VetSheet

로무스틴

Lomustine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)

항종양제 - 알킬화제 (니트로소우레아계)PO개고양이

다른 이름: CeeNu · Belustine · Cecenu · CiNU · Citosta · Lomeblastin · Lucostine · Prava · CCNU · Gleostine · lomustinum · NSC-79037 · RB1509 · WR-139017

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

50-90 mg/m2PO· every 2-6 weeks

체표면적(mg/m²) 기반 용량입니다. 투여 전에 체중을 체표면적으로 환산해야 합니다.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증용량경로빈도기간지역
Antineoplastic (CNS neoplasms, lymphomas, mast cell tumors, histiocytic sarcomas)50-90 mg/m2POevery 2-6 weeks—🌎 NA
All uses (brain tumours, mast cell tumours, lymphoma, histiocytic sarcoma)60-80 mg/m2POq3-4wkAs directed by oncologist🌍 EU
  • Antineoplastic (CNS neoplasms, lymphomas, mast cell tumors, histiocytic sarcomas): Dosed in mg/m2, NOT mg/kg. Exact protocol depends on indication.
  • All uses (brain tumours, mast cell tumours, lymphoma, histiocytic sarcoma): S-Adenosylmethionine and silybin may be used to prevent or treat hepatotoxicity.

고양이

적응증용량경로빈도기간지역
Antineoplastic (CNS neoplasms, lymphomas, mast cell tumors)60 mg/m2POevery 6 weeks—🌎 NA
Antineoplastic (CNS neoplasms, lymphomas, mast cell tumors)10 mgPOevery 3 weeks—🌎 NA
All uses30-60 mg/m2POq4-6wkAs directed by oncologist🌍 EU
  • Antineoplastic (CNS neoplasms, lymphomas, mast cell tumors): Administered as a single 10 mg total dose.
  • All uses: Dose is suggested but not well established. Specialist advice should be sought, as dosing intervals may need to be increased due to delayed myelosuppression.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

진료 중이신가요? VetSheet의 AI가 약물, 용량, 투여 기간을 구조화된 진료 기록에 바로 기입합니다.VetSheet 작동 방식 보기

개요

로무스틴(일반적으로 CCNU로 알려짐)은 지용성이 매우 높은 니트로소우레아계 알킬화 항종양제입니다. 높은 지용성 덕분에 혈액뇌장벽(BBB)을 쉽게 통과하여 중추신경계(CNS) 악성 종양 치료에 독보적인 가치를 지닙니다.

​주요 수의학적 적응증:​

  • ​비만세포종(MCT):​ 개와 고양이에서 1차 또는 구제 요법으로 자주 사용됩니다.
  • ​조직구육종:​ 개의 국소성 또는 파종성 조직구육종에 대한 우선적인 치료법으로 간주됩니다.
  • ​림프종:​ 재발성 다중심성 림프종의 구제 약물이나 상피성(피부) 림프종의 주요 약물로 자주 활용됩니다.
  • ​CNS 종양:​ 원발성 뇌종양(예: 신경교종) 또는 전이성 CNS 병변에 사용됩니다.

​임상 팁:​ 로무스틴은 개에서 지연성, 누적성 및 비가역적일 수 있는 간독성을 유발하는 것으로 악명이 높습니다. 많은 수의 종양학자들은 간 보호제(SAMe 및 실리마린 등)의 병용 투여를 강력히 권장합니다.

작용 기전

Lomustine is a cell cycle-phase nonspecific antineoplastic drug, meaning it is toxic to cancer cells regardless of their current phase in the division cycle.

  • ​Alkylating Activity:​ It undergoes spontaneous decomposition in vivo to form reactive intermediates. These intermediates transfer alkyl groups to DNA and RNA → causing cross-linking of DNA strands → preventing DNA replication and RNA transcription.
  • ​Carbamoylation:​ The drug also causes carbamoylation of cellular proteins (specifically lysine residues) → inhibits DNA repair enzymes, preventing the cancer cell from fixing the alkylation damage, ultimately leading to apoptosis.

안전성·주의사항

금기사항

  • Pre-existing severe bone marrow depression
  • Active infections
  • Pregnancy (Teratogenic - FDA Category D)
  • Nursing/lactating animals
  • Pre-existing bone marrow suppression
  • Pre-existing liver disease
  • Pregnancy and lactation

부작용

  • Bone marrow depression (anemia, thrombocytopenia, leukopenia) - nadirs typically at 1-6 weeks
  • Hepatotoxicity (delayed, cumulative, chronic, and irreversible in dogs)
  • Stomatitis
  • Alopecia
  • Corneal de-epithelization
  • Renal toxicity (rare)
  • Pulmonary infiltrates or fibrosis (rare)
  • Myelosuppression (dose-limiting; severe neutropenia and thrombocytopenia)
  • Hepatotoxicity (cumulative, dose-related, potentially irreversible in dogs)
  • Gastrointestinal toxicity (vomiting, diarrhea, anorexia)

주의

Use only when potential benefits outweigh risks in patients with pre-existing anemia, bone marrow depression, pulmonary function impairment, current infection, impaired renal function, or sensitivity to lomustine. Extreme caution is required in patients who have received previous chemotherapy or radiotherapy due to compromised bone marrow reserves. Hepatotoxicity in dogs can be severe, delayed, and irreversible. Teratogenic in laboratory animals; suppresses gonadal function. Nursing puppies/kittens should receive milk replacer if the mother is treated.

