Lomustine

Lomustine is a medicine used to treat certain types of cancer.

How is it given?

Lomustine is given by mouth in the form of a <%$Linker: Internal <?xml version="1.0" encoding="utf-16"?><dictionary /> 2 244344 0 oLinkInternal capsule How to give your child tablets or capsules false /medical-conditions/medicines-information/how-to-give-your-child-tablets-or-capsules/ true false%>.

What are the side effects of lomustine?

Nausea and vomiting

Taking lomustine with food will help this side effect. If this is not helpful, anti-sickness medicines can be given to reduce or prevent these symptoms.

Loss of appetite

It is possible that your child may ‘go off’ food and their appetite may reduce while having treatment. The dietitians may be able to suggest ways of making food more attractive to your child.

Bone marrow suppression

There will be a temporary reduction in how well your child’s bone marrow works. This means your child may become anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising or bleeding, or any signs of infection, especially a high temperature.

Hair loss

Your child may lose some or all of his or her hair, including eyebrows and eyelashes. This is temporary and the hair will grow back once the treatment is finished.

Mouth sores and ulcers

You will be given advice about appropriate mouth care including a copy of our Mouth care leaflet. If your child complains of having a sore mouth, please tell your doctor or nurse.

Temporary effect on liver function

Lomustine can cause some mild changes to your child’s liver function. This should return to normal when the treatment is finished. Blood tests may be taken to monitor your child’s liver function (LFTs).

Lomustine and interactions with other medicines

Some medicines can react with lomustine, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.

Important information you should know about lomustine

• Keep all medicines in a safe place where children cannot reach them.
• Lomustine should be kept in a cool, dry place away from direct sunlight or heat.
• You should handle these medicines with care, avoiding touching them where possible. If you are pregnant or think you could be pregnant, please discuss handling instructions with your doctor, nurse or pharmacist. Please see our Special handling requirements information sheet for further details.
• If your child vomits straight after taking the dose, inform your local doctor or nurse, as your child may need to take another one. Do not give them another dose without informing the doctor or nurse.
• If you forget to give your child a dose, do not give a double dose. Inform your doctor or nurse and keep to your child’s regular schedule.
• If your child cannot swallow capsules, they can be made into a mixture to be given by mouth as follows:
  • You will need a pair of rubber gloves, a small container such as a medicine pot, and a spoon or <%$Linker: Internal <?xml version="1.0" encoding="utf-16"?><dictionary /> 2 244320 0 oLinkInternal oral syringe How to give your child liquid medicines using an oral syringe false /medical-conditions/medicines-information/how-to-give-your-child-liquid-medicines-using-an-oral-syringe/ true false%> to prepare the mixture. ‘Duck’ masks are available from Day Care. Use a new mask for each use.
  • Put on your gloves and mask.
  • Put a little milk into the small container or put some yoghurt, fromage frais or ice cream onto the spoon.
  • Empty the contents of the required number of capsules into the milk or onto the food and mix carefully.
  • DO NOT mix the capsule contents with water or juice as this can cause stomach irritation.
  • If mixed with food, give the dose directly to your child using the spoon. If mixed with milk, draw the dose into the oral syringe and give to your child.
  • Wash the container and spoon or oral syringe in warm, soapy water and do not use for any other purpose.
• If you accidentally spill the tablets or mixture, wash the area thoroughly with plenty of water.
• If the mixture accidentally gets into your eyes, wash with plenty of running water for five to 10 minutes.
• Used paper towels, masks, vomit and dirty disposable nappies should be placed inside two rubbish bags and disposed of along with your normal rubbish.
• If your doctor decides to stop treatment with lomustine or the medicine passes its expiry date, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.

Last reviewed by Great Ormond Street Hospital: April 2013

Ref: 2013F0636 April 2013

Compiled by the Pharmacy department in collaboration with the Child and Family Information Group

Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.

Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.