Article Contents ::

Details About Generic Salt ::  Altretam

Main Medicine Class::    

(ahl-TRETT-uh-meen)
Hexalen
Gelatin capsules
50 mg
Class: Alkylating agents
Ethylenimines
Methylmelamines

 Indications Palliative therapy of refractory ovarian cancer.

 Contraindications Hypersensitivity to altretamine; pre-existing severe bone marrow depression or severe neurologic toxicity. Careful monitoring of neurologic function in these patients is essential.

 Route/Dosage

Refractory Ovarian Cancer

ADULTS: PO 260 mg/m2/day for 14 or 21 days in a 28-day cycle, given in 4 divided doses (round dose to the nearest 50 mg) after meals and at bedtime (usual dose, 400 mg/day). Discontinue therapy for at least 14 days and resume at 200 mg/m2/day in any of the following situations: treatment-resistant GI adverse effects; WBC less than 2000/mm3; granulocyte count less than 1000/mm3; platelet count less than 75,000/mm3; progressive neurotoxicity. Discontinue permanently if neurologic symptoms persist after dose reduction.

Interactions

Cimetidine

May increase altretamine’s half-life and toxicity.

Cytochrome P450 enzymes

Altretamine elimination may be altered by agents that inhibit or induce cytochrome P450 enzymes.

Tricyclic antidepressants or monoamine oxidase inhibitors

Coadministration of altretamine with these drugs may cause orthostatic hypotension.

Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Reversible peripheral neuropathy; ataxia; depression; vertigo; agitation; confusion; hallucinations. DERMATOLOGIC: Rash; pruritus. GI: Moderate potential for nausea and vomiting. HEMATOLOGIC: Bone marrow suppression; nadir at 3 to 4 wk with intermittent therapy (for 14 to 21 days in a cycle) and at 6 to 8 wk with continuous administration.

 Precautions

Pregnancy: Category D. Lactation: Undetermined Children: Safety and efficacy not established. Neurotoxicity: Altretamine causes mild to moderate neurotoxicity. Peripheral neuropathy and CNS symptoms (eg, mood disorders, disorders of consciousness, ataxia, dizziness, vertigo) have occurred. These are more likely to occur in patients receiving continuous high-dose daily altretamine. Neurologic toxicity appears to be reversible when therapy is discontinued. Hematologic: Altretamine causes mild to moderate dose-related myelosuppression. Nausea and vomiting: With continuous high-dose daily altretamine, nausea and vomiting of gradual onset occur frequently. Carcinogenesis: Drugs with similar mechanisms of actions are carcinogenic.

PATIENT CARE CONSIDERATIONS


 Administration/Storage

  • Administer prescribed number of capsules 4 times a day, after meals and at bedtime.
  • Dose is administered daily for either 14 or 21 days in a 28-day cycle.
  • Follow procedures for proper handling and disposal of anticancer drugs. Wear gloves and avoid skin exposure and inhalation of fumes.
  • Store capsules at controlled room temperature in a tightly closed container.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of bone marrow depression and neurologic toxicity.
  • Ensure that CBC and differential are determined at baseline, prior to each course, and as indicated during therapy.
  • Ensure that a neurologic examination is performed at baseline, prior to each course, and as indicated during therapy.
  • Temporarily discontinue therapy (for 14 days or longer) and then restart with lower dose if any of the following occurs: GI intolerance; WBC less than 2000/mm3; granulocyte count less than 1000/mm3; platelet count less than 75,000/mm3; or progressive neurotoxicity.
  • Implement infection control measures if WBC drops; implement bleeding precautions if platelet count drops.

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Review dosing schedule with patient (ie, 14 or 21 consecutive days in a 28-day cycle).
  • Advise patient to take prescribed dose 4 times a day, after meals, and at bedtime.
  • Advise patient that if a dose is missed, take it as soon as possible, but if close to the next dose, do not double the dose to catch up and take the next dose as scheduled.
  • Advise patient to immediately report any of the following to their health care provider: fever, chills or other signs of infection; sore throat; persistent nausea, vomiting or appetite loss; unusual bruising or bleeding, skin rash; abnormal skin sensations; mood changes; feeling of a whirling motion; incoordination.
  • Advise patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness.
  • Instruct women of child bearing potential to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
  • Instruct patient to not take any prescription or OTC medications or dietary supplements unless advised to do so by their health care provider.
  • Advise patient that follow-up examinations and lab tests will be required to monitor therapy and to keep appointments.

Medicscientist Drug Facts

 

Drugs Class ::

(ahl-TRETT-uh-meen)
Hexalen
Gelatin capsules
50 mg
Class: Alkylating agents
Ethylenimines
Methylmelamines

Indications for Drugs ::

 Indications Palliative therapy of refractory ovarian cancer.

