Lomustine (CCNU)

==General information==
Class/mechanism: Nitrosourea, alkylates DNA and RNA and may inhibit certain key enzymatic reactions by carbamoylation of amino acids in proteins.Lomustine (Ceenu) package insertLomustine (Ceenu) package insert (locally hosted backup)
Route: PO
Extravasation: n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information. 
==Diseases for which it is used==
*Acute myeloid leukemia
*Anaplastic glioma
*CNS lymphoma
*Glioblastoma
*High-grade glioma, pediatric
*Low-grade glioma
*Medulloblastoma
==Diseases for which it was used==
*Hodgkin lymphoma
*Non-small cell lung cancer
*Ovarian cancer
*Small cell lung cancer
==Patient drug information==
*Lomustine (Ceenu) package insert
*Lomustine (Ceenu) patient drug information (Chemocare)Lomustine (Ceenu) patient drug information (Chemocare)
*Lomustine (Ceenu) patient drug information (UpToDate)Lomustine (Ceenu) patient drug information (UpToDate)
==History of changes in FDA indication==
*1976-08-04: Initial approval
*2009-04-30: (oldest available label) has been shown to be useful as a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in brain tumors - both primary and metastatic, in patients who have already received appropriate surgical and/or radiotherapeutic procedures. (No supporting studies are cited)
*2009-04-30: (oldest available label) has been shown to be useful as a single agent in addition to other treatment modalities, or in established combination therapy with other approved chemotherapeutic agents in Hodgkin’s Disease-secondary therapy in combination with other approved drugs in patients who relapse while being treated with primary therapy, or who fail to respond to primary therapy. (No supporting studies are cited)
==History of changes in EMA indication==
*1976-01-26: EURD
==Also known as==
*Generic names: CCNU
*Brand names: CeeNu, Gleostine
**In 10/2013, Bristol-Myers Squibb discontinued production of their Lomustine brand name, CeeNu.Discontinued drug bulletin: Lomustine capsules (American Society of Health-System Pharmacists) Lomustine is currently supplied as Gleostine by NextSource Biotechnology LLC.NextSource Biotechnology Lomustine (CCNU) update
==COG ACNS0331 Lomustine Dosing Nomogram==
===Available Capsule Sizes===
*10 mg 
*40 mg 
*100 mg
Body Surface Area (m2)	Ideal Dose (75 mg/m2/day once daily)	Actual Dose to be Given
2.0 	150 mg, 	150 mg
1.9 	143 	140
1.8 	135 	130
1.7 	128 	130
1.6 	120 	120
1.5 	112 	110
1.4 	105 	100
1.3 	98 	100
1.2 	90 	90
1.1 	82 	80
1.0 	75 	80
0.95 	71 	70
0.9 	68 	70
0.85 	64 	60
0.8 	60 	60
0.75 	56 	60
0.7 	53 	50
0.65 	49 	50
0.6 	45 	40
0.55 	41 	40
0.5 	38 	40
0.45 	34 	30
0.4 	30 	30
0.35 	26 	30
0.3 	23 	20
==References==
Category:Drugs
Category:Oral medications
Category:Nitrosoureas
Category:Acute myeloid leukemia medications
Category:Anaplastic glioma medications
Category:CNS lymphoma medications
Category:Glioblastoma medications
Category:High-grade glioma, pediatric medications
Category:Low-grade glioma medications
Category:Medulloblastoma medications
Category:Classical Hodgkin lymphoma medications (historic)
Category:Non-small cell lung cancer medications (historic)
Category:Ovarian cancer medications (historic)
Category:Small cell lung cancer medications (historic)
Category:FDA approved in 1976
Category:EMA approved in 1976