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prednimustine

L01AA08

Forms & Strengths

Oral tablets: 10 mg
Oral capsules: 10 mg

Adult Dosing

Malignant lymphoma: 30-40 mg/m² daily orally
Chronic lymphocytic leukemia: 20-40 mg/m² daily orally, adjusted based on hematologic response
Maintenance therapy: 10-20 mg daily or intermittent dosing according to protocol

Pediatric Dosing

Safety and efficacy not established in pediatric patients
Use in children is generally off-label and requires specialist oncologic supervision

Indications

Malignant lymphomas (including Hodgkin lymphoma and non-Hodgkin lymphoma)
Chronic lymphocytic leukemia (CLL)

Mechanism of Action

Chlorambucil derivative conjugated with prednisolone
Acts as an alkylating agent that cross-links DNA strands, inhibiting DNA and RNA synthesis
Corticosteroid moiety contributes anti-inflammatory and lympholytic effects, potentially enhancing cytotoxicity in lymphoid malignancies

Contraindications

Hypersensitivity to prednimustine, chlorambucil, or prednisolone
Severe bone marrow suppression or profound cytopenias
Active severe systemic infections
Severe hepatic or renal impairment
Pregnancy and lactation

Adverse Reactions

Bone marrow suppression (leukopenia, thrombocytopenia, anemia)
Gastrointestinal disturbances (nausea, vomiting, diarrhea, stomatitis)
Corticosteroid-related effects (immunosuppression, secondary adrenal suppression, Cushingoid features, hyperglycemia)
Secondary malignancies
Alopecia
Hepatotoxicity (elevated liver enzymes)

Drug Interactions

Other myelosuppressive agents or radiation therapy increase the risk of severe bone marrow suppression
Live vaccines may cause disseminated infection due to immunosuppression
CYP3A4 inducers or inhibitors may alter the metabolism of the corticosteroid component
Antidiabetic agents may have reduced efficacy due to the hyperglycemic effect of the steroid moiety

Curated Content: Needs Vetting Before Put to Clinical Use