Lomustine (Gleostine®)

About This Drug

Lomustine is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
  • Extreme tiredness or feeling sleepy
  • Blurred vision or other changes in eyesight
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Nausea and throwing up (vomiting
  • Changes in your kidney function
  • Changes in your liver function
  • Confusion
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.

Note: Not all possible side effects are included above.

Warnings and Precautions

  • Severe bone marrow depression
  • Thickening and/or inflammation (swelling) of the lung tissues. You may have a dry cough or trouble breathing.
  • This drug may raise your risk of getting a second cancer
  • Severe changes in your liver function
  • Severe changes in your kidney which can cause kidney failure

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

How to Take Your Medication

  • Swallow the medicine whole with or without food. Taking it on an empty stomach may help with nausea and vomiting. Do not break the capsules.
  • This drug is usually taken a single dose that will not be repeated for at least 6 weeks. Each dose may be from different strengths and colors of capsules.
  • Missed dose: If you vomit or miss a dose, take your next dose at the regular time.  Do not take 2 doses at the same time.
  • Handling: Wash your hands after handling your medicine, yourself and your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • If you get any of the content of a broken capsules on your skin, you should wash the area of the skin well with soap and water right away. Call your doctor if you get a skin reaction.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine.

Treating Side Effects

  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day.
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions

  • There are no known interactions of lomustine with food or other medications.
  • Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Blurred vision or other changes in eyesight
  • Confusion or agitation
  • Pain in your chest
  • Dry cough
  • Trouble breathing
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Decreased urine, or very dark urine
  • Pain that does not go away, or is not relieved by prescribed medicines
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug may have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 2 weeks after treatment. Men with female partners of childbearing potential should use a condom during your cancer treatment and for at least 4 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised March 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.