Brand and Other Names:Hexalen
- Classes: Antineoplastics, Other
Dosing & Uses
Dosage Forms & Strengths
Recurrent Ovarian Cancer
Indicated for recurrence following alkylating agent or cisplatin treatment
Administration: PC & HS
Monitor: peripheral blood counts at least qMonth
- Discontinue temporarily and restart at 200 mg/sq.meter/day if any of the following develop
- GI intolerance unresponsive to symptomatic treatment
- WBC <2000/cu.mm or granulocytes <1000/cu.mm
- Platelets <75,000/cu.mm
- Progressive neurotoxicity
Other Indications & Uses
Palliative treatment of persistent or recurrent ovarian cancer following alkylating agent or cisplatin treatment
Safety & efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Peripheral sensory neuropathy (31%)
Alk phos increased (9%)
Black Box Warnings
Administer under the supervision of an experienced cancer chemotherapy physician
Bone marrow suppression
- Perform peripheral blood counts routinely before and after drug therapy
- Perform neurologic examinations routinely before and after drug therapy
Pre-existing severe bone marrow suppression or severe neurologic toxicity
Neurotoxic-perform regular neurologic exams
Previous tx w/ other myelosuppressive drugs or pre-existing neurotoxicity
Discontinue indefinitely if neurologic sx persist on reduced dose
Risk of orthostatic hypotension with concomitant MAO inhibitors, esp in >60 yo
Pregnancy & Lactation
Pregnancy Category: D
Lactation: excretion in milk unknown/not recommended
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Absorption: well absorbed
Distribution: highly concentrated in liver, kidney & small intestine
Protein Bound: to plasma proteins
Peak Plasma Time: 0.5-3 hr
Metabolism: hepatic; rapid & extensive demethylation to active metabolites
Excretion: urine (90%; <1% as unchanged drug)
Mechanism of Action
Unclear, reactive intermediates covalently bind to microsomal proteins & DNA, possibly causing DNA damage
Metabolism required for cytotoxicity
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