약물 상호작용

Immunosuppressive drugs (e.g., azathioprine, cyclophosphamide, corticosteroids)

May increase the risk of severe infection due to additive immunosuppression.

Myelosuppressive drugs (e.g., chloramphenicol, flucytosine, amphotericin B, colchicine)

Additive bone marrow depression; concurrent use should be avoided or strictly monitored.

Live virus vaccines

Increased risk of vaccine-induced infection or decreased vaccine efficacy; use with extreme caution or avoid during therapy.

Other myelosuppressive agentsMajor

Increased risk of severe and potentially fatal bone marrow suppression.

Phenobarbital (and other liver enzyme inducers)Moderate

Altered metabolism of lomustine, which requires hepatic microsomal enzyme hydroxylation. Use with caution.

CimetidineMajor

Enhances the toxicity of lomustine (reported in humans).

모니터링

  • CBC with platelets one week after dosing and prior to next dose (If platelets < 200,000/mcl, stop therapy until thrombocytopenia is resolved)
  • Liver function tests (ALT, AST, ALP, Bilirubin) initially before starting treatment and then every 3-4 months
  • Complete Blood Count (CBC) including platelets, particularly 7-14 days post-administration (and up to 6 weeks in cats)
  • Liver function tests (ALT, AST, ALP, Bilirubin) prior to every dose
  • Clinical signs of gastrointestinal toxicity

약동학

반감기

고양이Prolonged compared to dogs, leading to delayed myelosuppression.개Short for parent drug (minutes), but active metabolites have longer half-lives.

흡수

Absorbed rapidly and extensively from the GI tract. Some absorption occurs after topical administration.

분포

Lomustine and its active metabolites are widely distributed in the body. Highly lipophilic. While parent lomustine is not detected in the CSF, its active metabolites cross the blood-brain barrier and are detected in substantial concentrations.

대사

Metabolized extensively in the liver to both active and inactive metabolites.

배설

Eliminated primarily in the urine.

과다투여

Because of the severe potential toxicity of the drug (profound myelosuppression and hepatotoxicity), overdoses should be treated aggressively.

  • Employ gut emptying protocols (emesis, activated charcoal) immediately if exposure was recent and the patient is asymptomatic.
  • Provide aggressive supportive care and monitor CBC and liver enzymes closely.
  • Consult an animal poison control center or a veterinary oncologist for specific guidance.

제품

제형

  • Capsules
  • 40 mg oral capsule

인용의약품

  • Lomustine Capsules: 10 mg, 40 mg & 100 mg with mannitol; CeeNu® (Bristol Labs Oncology); (Rx)
  • 10 mg capsule
  • 40 mg capsule
  • 100 mg capsule

규제 현황

European Union✓ 승인됨처방전의약품EMA

POM (Prescription Only Medicine). Handled under cascade.

United Kingdom✓ 승인됨처방전의약품VMD

POM-V. Handled under the prescribing cascade.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store capsules in well-closed containers at room temperature. Expiration dates of two years are assigned after manufacture.

보호자 정보

​중요 안전 및 취급 지침:​

  • ​세포독성 주의사항:​ 로무스틴은 항암제입니다. 캡슐을 만질 때는 일회용 장갑을 착용하십시오. ​캡슐을 열거나 부수거나 쪼개지 마십시오.​
  • ​폐기물 관리:​ 투여 후 최대 24시간(일부 프로토콜에서는 48-72시간 주의 권장) 동안 반려동물의 소변과 대변에서 약물 및 독성 대사산물이 검출될 수 있습니다. 소변, 대변 또는 토사물을 치울 때는 장갑을 착용하고, 이후 손을 철저히 씻으십시오. 임산부나 면역력이 저하된 사람은 약물이나 반려동물의 배설물 접촉을 피해야 합니다.

​수의사에게 연락해야 할 때:​

  • 로무스틴은 심각한 골수 억제 및 간 손상을 유발할 수 있습니다.
  • 반려동물에게 감염 징후, 발열, 비정상적인 멍이나 출혈, 눈의 흰자위나 잇몸이 노랗게 변함(황달), 지속적인 구토, 설사가 나타나거나 단순히 무기력해지고 아파 보인다면 ​즉시​ 수의사에게 연락하십시오.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.