Lomustine
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 datahalf-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 drugsNone 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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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