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CeeNU Warnings and Precautions

Chemotherapy treatment with CeeNU is not appropriate for some people, including those who have certain allergies or those who have problems with their liver, kidneys, or lungs. Serious problems can occur with this medication, so there are important safety precautions and warnings in place to help minimize complications. CeeNU, for example, can cause life-threatening side effects, serious infections, or other problems in some people.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking CeeNU® (lomustine) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Lung disease
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With CeeNU

Some warnings and precautions to be aware of prior to taking this medication include the following:
  • This medicine is associated with potentially serious and life-threatening side effects. Your healthcare provider will consider both the benefits and risks of using it before making a treatment recommendation for your situation. Many of the CeeNU side effects are reversible if caught early. Therefore, you will be closely monitored during treatment. If potentially serious side effects occur, your healthcare provider may delay your treatment, adjust your dose, or stop treatment altogether.
  • CeeNU can temporarily damage the bone marrow and reduce its ability to produce blood cells (known medically as bone marrow suppression). This can reduce the amount of blood cells in your body, which could increase your risk for the following problems:
    • Anemia due to low red blood cells
    • Infections due to low white blood cells
    • Bleeding due to low platelets.
  • You will need blood tests, sometimes as often as every week, to count the number of blood cells in your body. It normally takes the bone marrow at least six weeks to recover from each dose, and you will not receive another dose until the blood tests show that your bone marrow has adequately recovered. Your healthcare provider will also use the blood cell counts to recommend your next CeeNU dosage.
  • Let your healthcare provider know if you have signs of bone marrow suppression, such as:
    • Unusual bleeding or bruising
    • Signs of infection, such as:
      • Fever
      • Chills
      • Aches and pains
    • Signs of anemia, such as:
      • Tiredness
      • Shortness of breath
      • Paleness.
  • CeeNU may cause lung damage, especially in people who receive multiple doses of the medication over many months. There have been reports of lung damage occurring up to 17 years after treatment in people who were given similar medicines as children. In some cases, the lung damage caused death. Your healthcare provider will monitor your lung function before starting treatment and frequently throughout treatment.
  • You should know that long-term use of this medication may increase your risk for developing other types of cancer, including leukemia.
  • This medicine has been reported to cause kidney and liver damage. Therefore, your healthcare provider will monitor your kidneys and liver periodically during treatment. Make sure to keep all of your healthcare provider and laboratory appointments.
  • CeeNU is a pregnancy Category D medication, which means it may harm an unborn child if taken during pregnancy (see CeeNU and Pregnancy).
  • It is unknown whether CeeNU passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see CeeNU and Breastfeeding).
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