Drug interactions
Carmustine + Lomustine
Severity: Major
Carmustine and Lomustine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are nitrosoureas with delayed, cumulative myelosuppression and pulmonary toxicity. Using them together increases the risk of profound and prolonged cytopenias and lung injury. There is no therapeutic rationale for combining agents of the same class.
What this interaction means in plain words
Carmustine and Lomustine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Carmustine belongs to Oncology; Lomustine belongs to Oncology.
Why it happens
Additive alkylating cytotoxicity affecting bone marrow and lung tissue.
What to do
Avoid concurrent use where possible. If sequential use is needed, monitor blood counts weekly for several weeks and check pulmonary function.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Lomustine
- Adenovirus types 4 and 7 live + Lomustine Contraindicated
- Bcg vaccine live + Lomustine Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Lomustine Contraindicated
- Lomustine + Measles mumps and rubella vaccine Contraindicated
- Lomustine + Measles mumps and rubella vaccine live Contraindicated
- Lomustine + Measles mumps rubella and varicella vaccine live Contraindicated
Other interactions of Carmustine
- Carmustine + Pentostatin Contraindicated
- Carmustine + Chlorambucil Major
- Carmustine + Cimetidine Major
- Carmustine + Cyclophosphamide Major
- Carmustine + Dacarbazine Major
- Carmustine + Fingolimod Major
Frequently asked questions
Can I take Carmustine with Lomustine?
MediHelp rates the interaction as major. Carmustine and Lomustine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are nitrosoureas with delayed, cumulative myelosuppression and pulmonary toxicity. Using them together increases the risk of profound and prolonged cytopenias and lung injury. There is no therapeutic rationale for combining agents of the same class.
How serious is the interaction between Carmustine and Lomustine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible. If sequential use is needed, monitor blood counts weekly for several weeks and check pulmonary function.
What other medicines interact with Lomustine?
MediHelp also lists interactions of Lomustine with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Lomustine page.
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