Lomustine Capsules

Lomustine

5mg/10mg/20mg/40mg

Capsules

Oral drug anti-tumor (anti-cancer) chemotherapy is only used in animals only

Description:

Lomustine is an anticancer medication used in the treatment of various types of cancer, including brain tumors, lymphoma, mast cell tumors, and histiocytic sarcomas in dogs and cats. In pets, Lomustine is a chemotherapy medication used in veterinary medicine for the treatment of various cancers in dogs.  Lomustine is classified as an alkylating agent, which means it works by interfering with the genetic replication process of DNA and RNA in cells, particularly those that are rapidly dividing, such as cancer cells. The chemical name of Lomustine is C9H16ClN3O2.The ctural formula of Lomustine is: 

Indications:

Lomustine is used in dogs primarily for the treatment of certain types of cancer. The key indications for its use include:

Lymphoma

Mast Cell Tumors

Brain Tumors

Histiocytic Disorders

Other Cancers

Its use may depend on factors such as the type and stage of cancer, the pet's overall health, and treatment goals.

Dosage and Administration:

Lomustine is a drug used to treat cancer in dogs and cats. The dosage and how often it's given depend on the type of cancer, the pet's size, and overall health. 

Dosage:

The dosage of Lomustine is often calculated based on the animal's body surface area (BSA), which is a more accurate method for dosing chemotherapeutic agents in animals than basing it solely on weight.

The usual dose range for Lomustine in animals is between 50 to 90 mg per square meter of BSA.

Frequency:

Lomustine is typically administered once every 3 to 8 weeks.

The frequency of dosing depends on the type of cancer being treated, the individual response of the animal, and the overall treatment plan devised by the veterinarian.

Administration:

Lomustine is available in capsule form and is administered orally.

It should be given on an empty stomach to enhance absorption and reduce gastrointestinal side effects. It's recommended to administer the medication at bedtime.

Handlers should wear gloves when handling Lomustine capsules, as the drug can be harmful if absorbed through the skin.

Treatment Duration:

The duration of treatment with Lomustine varies based on the type of cancer, the animal's response to therapy, and the overall therapeutic goals.

Contraindications:

When using Lomustine in animals, especially pets like dogs and cats, there are several contraindications that need to be considered to ensure safe and effective treatment. These contraindications include:

Known Hypersensitivity

Severe Bone Marrow Suppression

Liver or Kidney Dysfunction

Recent or Concurrent Radiation Therapy

Pregnancy and Lactation

Infection

Recent Vaccination

Concurrent Use with Other Immunosuppressive Drugs

Warnings:

Warnings for Humans:

Direct Contact: Humans should avoid direct contact with Lomustine capsules or any liquid formulation. The drug can be harmful if absorbed through the skin or inhaled.

Handling Precautions: Wear gloves when handling Lomustine. If the medication needs to be cut or crushed, this should be done in a controlled environment to prevent inhalation of dust.

Wash Hands: Always wash hands thoroughly after handling the medication, even if gloves have been worn.

Pregnancy and Nursing: Pregnant or nursing women should be particularly cautious and ideally avoid handling Lomustine, as it can be harmful to the fetus or nursing infant.

Disposal: Dispose of any unused medication safely and according to guidelines to prevent environmental contamination or accidental exposure to other pets and humans.

Ensure that other pets or children in the household do not have access to the medication.

Warnings for Animals:

Regular Monitoring: Animals being treated with Lomustine should undergo regular monitoring, including blood tests, to check for side effects such as bone marrow suppression, liver, and kidney function.

Bone Marrow Suppression: Lomustine can cause a decrease in white blood cells, red blood cells, and platelets. Monitoring for signs of infection, anemia, or bleeding is essential.

Liver and Kidney Function: As Lomustine is metabolized in the liver and excreted through the kidneys, animals with existing liver or kidney problems should be treated with caution.

Gastrointestinal Upset: Monitor for signs of nausea, vomiting, or loss of appetite, as these can be side effects of the medication.

Secondary Infections: Due to its immunosuppressive effects, there is an increased risk of secondary infections. Any signs of infection should be promptly addressed.

Dosage Compliance: It's crucial to administer Lomustine exactly as prescribed by the veterinarian. Incorrect dosing can significantly increase the risk of side effects.

Interaction with Other Medications: Inform the veterinarian of any other medications or supplements the animal is taking, as Lomustine can interact with other drugs.

Adverse Reactions:

Lomustine used as a chemotherapy drug in animals, particularly in dogs and cats, can cause various adverse reactions. ICommon adverse reactions include:

Bone Marrow Suppression

Gastrointestinal Upset such as experience nausea, vomiting, loss of appetite, and diarrhea. 

