Uses of G-Lomustin: - Brain tumor - Lung cancer - Hodgkin’s disease - Malignant melanoma Brain tumours, Hodgkin's disease, Lung cancer, Malignant melanoma Pregnancy and lactation.

How to use Lomustine: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Lomustine is to be taken empty stomach. Administration: Should be taken on an empty stomach. Take on an empty stomach. May be taken at bedtime to reduce occurrence of nausea. Adult Dose: Oral Brain tumours; Hodgkin's disease, resistant or relapsed; Malignant melanoma; Lung cancer Adult: 100-130 mg/m2 as a single dose every 6 wk. Adjust dose according to platelet and leukocyte counts. Compromised marrow function: 100 mg/m2 as a single dose every 6 wk. Child Dose: Oral Brain tumours; Hodgkin's disease, resistant or relapsed; Malignant melanoma; Lung cancer Child: 75-150 mg/m2 as a single dose every 6 wk. Readjust dose according to platelet and leukocyte counts. Renal Dose: Renal impairment: CrCl (ml/min) Dosage Recommendation 10-50 Admin 75% of normal dose. <10 Admin 25-50% of normal dose.

Increased levels/effects with CYP2D6 inhibitors.

Pregnancy and lactation.

Common - Nausea - Vomiting - Stomatitis (Inflammation of the mouth) - Hair loss - Decreased white blood cell count >10% Nausea (54%),Vomiting (54%) 1-10% Neurotoxicity,Myelosuppression (delayed 4-5 weeks) Frequency Not Defined Ataxia,Lethargy,Disorientation,Stomatitis,Mucositis,Pulmonary fibrosis (rare),Pulmonary toxicity,Elevated LFTs,Leukemia,Renal toxicity,Hepatic toxicity,Infertility,Alopecia,Optic atrophy (rare) Potentially Fatal: Delayed bone marrow suppression and permanent marrow damage following prolonged use.

Precaution: Monitor CBC with differential platelet count wkly for at least 6 wk after a dose. Periodically perform pulmonary function studies and LFTs. Lactation: Unknown if metabolites present in breast milk; avoid nursing during treatment and for 2 weeks after final dose

Lomustine inhibits the synthesis of DNA and RNA via alkylation although carbamoylation and modification of cellular proteins may also be involved.