Verify Lomustine (CCNU)

Drug JSON

This is exactly what your browser canonicalizes + SHA-256-hashes

{
  "slug": "lomustine",
  "nameEn": "Lomustine (CCNU)",
  "nameTh": "โลมัสทีน (CCNU)",
  "class": "Antineoplastic — nitrosourea alkylating agent (lipophilic, crosses BBB)",
  "mechanism": "ยา alkylating กลุ่ม nitrosourea ละลายไขมันสูงจึงผ่าน blood-brain barrier ได้ดี เชื่อมขวาง DNA; ใช้กับมะเร็งที่ระบบประสาทและ rescue protocol ของ lymphoma",
  "brandNamesTh": [
    "CeeNU",
    "CCNU",
    "Gleostine"
  ],
  "indications": [
    {
      "text": "มะเร็งต่อมน้ำเหลือง (rescue/relapse protocol), mast cell tumor, brain tumor, histiocytic sarcoma ในสุนัขและแมว — ให้ทางปาก",
      "cites": [
        "vsso-ccnu",
        "vca-lomustine"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ ยาเคมีบำบัด PPE; กดไขกระดูกชัดเจน (nadir ที่ ~1 และ 3 สัปดาห์); ⚠️ ตับเป็นพิษสะสมแบบ delayed — ตรวจตับทุกรอบ; ห้ามในตับบกพร่อง",
      "cites": [
        "vsso-ccnu",
        "vca-lomustine"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "กดไขกระดูก (โดยเฉพาะ neutropenia/thrombocytopenia), ⚠️ delayed cumulative hepatotoxicity (อาจรุนแรง), GI upset; พิจารณาให้ร่วม Denamarin ป้องกันตับ",
      "cites": [
        "vsso-ccnu",
        "vca-lomustine"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Lymphoma rescue / MCT / brain tumor (specialist)",
      "route": "PO",
      "dose": "60–90 mg/m² PO ทุก 3–4 สัปดาห์ (บาง protocol 70 mg/m²) — ⚠️ oncology only",
      "notes": "ตรวจ CBC ที่ 7 วัน (nadir) + ค่าตับทุกรอบ",
      "cites": [
        "vsso-ccnu",
        "vca-lomustine"
      ]
    },
    {
      "species": "feline",
      "indication": "Lymphoma / MCT (specialist)",
      "route": "PO",
      "dose": "50–60 mg/m² PO ทุก 3–6 สัปดาห์ — ⚠️ oncology only",
      "cites": [
        "vca-lomustine"
      ]
    }
  ],
  "monitoring": [
    {
      "text": "ตรวจ CBC ที่ ~7 วันหลังให้ (nadir) และก่อนรอบถัดไป; ⚠️ ตรวจค่าตับ (ALT) ทุกรอบ — delayed hepatotoxicity",
      "cites": [
        "vsso-ccnu"
      ]
    }
  ],
  "citations": [
    {
      "id": "vsso-ccnu",
      "type": "guideline",
      "title": "CCNU (Lomustine) protocol — Veterinary Society of Surgical Oncology",
      "url": "https://www.vsso.org/ccnu-lomustine",
      "year": 2024,
      "note": "VSSO chemotherapy protocol reference. Authoritative veterinary oncology.",
      "cid": null
    },
    {
      "id": "vca-lomustine",
      "type": "monograph",
      "title": "Lomustine — VCA Animal Hospitals",
      "year": 2025,
      "url": "https://vcahospitals.com/know-your-pet/lomustine",
      "note": "Clinical drug-library reference.",
      "cid": null
    },
    {
      "id": "wikipedia-lomustine",
      "type": "monograph",
      "title": "Lomustine — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Lomustine",
      "note": "Tertiary cross-check for class + mechanism. CC BY-SA 4.0. Not sole authority.",
      "cid": null
    }
  ],
  "mirroredFrom": [
    {
      "id": "who-atc",
      "name": "WHO ATC/DDD Index",
      "url": "https://www.whocc.no/atc_ddd_index/",
      "asOfDate": "2026-05-30",
      "license": "WHO publication, free for use with attribution"
    }
  ],
  "mirrorCIDs": [],
  "codes": {
    "atc": {
      "code": "L01AD02",
      "name": "Lomustine",
      "level": 5
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-30",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-30",
  "version": 1,
  "changelog": [
    {
      "version": 1,
      "date": "2026-05-30",
      "summary": "New entry — clinical content compiled from cited authoritative sources (Merck Veterinary Manual / VCA / VSSO chemo protocols / FDA-EMA labels / Today's Vet Practice), cross-checked. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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