Liver Toxicity

Kidney Damage

Neurological Effectssuch as ataxia (lack of muscle coordination) or lethargy.

Dermatological Reactions

Respiratory Problems

Secondary Infections: Due to immunosuppression caused by bone marrow suppression, animals may be more susceptible to secondary infections.

Clinical Pharmacology:

The clinical pharmacology of Lomustine, when used in veterinary medicine for animals like dogs and cats, involves understanding its pharmacokinetics (how the drug moves through and is processed by the body) and pharmacodynamics (the effects the drug has on the body). Here's an overview based on available information:

Absorption:

Lomustine administered orally and is absorbed through the gastrointestinal tract.

The absorption rate can vary, and the presence of food might affect its absorption.

Distribution:

After absorption, Lomustine is distributed throughout the body. Its ability to cross the blood-brain barrier makes it effective for treating certain types of brain tumors.

It tends to distribute into various body tissues and has a relatively high lipid solubility, which can influence its distribution and effectiveness against certain types of tumors.

Metabolism:

Lomustine undergoes extensive metabolism in the liver.

The metabolic pathways in animals might vary slightly from humans, but the general process involves the conversion of Lomustine into active metabolites, which are responsible for its anti-cancer effects.

Excretion:

The metabolites of Lomustine, along with some unchanged drug, are primarily excreted through the kidneys and in the feces.

The rate of excretion can be influenced by the animal's kidney and liver function, which is an important consideration in patients with existing liver or kidney disease.

Pharmacodynamics:

Lomustine is an alkylating agent, and its anti-cancer effects are primarily due to its ability to cause cross-linking of DNA strands. This action results in the inhibition of DNA replication and transcription, leading to cell death, particularly in rapidly dividing cancer cells.

It is considered a cell-cycle phase-nonspecific drug, meaning it can act on cancer cells at various stages of their development.

Therapeutic Use:

In animals, Lomustine is primarily used for treating certain types of cancers, including lymphoma, mast cell tumors, and brain tumors.

It is particularly valued in cases where the cancer has not responded to other treatments or when a systemic treatment that can reach all areas of the body, including the brain, is needed.

Storage Information:

Store this medication in a sealed container at room temperature between 68°F and 77°F (20°C and 25°C). Do not expose this medication to temperatures above 104°F (40°C). Protect from light.

Generic medication and its counterpart to have the same active ingredients, strength, quality, route of administration, and safety standards.All of our products are produced in GMP factories, Your pet’s health is our top priority.

This summary contains important information about Lomustine. You should read this information before you start giving your pet Lomustine and review it each time the prescription is refilled as there may be new information. This sheet is provided only as a summary and does not take the place of instructions from your veterinarian. Talk with your veterinarian if you do not understand any of this information or if you want to know more about Lomustine.

What is Lomustine?

Lomustine is an anticancer medication used in the treatment of various types of cancer, including brain tumors, lymphoma, mast cell tumors, and histiocytic sarcomas in dogs and cats. In pets, Lomustine is a chemotherapy medication used in veterinary medicine for the treatment of various cancers in dogs. Lomustine is classified as an alkylating agent, which means it works by interfering with the genetic replication process of DNA and RNA in cells, particularly those that are rapidly dividing, such as cancer cells.

What are the indications for Lomustine?

Lomustine is used in dogs primarily for the treatment of certain types of cancer. The key indications for its use include:

Brain Tumors: Lomustine is commonly prescribed for the treatment of primary and metastatic brain tumors in dogs and cats. It has the ability to cross the blood-brain barrier, making it effective in targeting cancer cells within the central nervous system.

Lymphoma: Lomustine may be used in the treatment of lymphoma in dogs. It is often considered as part of rescue protocols for relapsed canine lymphoma when other treatments have failed or in cases where the pet's condition necessitates it.

Cutaneous Lymphoma: It is indicated for the treatment of cutaneous (skin) lymphoma in dogs. Lomustine has shown response rates of 80-90% in the treatment of this type of lymphoma, with some patients achieving complete remission.

Mast Cell Tumors: Lomustine can be used in the chemotherapy of mast cell tumors in both dogs and cats. It is typically considered when complete surgical removal of the tumor is not feasible due to location or size.

Histiocytic Sarcoma: Lomustine may be prescribed for histiocytic sarcoma in dogs, a rare and aggressive form of cancer that affects various tissues in the body.

Other Cancers: In some cases, Lomustine might be considered for the treatment of other types of cancers in dogs and cats when recommended by a veterinarian. Its use may depend on factors such as the type and stage of cancer, the pet's overall health, and treatment goals.

What are the side effects of Lomustine?

Lomustine a chemotherapy medication used in dogs and cats to treat various cancers, Common side effects of Lomustine include:

Gastrointestinal Upset: This is one of the most common side effects and may include symptoms such as decreased appetite, vomiting, and diarrhea. Anti-nausea medications may be prescribed to help manage these symptoms.

