Altretamine

Mechanism of Action
Unknown

Indications

• Palliative treatment for recurrent or persistent ovarian cancer after first-line therapy with cisplatin or alkylating agent; use as a single agent
• Lymphoma, lung cancer

Metabolism/Excretion

Undergoes rapid and extensive metabolism in the liver and is excreted by the kidneys. Half-life: 0.5 to 3.0 hours.

Dosage Range

• Adult: Given for 14 or 21 days in a 28-day cycle at a dosage of 260 mg/m2 per day. Therapy may be temporarily discontinued (for more than 14 days) and subsequently restarted at 200 mg/kg per day for any of the following: GI intolerance unresponsive to symptomatic measures; WBC count <2000/mm3>
• Pediatric: Safety and efficacy not established.

Drug Preparation/Stability
Available in 50- and 100-mg capsules. No stability data available.

Drug Administration
Give the total daily dose in four divided PO doses after meals and at bedtime.

Drug Interaction
Concurrent therapy with monoamine oxidase inhibitors may cause severe orthostatic hypotension.

Side Effects and Toxicities

• CNS: Peripheral neuropathy, mood disorders, disorders of consciousness, ataxia, vertigo
• GI: Nausea and vomiting
• GU: Elevated serum creatinine and BUN levels
• Hematologic: Leukopenia, thrombocytopenia, anemia
• Special Considerations
• Do not give to patients with known hypersensitivity to the drug, severe bone marrow depression, or severe neurologic toxicity.
• If patients who have been heavily treated with cis-platin or alkylating agents and have cisplatin-induced toxicity are given altretamine, monitor their neurologic function before each course of treatment.
• Obtain peripheral blood counts before initiation of treatment.
• Administer antiemetics to patients receiving high-dose courses. For nausea and vomiting not controlled by anti-emetics,the dose should be reduced or discontinued according to the patient's tolerance.