Drug Dose ::

 Route/Dosage

Refractory Ovarian Cancer

ADULTS: PO 260 mg/m2/day for 14 or 21 days in a 28-day cycle, given in 4 divided doses (round dose to the nearest 50 mg) after meals and at bedtime (usual dose, 400 mg/day). Discontinue therapy for at least 14 days and resume at 200 mg/m2/day in any of the following situations: treatment-resistant GI adverse effects; WBC less than 2000/mm3; granulocyte count less than 1000/mm3; platelet count less than 75,000/mm3; progressive neurotoxicity. Discontinue permanently if neurologic symptoms persist after dose reduction.

Contraindication ::

 Contraindications Hypersensitivity to altretamine; pre-existing severe bone marrow depression or severe neurologic toxicity. Careful monitoring of neurologic function in these patients is essential.

Drug Precautions ::

 Precautions

Pregnancy: Category D. Lactation: Undetermined Children: Safety and efficacy not established. Neurotoxicity: Altretamine causes mild to moderate neurotoxicity. Peripheral neuropathy and CNS symptoms (eg, mood disorders, disorders of consciousness, ataxia, dizziness, vertigo) have occurred. These are more likely to occur in patients receiving continuous high-dose daily altretamine. Neurologic toxicity appears to be reversible when therapy is discontinued. Hematologic: Altretamine causes mild to moderate dose-related myelosuppression. Nausea and vomiting: With continuous high-dose daily altretamine, nausea and vomiting of gradual onset occur frequently. Carcinogenesis: Drugs with similar mechanisms of actions are carcinogenic.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Reversible peripheral neuropathy; ataxia; depression; vertigo; agitation; confusion; hallucinations. DERMATOLOGIC: Rash; pruritus. GI: Moderate potential for nausea and vomiting. HEMATOLOGIC: Bone marrow suppression; nadir at 3 to 4 wk with intermittent therapy (for 14 to 21 days in a cycle) and at 6 to 8 wk with continuous administration.

Drug Mode of Action ::  

(ahl-TRETT-uh-meen)
Hexalen
Gelatin capsules
50 mg
Class: Alkylating agents
Ethylenimines
Methylmelamines

Drug Interactions ::

Interactions

Cimetidine

May increase altretamine’s half-life and toxicity.

Cytochrome P450 enzymes

Altretamine elimination may be altered by agents that inhibit or induce cytochrome P450 enzymes.

Tricyclic antidepressants or monoamine oxidase inhibitors

Coadministration of altretamine with these drugs may cause orthostatic hypotension.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of bone marrow depression and neurologic toxicity.
  • Ensure that CBC and differential are determined at baseline, prior to each course, and as indicated during therapy.
  • Ensure that a neurologic examination is performed at baseline, prior to each course, and as indicated during therapy.
  • Temporarily discontinue therapy (for 14 days or longer) and then restart with lower dose if any of the following occurs: GI intolerance; WBC less than 2000/mm3; granulocyte count less than 1000/mm3; platelet count less than 75,000/mm3; or progressive neurotoxicity.
  • Implement infection control measures if WBC drops; implement bleeding precautions if platelet count drops.

Drug Storage/Management ::

 Administration/Storage

  • Administer prescribed number of capsules 4 times a day, after meals and at bedtime.
  • Dose is administered daily for either 14 or 21 days in a 28-day cycle.
  • Follow procedures for proper handling and disposal of anticancer drugs. Wear gloves and avoid skin exposure and inhalation of fumes.
  • Store capsules at controlled room temperature in a tightly closed container.

Drug Notes ::

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Review dosing schedule with patient (ie, 14 or 21 consecutive days in a 28-day cycle).
  • Advise patient to take prescribed dose 4 times a day, after meals, and at bedtime.
  • Advise patient that if a dose is missed, take it as soon as possible, but if close to the next dose, do not double the dose to catch up and take the next dose as scheduled.
  • Advise patient to immediately report any of the following to their health care provider: fever, chills or other signs of infection; sore throat; persistent nausea, vomiting or appetite loss; unusual bruising or bleeding, skin rash; abnormal skin sensations; mood changes; feeling of a whirling motion; incoordination.
  • Advise patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness.
  • Instruct women of child bearing potential to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
  • Instruct patient to not take any prescription or OTC medications or dietary supplements unless advised to do so by their health care provider.
  • Advise patient that follow-up examinations and lab tests will be required to monitor therapy and to keep appointments.

Medicscientist Drug Facts

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