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altretamine (Rx)Brand and Other Names:Hexalen

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 50mg
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Recurrent Ovarian Cancer

Indicated for recurrence following alkylating agent or cisplatin treatment

260 mg/sq.meter/day divided QID PO x14-21 days of a 28-day cycle 

Other Information

Administration: PC & HS

Monitor: peripheral blood counts at least qMonth

Dosage adjustment

  • 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

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Interactions

Interaction Checker

altretamine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Anemia (33%)

            Nausea/vomiting (33%)

            Peripheral sensory neuropathy (31%)

            Thrombocytopenia (31%)

            1-10%

            Alk phos increased (9%)

            Leukopenia (5%)

            Anorexia (1%)

            Seizures (1%)

            <1%

            Alopecia

            Rash

            Depression

            Dizziness

            Hepatotoxicity

            Tremor

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            Warnings

            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

            Neurotoxicity

            • Perform neurologic examinations routinely before and after drug therapy

            Contraindications

            Hypersensitivity

            Pre-existing severe bone marrow suppression or severe neurologic toxicity

            Pregnancy

            Cautions

            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

            Avoid pregnancy

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            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            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.

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            Pharmacology

            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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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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