CeeNU (Lomustine)

Do’s

• Take CeeNU by mouth as a single dose as directed by your healthcare provider, usually once every 6 weeks. Your dose may consist of 2 or more different strengths/colors of capsules. 
• To prevent nausea and vomiting, take this medication on an empty stomach at least 1 hour before or 2 to 3 hours after a meal with a full glass of water (8 ounces/240 milliliters) unless your healthcare provider directs you otherwise. 
• Swallow the capsules whole.
• The dosage is based on your medical condition, response to treatment, body size, and lab tests.
• Wear rubber or latex gloves when handling the capsules.
• Store this medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep it from freezing and out of the reach of children.

Don’ts

• CeeNU should not be taken more often than once every 6 weeks. 
• Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase 
• This drug can be absorbed through the skin and lungs and may harm an unborn baby. Therefore, women who are pregnant or may become pregnant should not handle this medication or breathe the dust from the capsules.

• Nausea and vomiting (usually last less than 24 hours)
• Loss of appetite (may last for several days)
• Blood problems, such as leukopenia (low white blood cell count) and thrombocytopenia (low platelet count)
•  Allergic reactions, such as skin rash, itching, hives, and swelling of the face, lips, tongue, or throat. Report any allergic reactions to your healthcare provider as soon as possible
• Kidney injury, which can manifest as a decrease in the amount of urine, swelling of the ankles, hands, or feet
• Liver injury, leading to right upper belly pain, loss of appetite, nausea, and changes in urine color 
• Dry cough
• Shortness of breath
• Trouble breathing
• General feelings of discomfort or being unwell 

The exact side effects experienced can vary from person to person. If you are taking CeeNU and experience any side effects, report them to your healthcare provider. 

CeeNU can cause potentially serious blood problems like low white blood cell count (leukopenia) and low platelet count (thrombocytopenia). Regular blood work is required while on this medication.

Low white blood cell counts increase the risk of infection. Patients should be aware of infection symptoms and see a healthcare provider immediately if any occur.

Low platelet counts increase the risk of bleeding. Patients should avoid activities with a bleeding risk like dental work except with prior approval from their healthcare provider.

CeeNU can harm an unborn baby or breastfeeding infant. Women should not get pregnant or breastfeed while taking this medication.

CeeNU can potentially cause kidney or liver injury. Patients should monitor for symptoms like changes in urination or abdominal pain and see their healthcare provider promptly.

Live virus vaccines should generally be avoided due to the immunosuppressive effects of CeeNU. Inactivated vaccines may be given but require healthcare provider approval.

Patients should inform any healthcare provider providing anesthesia of their CeeNU use, as it may impact anesthesia safety.

CeeNU may impact fertility in males. Patients concerned about future fertility should discuss options with their healthcare provider.

As with any chemotherapy medication, following all warnings, precautions, and healthcare provider's instructions is essential when taking CeeNU to help maximize safety and treatment effectiveness.