Lomustine

CLINICAL USE

Treatment of Hodgkin’s disease and certain solid tumours

DOSE IN NORMAL RENAL FUNCTION

120–130 mg/m2 every 6–8 weeks if used alone; lower dose is used in combination treatment and compromised bone marrow function

PHARMACOKINETICS

Molecular weight :233.7

%Protein binding :60

%Excreted unchanged in urine : 50 (as metabolites)

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :16–48 (metabolites)

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

45–60 75% of dose30–45 50–70% of dose<30 Not recommended.

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Avoid

HD :Not dialysed. Avoid.

HDF/high flux :Unknown dialysability. Avoid. See ‘Other Information’

CAV/VVHD :Unlikely to be dialysed. Avoid. See ‘Other Information’

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Bone marrow toxicity is delayed Relatively rapid and complete oral absorption, followed by first pass metabolism. Part of lomustine metabolism is mediated through hepatic microsomal enzymes. Metabolites predominantly excreted by kidneys; 10% excreted as CO2 and < 5% in faeces

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