Bone Marrow Suppression: Lomustine can affect the bone marrow's ability to produce blood cells, leading to low blood cell counts. This can result in anemia (low red blood cell count), thrombocytopenia (low platelet count), and leucopenia (low white blood cell count). Low blood cell counts can increase the risk of infection, bleeding, and fatigue.

Liver Toxicity: Lomustine has the potential to cause liver damage or hepatotoxicity. Signs of liver problems may include jaundice (yellowing of the skin, eyes, or gums), changes in appetite, and abdominal discomfort. Your veterinarian may prescribe liver support supplements like Denamarin® to reduce the risk of liver toxicity.

Kidney Dysfunction: Although less common, Lomustine can cause kidney problems in some pets. Signs may include changes in urination patterns, increased thirst, or lethargy.

Fever: Some pets may develop a fever as a reaction to Lomustine, indicating an inflammatory response.

Lethargy: Dogs and cats receiving Lomustine may experience fatigue or lethargy.

Hair Loss: Hair loss or alopecia can occur in some pets, but it is usually temporary.

Sores in the Mouth and Gums: Ulcers or sores in the oral cavity may develop, causing discomfort.

Eye Problems: Some pets may experience eye redness, irritation, discharge, or discomfort.

Respiratory Issues: Rarely, pets may exhibit trouble breathing or coughing as a side effect of Lomustine.

It's important to note that not all pets will experience these side effects, and some may only have mild symptoms. Your veterinarian will carefully monitor your pet's response to treatment and may adjust the dosage or provide supportive care as needed. Be sure to follow your veterinarian's guidance and report any concerning side effects promptly. Additionally, your veterinarian will perform regular blood tests to assess your pet's overall health and detect any potential complications early. Always consult with your veterinarian for specific information regarding your pet's treatment plan and potential side effects.

What drug interactions should be noted when using Lomustine?

When using Lomustine in dogs, it's essential to be aware of potential drug interactions, as certain medications and substances can interact with Lomustine and either increase the risk of side effects or reduce its effectiveness. Here are some drug interactions to note：

Myelosuppressive Agents: Myelosuppressive drugs are those that suppress bone marrow function, leading to decreased production of blood cells. When Lomustine is used in combination with other myelosuppressive agents (e.g., certain antibiotics, chemotherapy drugs), there can be an additive effect on bone marrow suppression. This may result in a higher risk of anemia, decreased platelets, and decreased white blood cells. Your veterinarian will carefully consider the use of multiple myelosuppressive drugs and monitor blood counts accordingly.

Live Virus Vaccines: Dogs receiving Lomustine should not receive live virus vaccines. Chemotherapy drugs like Lomustine can weaken the immune system's response to vaccines, potentially rendering them less effective. It's essential to discuss your dog's vaccination schedule with your veterinarian, and they will recommend the appropriate timing for vaccinations.

Corticosteroids (Prednisone): Lomustine is sometimes used in combination with corticosteroids like prednisone for cancer treatment. While this combination can be effective, it may increase the risk of certain side effects, such as gastrointestinal upset. Your veterinarian will carefully determine the appropriate dosages and monitor your dog for any adverse effects.

Phenobarbital: Phenobarbital, a medication commonly used to treat seizures in dogs, can potentially affect the metabolism of Lomustine. This interaction may require adjustments to the dosages of both medications, and your veterinarian will monitor your dog's response closely.

Other Medications: It's essential to inform your veterinarian about all medications, supplements, and herbal therapies your dog is taking, as they can potentially interact with Lomustine. These interactions may affect the drug's effectiveness, increase the risk of side effects, or alter the metabolism of either medication. Your veterinarian will consider these factors when creating a treatment plan.

What if I miss giving my pet the medication?

If you miss a dose, contact your veterinarian for further instructions, as this medication must be dosed very carefully.

Are there any risk factors for this medication?

Lomustine should not be used in pets that are severely allergic to it. Use this medication with extreme caution in pets with anemia, bone marrow problems, active infections, or liver, kidney, or lung dysfunction; in these cases, this medication should only be used when the potential benefits outweigh the risks. Only use Lomustine during pregnancy when the potential benefits to the mother outweigh the risks to the offspring. If use in lactating pets is necessary, use a milk replacer.

Is there any monitoring that needs to be done with this medication?

Liver, kidney, and lung function tests should be performed prior to starting the treatment and immediately prior to the next scheduled dose. Complete blood counts should be performed one week after dosing and immediately prior to the next scheduled dose to evaluate your pet’s fitness to receive that dose. Your veterinarian may monitor your pet to be sure that the medication is working.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.