Chemotherapy Patient Resource Area

Altretamine/Hexalen^®

Drug
Altretamine (generic name) is manufactured as Hexalen^® (trade name) (MGI Pharma, Bloomington, MN).

Action
Altretamine is an anticancer drug that stops cell growth and division. It is a type of drug resembling an alkylating agent, but its precise mechanism of action is unknown. It is used to treat persistent or recurrent ovarian cancer.

What does the drug look like?
Altretamine is supplied as clear, hard, 50-mg gelatin capsules.

How long will I take the drug?
The length of treatment varies and depends on your diagnosis and how well your body responds to treatment.

How do I take the drug?
Altretamine is taken by mouth for 14 or 21 consecutive days in each 28-day treatment cycle. The dose of altretamine is based on your body size and is determined by your doctor. Your doctor and pharmacist will tell you how many capsules to take each day. The total daily dose usually is given as four divided doses after meals and at bedtime. Be sure to read the label on your medicine closely so that you take the dose you need. Your dosage may need to be adjusted or even temporarily discontinued, depending on your blood counts and response to treatment. Swallow each capsule whole; do not chew them. If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. If you accidentally take too many pills or someone else accidentally takes your medicine, contact your doctor or the nearest emergency room immediately.

Storage
Store this medicine at room temperature away from excess heat and moisture (do not store on a windowsill or in a bathroom). Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Altretamine often causes nausea and vomiting. The onset of nausea and vomiting is usually gradual and, in most instances, can be controlled by antinausea medication. After several weeks of therapy, many women build up a tolerance to the gastrointestinal effects of the drug and no longer experience nausea and vomiting.
• Peripheral neuropathy (tingling sensation felt in the hands and feet) and central nervous system symptoms (mood disorders, dizziness, trouble with coordination) have been reported to occur. They are more likely to occur in people who receive continuous, high-dose altretamine than in people who receive moderate doses of the drug given on an intermittent schedule.
• Altretamine temporarily lowers the number of white blood cells in your blood, increasing your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5oF or have chills, a cough, or painful urination.
• Altretamine temporarily lowers the number of red blood cells in your blood, which carry oxygen, and may cause you to feel tired and lack energy. Conserve your energy, get adequate rest, and enlist help in carrying out daily activities (such as meal preparation) as needed. If you feel unusually tired and your skin and mucous membranes (lining of eyes and mouth) appear unusually pale or if you experience unusual or heavy bleeding, contact your doctor immediately, as these may be signs of anemia (low red blood cell count).

Drug interactions
Let your doctor know what medications you are taking. Taking monoamine oxidase (MAO) inhibitor antidepressants along with altretamine can cause severe orthostatic hypotension (drop in blood pressure when standing or rising quickly, which may lead to dizziness and fainting). Cimetidine (Tagamet^® [GlaxoSmithKline, Research Triangle Park, NC]), an antacid, may increase altretamine's clearance time and lead to increased toxicity. Do not take cimetidine while taking altretamine. DO NOT take aspirin or aspirin-containing products while taking altretamine. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills and cough
• Heavy or unusual bleeding
• Pale skin or mucous membranes (lining of eyes and mouth)
• Moderate to severe nausea and vomiting
• Tingling and numbness of the fingers or toes