Nimustine Hydrochloride
Pronunciation: (nih-MUSS-teen).
- Generic name
- Nimustine hydrochloride
- Brand names
- Nidran (Japan), ACNU (compound abbreviation, used interchangeably with the generic name), No approved US brand name, No approved UK brand name, No approved Canadian brand name, No approved Australian brand name
- Drug class
- Alkylating agent (Nitrosourea class) – Antineoplastic
Availability and supply rules vary by country
Trade names by country:
Australia: · Full directory
What Nimustine hydrochloride is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Nimustine hydrochloride works
Nimustine is a nitrosourea alkylating agent. It exerts its antineoplastic effects by forming covalent bonds with DNA, leading to cross-linking and strand breaks. This inhibits DNA replication and transcription, resulting in cell cycle arrest and apoptosis of rapidly dividing tumor cells. Its lipophilic nature allows it to cross the blood-brain barrier, making it effective for central nervous system malignancies. (2)
What Nimustine hydrochloride is used for
Brain tumors (glioblastoma, medulloblastoma, astrocytoma, and other gliomas)
This is nimustine's best-established use, particularly in Japan where it has been used since the 1970s; its ability to cross the blood-brain barrier makes it useful for CNS malignancies. (2) (3)
Hodgkin's lymphoma and non-Hodgkin's lymphoma
Approved for malignant lymphoma in Japan since 1979. (2) (3)
Lung cancer (including small-cell lung cancer with intracranial spread) and multiple myeloma
These uses appear in the published oncology literature, but a formal Japanese-label indication list could not be independently confirmed in the English-language sources reviewed for this page; treat as clinician-directed use rather than a confirmed universal label indication. (2) (3)
Before taking Nimustine hydrochloride
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to nimustine or other nitrosoureas, severe bone marrow suppression, or active severe infections. (Contraindication) (3)
- Fertility impairment and teratogenicity are significant concerns. (Contraindication)
Tell your clinician about
(2) (3)How to take Nimustine hydrochloride
- General Instructions: Nimustine is administered as an intravenous infusion by a healthcare professional. Do not self-administer.. Adult Dosing: Typical adult dose is 100-150 mg/m² as a single intravenous infusion every 6-8 weeks, or as directed by your oncologist. Dose may be adjusted based on blood counts and organ function.. Pediatric Dosing: Safety and efficacy in children have not been well established. Pediatric dosing should be determined by a specialist.. Administration: Given slowly into a vein over several minutes. Pre-medication for nausea may be provided.. When To Stop: Treatment is usually stopped if there is evidence of severe toxicity, allergic reaction, or disease progression.. Storage: Store vials at room temperature, protected from light and moisture. Reconstituted solutions should be used promptly as per hospital protocols.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2) (3)
Missed dose
If a dose is missed, contact your healthcare provider immediately. Do not attempt to make up the dose yourself.
Overdose
In case of overdose, seek emergency medical attention. Overdose may cause severe bone marrow suppression, organ toxicity, and increased risk of infection. Supportive care and monitoring are essential. (2) (3)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Bone marrow suppression
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Alopecia
Incidence: Reported in the clinician-authored database; frequency not established
Stomatitis
Incidence: Reported in the clinician-authored database; frequency not established
Liver toxicity
Incidence: Reported in the clinician-authored database; frequency not established
Kidney toxicity
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
May cause severe bone marrow suppression — serious
Symptoms: May cause severe bone marrow suppression. Increases risk of serious infections. Can cause liver and kidney toxicity. May be harmful to an unborn baby. Long-term use may increase risk of secondary cancers.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with hypersensitivity to nimustine or other nitrosoureas, severe bone marrow suppression, or active severe infections. Use with caution in patients with hepatic or renal impairment, and those with a history of previous chemotherapy or radiotherapy. Fertility impairment and teratogenicity are significant concerns.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2) (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Nimustine may interact with other chemotherapy agents, immunosuppressants, and drugs affecting bone marrow function. Use with caution alongside nephrotoxic or hepatotoxic drugs. Always inform your healthcare provider of all medications and supplements you are taking. | (3) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
As an alkylating chemotherapy agent, nimustine may be harmful to an unborn baby and is generally avoided in pregnancy. Effective contraception is recommended during and after treatment. If you are pregnant, think you may be pregnant, or become pregnant during treatment, seek medical advice promptly. (2) (3)
Breastfeeding
Breastfeeding is not recommended during nimustine treatment, consistent with general guidance for cytotoxic alkylating chemotherapy agents; specific published data on nimustine in breast milk were not found in the sources reviewed for this page. Discuss feeding options with your healthcare provider before starting treatment. (2) (3)
Children
Safety and efficacy in children have not been well established; pediatric use is determined by a pediatric oncology specialist on a case-by-case basis, not as a standard, dose-established indication. (2) (3)
Renal_impairment
Use with caution in patients with hepatic or renal impairment, as nimustine can cause liver and kidney toxicity and dosing may need adjustment; specific validated dose-reduction figures for renal or hepatic impairment were not established in the sources reviewed for this page, so dosing in organ impairment should be individualised by the treating oncologist. (2) (3)
Hepatic_impairment
Use with caution in patients with hepatic or renal impairment, as nimustine can cause liver and kidney toxicity and dosing may need adjustment; specific validated dose-reduction figures for renal or hepatic impairment were not established in the sources reviewed for this page, so dosing in organ impairment should be individualised by the treating oncologist. (2) (3)
Monitoring
(2) (3)Storage
This is a healthcare-professional-administered infusion; storage and preparation are handled by the treating facility. Vials are stored at room temperature, protected from light and moisture, and reconstituted solutions are used promptly per hospital protocol.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Brain tumors (glioblastoma, medulloblastoma, astrocytoma)
Dose summary: The recommended dose of Nimustine hydrochloride is 100 mg/m² administered intravenously on day 1 of each treatment cycle.
