Cancer drugs A to Z list
Lomustine is a chemotherapy drug. It is also called CCNU.
Doctors use lomustine to treat brain tumours. You might have it by itself or in combination with other drugs. They also use it in combination with other drugs to prepare people for a stem cell or bone marrow transplant.
Lomustine is a chemotherapy drug known as an alkylating agent. These drugs work by sticking to one of the cancer cell's strands. This stops the cell from growing and dividing into 2 new cells.
Lomustine comes as a capsule. Your doctor will you tell how many to take.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug or if you miss a dose.
Taking lomustine can make you feel sick. To help manage this you can take the capsules at night before bedtime.
You usually have lomustine as a single dose once every 6 to 8 weeks. You might have up to 6 or less if your cancer gets worse.
You might also have lomustine alongside radiotherapy or with other chemotherapy drugs.
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
you have severe side effects
your side effects aren’t getting any better
your side effects are getting worse
Early treatment can help manage side effects better.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.
Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.
You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.
You have regular blood tests to check for any changes in the way your liver is working.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
You might develop a cough or breathing problems. This could be due to scarring of the lungs (pulmonary fibrosis). This makes the lung stiff which makes it more difficult to breathe. Let your doctor or nurse know straight away if you suddenly become breathless or develop a cough.
You might have before and during treatment. This is to find out how well your lungs are working.
Lomustine can sometimes affect the nerves and brain causing:
confusion
extreme tiredness
difficulty walking
difficulty speaking
loss of balance
Talk to your doctor straight away if you have any of these symptoms.
There is a risk that you may develop some types of blood cancer years after this treatment. These include:
acute leukaemia
myelodysplastic syndrome
Your doctor will discuss this with you.
You might be breathless and look pale due to a drop in red blood cells. This is anaemia. There isn't enough information to work out how often this side effect might happen.
We have more information about side effects and tips on how to cope with them.
Read more about how to cope with side effects
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
This drug may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment with this drug and for at least 6 months after treatment.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant while having treatment.
You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
Read more about immunisations and cancer treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 10 Feb 2023
Next review due: 10 Feb 2026
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