Generic Name

Altretamine

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Classification

FDA Approved Indications

• Ovarian cancer, persistent or recurrent

Mechanism of Action

Altretamine is an alkylating agent that interferes with DNA synthesis by forming cross-links, leading to cell death, particularly in ovarian cancer cells.

Dosage and Administration

Adult: Initially, 5 mg orally 4 times daily for 14 days, then 2-week rest, repeating cycles.

Pediatric: Not typically used in pediatric patients.

Geriatric: No specific dose adjustment; monitor for toxicity.

Renal Impairment: Use with caution; no specific adjustments provided.

Hepatic Impairment: Use with caution; no specific adjustments provided.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Hepatic, primarily via demethylation.

Excretion: Renal, mainly as metabolites.

Half Life: Approximately 8 hours.

Contraindications

• Known hypersensitivity

Precautions

• Monitor blood counts regularly, as myelosuppression is common.
• Use with caution in hepatic impairment.
• Potential for neurotoxicity and other adverse effects; adjust dose or discontinue as needed.

Adverse Reactions - Common

• Nausea, vomiting (Common)
• Myelosuppression (Common)
• Alopecia (Less common)

Adverse Reactions - Serious

• Bone marrow suppression leading to anemia, leukopenia, thrombocytopenia (Serious)
• Neurotoxicity (peripheral neuropathy) (Less common)
• Hemorrhagic cystitis (Less common)

Drug-Drug Interactions

• CNS depressants, other myelosuppressive agents

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report signs of infection, bleeding, or unusual neurological symptoms.
• Use effective contraception during therapy and for at least 6 months after.
• Avoid alcohol and hepatotoxic drugs.
• Attend regular blood tests as scheduled.

Special Considerations

Black Box Warnings:

• Potentially severe myelosuppression, including leukopenia and thrombocytopenia, which can be life-threatening.

Genetic Factors: None specified.

Lab Test Interference: May affect hepatic and hematologic laboratory tests.

Overdose Management

Signs/Symptoms: Severe myelosuppression, neurological symptoms.

Treatment: Supportive care including growth factors, transfusions, and symptomatic management; no specific antidote.

Storage and Handling

Storage: Store at room temperature, protected from light and moisture.

Stability: Stable when stored properly, check expiration date regularly.