delayed low blood cell counts
- Risk factors: High lomustine (Gleostine) dose | Large cumulative dose of lomustine (Gleostine)
Lomustine (Gleostine) lowers how well your bone marrow can make blood cells. This is called bone marrow suppression, or myelosuppression. It can cause a low white blood cell count. This can put you at risk of infections, which can be serious or even fatal. It can also cause low platelet counts, which can make it easier for you to bleed or bruise. Usually, the drop in platelets is more severe than the drop in white blood cells.
Blood cell counts usually drop 4 to 6 weeks after you take lomustine (Gleostine). They can stay low for 1 to 2 weeks before going back up.
Your oncologist will check your blood cell counts regularly for at least 6 weeks after each dose of lomustine (Gleostine). If your counts drop too much, your oncologist might lower your dose, delay your next dose, or stop treatment.
Call your oncology care team right away if you have unusual bleeding or bruising, feel very weak or tired, or have a fever. These can be signs of low blood cell counts.
Risk of overdose
Taking too much lomustine (Gleostine) can be deadly. To prevent an accidental overdose, your oncologist will prescribe only one dose at a time. Take your full dose all at once as a single dose. Don’t take lomustine (Gleostine) more than once every 6 weeks.
An overdose with lomustine (Gleostine) can cause severely low blood cell counts. Other signs include stomach pain, diarrhea, vomiting, low appetite, tiredness, dizziness, cough, and shortness of breath. Call 911 right away if you have these signs or think you took too much lomustine (Gleostine).
Lung problems
- Risk factors: History of low lung function
Some people who take lomustine (Gleostine) have had lung damage. In rare cases, it can be life-threatening. Lung problems usually happen 6 months or more after starting treatment.
Before you start lomustine (Gleostine), your oncologist will have you do breathing tests to check your lungs. You’ll have these tests regularly during treatment.
Tell your care team right away if you have a new or worse cough, shortness of breath, or unusual tiredness. You might need to stop lomustine (Gleostine) while your care team checks your lungs.
Liver problems
Lomustine (Gleostine) might damage your liver. This can show up as higher liver enzyme levels on blood tests. Your oncologist will order blood tests regularly during treatment to track your liver health. If oncologist thinks you have liver damage, you might need to take a break from lomustine (Gleostine).
Many people don’t feel any physical symptoms from liver problems. But it’s a good idea to be aware of them. They can include pain on the right side of the stomach, yellowing of the eyes or skin, or dark or brown urine. If you notice these symptoms, let your care team know so they can check it out.
Kidney problems
Lomustine (Gleostine) can sometimes cause kidney problems. During treatment, your oncologist will check your kidneys with lab tests. Look out for signs of kidney problems, like dark urine or urinating less than usual. If this happens, let your care team know.
Risk for second cancers
There have been rare reports of people who took lomustine (Gleostine) for a long time developed new cancers. These included blood cancers like myelodysplastic syndrome (MDS) and acute leukemia. Talk to your oncologist if you’re worried about the risk of new cancers while taking lomustine (Gleostine).
Harm to an unborn baby
Based on animal studies and how lomustine (Gleostine) works, this medication might harm an unborn baby. If you can become pregnant, use reliable birth control during treatment and for 2 weeks after your last dose. If your partner can become pregnant, use birth control like condoms during sex while you’re taking lomustine (Gleostine) and for 3.5 months after stopping it. Call your oncologist right away if you or your partner gets pregnant.
Lomustine (Gleostine) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg of | 1 capsule | $30.77 | $30.77 |
| 40mg of | 1 capsule | $93.10 | $93.10 |
| 100mg of | 2 capsules | $468.78 | $234.39 |
Typical dosage for Lomustine (Gleostine)
Your oncologist will calculate the dose based on your body size or body surface area (BSA). This is calculated into m² units from your height and weight.
The typical dose is 130 mg/m² by mouth as a single dose once every 6 weeks. The dose will be rounded to the nearest 10 mg.
Your oncologist might lower your dose depending on the severity of any side effects.
Interactions between Lomustine (Gleostine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Bacillus of Calmette and Guerin Vaccine, Live
- Cholera Vaccine, Live
- Dengue Tetravalent Vaccine, Live
- Influenza Virus Vaccine, Live
- Poliovirus Vaccine, Live
- Smallpox Vaccine
- Typhoid Vaccine, Live
- Yellow Fever Vaccine
How much does Lomustine (Gleostine) cost?
What are alternatives to Lomustine (Gleostine)?
Lomustine (Gleostine) images
