Pharmacy Author: Emmanuel Saltiel, Pharm. D.
Medical Editor: Jay Marks, M.D.

GENERIC NAME: altretamine

BRAND NAME: Hexalen

DRUG CLASS AND MECHANISM: Altretamine is an oral drug that is used to treat ovarian cancer . The precise mechanism by which altretamine exerts its anti-cancer effect is unknown. It was approved by the FDA in 1990.

PRESCRIPTION: Yes.

GENERIC AVAILABLE: No.

PREPARATIONS: Capsules of 50 mg.

STORAGE: Capsules should be stored at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Altretamine is used for the treatment of ovarian cancer that has persisted or has recurred following treatment with other anti-cancer drugs. Although not an approved use, altretamine also has been used for treating lung cancer .

DOSING: The dose of altretamine is based on the patient's height and weight. Altretamine may be taken either for 14 or 21 consecutive days as part of one or more 28 day cycles. The total daily dose generally is split into four oral doses, one oral dose after each meal and at bedtime.

DRUG INTERACTIONS: Altretamine, when given to patients receiving antidepressants of the monoamine oxidase (MAO) inhibitor class, may cause severe orthostatic hypotension (a sudden drop in blood pressure upon standing). Cimetidine (Tagamet) may reduce the elimination of altretamine from the body, increasing its blood levels and the risk of side effects . Pyridoxine ( vitamin B6 ) may reduce the risk of neurotoxicity (see below) but may also reverse the beneficial affect of altretamine in the treatment of ovarian cancer.

PREGNANCY: Altretamine should not be used by pregnant women.

NURSING MOTHERS: It is not known whether altretamine is secreted in human milk. Since altretamine may be toxic to nursing infants, it is recommended that breastfeeding not be done if the mother is being treated with altretamine.

SIDE EFFECTS: Nausea and vomiting of gradual onset occur frequently with altretamine. Peripheral neuropathy (abnormal function of the sensory nerves of the arms and legs giving rise to symptoms such as numbness, tingling, etc.) and central nervous system symptoms (mood disorders, disorders of consciousness, ataxia , dizziness , vertigo ) have been reported; these effects appear to be reversible. White blood cell counts and platelet counts may drop with altretamine treatment, increasing the risk of infection and bleeding, respectively.

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