Altretamine
Trade Names:
Hexalen, Hexamethylmelamine
Type of Drug:
Altretamine belongs to the general group of chemotherapy drugs known as alkylating agents. It is used to treat ovarian cancer that no longer responds to first-line drugs.
How Drug Works:
Altretamine disrupts the growth of cancer cells, which are then destroyed.
How Drug Is Given:
Altretamine is a capsule taken by mouth. The dose depends upon your size. The daily dose is split into 4 divided doses, taken after meals and at bedtime. Altretamine is taken for 14 or 21 days every 4 weeks (28 days). The dose may need to be decreased if you have problems taking the drug (stomach upset that doesn’t respond to usual antinausea medicines, low white blood cell or platelet count, or neuropathy [sensations of pins and needles in hands and feet]) that seem to be worsening. Keep the medicine in a tightly closed container and out of the reach of children and pets.
Read the following information. If you do not understand it or if any of it causes you special concern, check with your doctor.

Before taking this drug, tell your doctor:

  • If you are trying to become pregnant, are pregnant, or breastfeeding. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. However, do not use oral contraceptives (“the pill”) without checking with your doctor.

  • If you think you may want to have children in the future. Many chemotherapy drugs can cause sterility.

  • If you have any of the following medical problems: chickenpox or exposure to chickenpox, gout, heart disease, congestive heart failure, shingles, kidney stones, liver disease, or other forms of cancer.

  • If you are taking any other prescription or over-the-counter drugs, including vitamins and herbals.

Should I avoid any other medicines, foods, alcohol, and/or activities?
Your prescription and nonprescription medicines may interact with other drugs, causing harm. Certain foods or alcohol can also interact with drug products. Never begin taking a new medicine—prescription or nonprescription—without asking your doctor or nurse if it will interact with alcohol, food, or other medicines. Some drug products can cause drowsiness and affect activities such as driving.
Precautions:
While you are being treated with altretamine and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor’s okay. Try to avoid contact with people who have recently taken the oral polio vaccine. Check with your doctor about this.
Altretamine can lower your blood counts (white blood cells, red blood cells, and platelets). Your doctor will check your blood counts before and after each treatment to see how it affects your blood counts. Your doctor or nurse will give you specific instructions if your blood counts are low.
Altretamine can cause a decrease in your white blood cell count, especially 21 to 28 days after the drug is given. This can increase your chance of getting an infection. Report fever of 100.5°F or higher, or signs of infection such as pain in passing your urine, coughing, and bringing up sputum.
Altretamine can cause a decrease in your platelet count. This can increase your risk of bleeding. DO NOT take any aspirin or aspirin-containing medicines. Report unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.
Altretamine can cause nausea, diarrhea, and abdominal cramping. Your doctor or nurse will give you medicines to prevent these side effects. If you do get them, talk to your doctor or nurse right away about ways to prevent or lessen them.
Tell all the doctors, dentists, and pharmacists you visit that you are taking this drug.
  • Most of the following side effects probably will not occur.
  • Your doctor or nurse will want to discuss specific care instructions with you.
  • They can help you understand these side effects and help you deal with them.
Side Effects:
More Common Side Effects
  • Decreased white blood cell count with increased risk of infection
  • Decreased platelet count with increased risk of bleeding
  • Nausea
  • Vomiting
  • Decreased production of sperm
  • Fetal abnormalities if pregnant
Less Common Side Effects
  • Sleepiness
  • Mood changes
  • Tiredness
  • Decreased appetite
  • Abdominal cramps
  • Diarrhea
  • Changes in kidney function
Rare Side Effects
  • Sensation of pins and needles in hands and/or feet due to effect of drug on the nerves
  • Difficulty walking
  • Skin rash, itching
Other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop any problems.
FDA Approval: This drug is approved for cancer treatment.