Renal context: No validated numeric dose-reduction table for renal or hepatic impairment has been published for nimustine in the English-language oncology literature reviewed for this page — nimustine has no FDA, EMA, TGA, or Medsafe label to provide one. Nitrosourea alkylating agents as a class (which includes nimustine/ACNU alongside carmustine and lomustine) are recognised to cause dose-dependent nephrotoxicity, with cumulative, sometimes delayed and permanent, impairment of kidney function (rising blood urea nitrogen/creatinine, falling filtration rate) reported with repeated dosing; renal and hepatic function are both determinants of drug exposure for cytotoxic agents generally. Because a specific validated adjustment has not been published for nimustine, dosing in patients with renal or hepatic impairment must be individualised by the treating oncologist, typically with more frequent monitoring and a lower starting dose considered on clinical grounds. (3)
Frequently asked questions
What conditions does nimustine treat?
Nimustine is mainly used to treat malignant brain tumors (such as gliomas) and malignant lymphomas, especially when other treatments have not been effective. (2)
How is nimustine given?
It is given as an intravenous infusion by a healthcare professional, usually in a hospital or clinic setting.
What are the most common side effects?
Common side effects include nausea, vomiting, temporary hair loss, and decreased blood cell counts.
Can nimustine be used during pregnancy?
No, nimustine should not be used during pregnancy as it may harm the unborn baby. Effective contraception is recommended during and after treatment.
What should I do if I miss a dose?
Contact your healthcare provider immediately. Do not try to make up the missed dose on your own.
Are there any foods or medicines I should avoid?
Avoid alcohol and live vaccines. Inform your doctor about all other medicines and supplements you are taking.
How will my doctor monitor me during nimustine therapy?
Your doctor will regularly check your blood counts, liver and kidney function, and monitor for signs of infection or other side effects.
What happens if I take too much Nimustine?
Taking too much Nimustine can lead to severe adverse effects, including profound myelosuppression, gastrointestinal toxicity, and neurological complications. Symptoms may include extreme fatigue, easy bruising or bleeding, and severe nausea or vomiting. If an overdose is suspected, seek immediate emergency medical attention. Prompt medical intervention is critical to manage potential life-threatening complications.
Can I drink alcohol while taking Nimustine?
It is generally advised to avoid alcohol consumption while undergoing treatment with Nimustine. As an antineoplastic agent, Nimustine can cause significant side effects, including gastrointestinal upset and liver toxicity. Alcohol can exacerbate these side effects and may also interfere with the drug's metabolism, potentially increasing its toxicity or reducing its effectiveness. Consult your healthcare provider for personalized advice.
Is Nimustine safe during pregnancy?
Nimustine's pregnancy category requires careful consideration due to its potential for fetal harm. As an antineoplastic agent, it can have teratogenic effects. Therefore, Nimustine is generally not recommended during pregnancy. It is crucial for pregnant individuals or those planning pregnancy to discuss the risks and benefits thoroughly with their healthcare provider to determine the most appropriate course of action.
What is the mechanism of action of Nimustine hydrochloride?
Nimustine is a nitrosourea alkylating agent. It exerts its antineoplastic effects by forming covalent bonds with DNA, leading to cross-linking and strand breaks. This inhibits DNA replication and transcription, resulting in cell cycle arrest and apoptosis of rapidly dividing tumor cells. Its lipophilic nature allows it to cross the blood-brain barrier, making it effective for central nervous system malignancies. (2)
What is the generic name of Nimustine Hydrochloride?
The generic name is Nimustine hydrochloride. It is sold under brand names including Nidran (Japan), ACNU (compound abbreviation, used interchangeably with the generic name), No approved US brand name, No approved UK brand name, No approved Canadian brand name, No approved Australian brand name.
What class of drug is Nimustine hydrochloride?
Nimustine Hydrochloride is classed as: Alkylating agent (Nitrosourea class) – Antineoplastic.
References
- Clinician-authored medicine record: NimustineMedGuideGlobal · International (clinical database) · accessed 2026-08-06 · source 1
- Peer-reviewed oncology literature on nimustine (ACNU)Oxford Academic Neuro-Oncology Advances, PMC/NCBI · International (academic literature) · accessed 2026-08-06 · source 2
- Nitrosoureas ToxicityStatPearls, National Center for Biotechnology Information (NIH) · International (academic literature) · accessed 2026-08-07 · source 3
Brand names by country
Single-ingredient Nimustine hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.