Altretamine, also known as hexalen, is a cytotoxic chemotherapy agent used in the treatment of certain types of cancer, including ovarian cancer. It belongs to the class of alkylating agents and works by interfering with DNA synthesis and function in rapidly dividing cancer cells, ultimately leading to cell death.
Recommended Dose and Dosage Regimen
The recommended dose of altretamine for the treatment of ovarian cancer is typically 260 milligrams (mg) per square meter of body surface area, taken orally four times daily for 14 to 21 days, followed by a 14-day rest period. This 28-day cycle may be repeated as necessary based on individual patient response and tolerance. The total daily dose and treatment duration may vary depending on the specific regimen prescribed by the healthcare provider.
Frequency of Administration
Altretamine is typically administered orally four times daily, with doses spaced evenly throughout the day to maintain consistent drug levels in the bloodstream. Patients should adhere to the prescribed dosing schedule and follow up with their healthcare provider regularly for monitoring of treatment efficacy and safety.
Route of Administration
Altretamine is available as oral capsules, which should be swallowed whole with a full glass of water to facilitate proper absorption. The capsules should not be chewed, crushed, or opened, as this may affect the drug’s efficacy and increase the risk of adverse effects.
Mechanism of Action (MOA)
The exact mechanism of action of altretamine in the treatment of ovarian cancer is not fully understood. However, it is believed to exert its cytotoxic effects by forming reactive intermediates that alkylate DNA and cross-link DNA strands, leading to inhibition of DNA synthesis and function in rapidly dividing cancer cells. Altretamine primarily affects cells in the S phase of the cell cycle, ultimately inducing apoptosis and cell death.
Pharmacokinetics (PK)
Following oral administration, altretamine is well absorbed from the gastrointestinal tract, with peak plasma concentrations reached within 1 to 3 hours. It undergoes extensive metabolism in the liver via cytochrome P450 enzymes, primarily CYP3A4, to form pharmacologically active metabolites. The elimination half-life of altretamine and its metabolites is approximately 7 to 14 hours. Dosage adjustments may be necessary in patients with hepatic impairment or concomitant use of medications that affect its metabolism.
Pharmacodynamics (PD)
The pharmacodynamic effects of altretamine in the treatment of ovarian cancer include inhibition of DNA synthesis and function, disruption of cell cycle progression, and induction of apoptosis in cancer cells. Altretamine targets rapidly dividing cancer cells while sparing normal cells with slower proliferation rates, thereby reducing the systemic toxicity associated with chemotherapy.
Primary Indications
Altretamine is indicated for the treatment of advanced ovarian cancer that has recurred or progressed despite previous chemotherapy regimens. It is often used as a second-line or salvage therapy in patients who have failed to respond to platinum-based chemotherapy or have become resistant to other standard treatments. Altretamine may be administered alone or in combination with other chemotherapy agents, depending on the specific clinical scenario and patient characteristics.
Contraindications
Altretamine is contraindicated in patients with a known hypersensitivity to the drug or any component of the formulation. It should not be used in pregnant women, as it may cause fetal harm or birth defects. Altretamine is also contraindicated in patients with severe bone marrow suppression or significant renal impairment. Female patients of childbearing potential should undergo pregnancy testing before starting altretamine therapy and use effective contraception during treatment.
Purpose of Taking Medication
The primary purpose of taking altretamine is to inhibit the growth and spread of ovarian cancer cells and improve clinical outcomes in affected patients. Altretamine is used as a cytotoxic chemotherapy agent to induce tumor regression, prolong progression-free survival, and alleviate cancer-related symptoms in patients with advanced ovarian cancer. Treatment with altretamine may help delay disease progression and improve overall quality of life in affected individuals.
Usage Instructions
Patients should take altretamine capsules orally four times daily, with doses spaced evenly throughout the day, to maintain consistent drug levels in the bloodstream. The capsules should be swallowed whole with a full glass of water and can be taken with or without food. Patients should adhere to the prescribed dosing regimen and follow up with their healthcare provider regularly for monitoring of treatment efficacy and safety.
Precautions and Care
Patients receiving altretamine should be monitored regularly for signs of adverse effects, including myelosuppression, gastrointestinal toxicity, neurotoxicity, and allergic reactions. Healthcare providers should counsel patients on the importance of adherence to the prescribed dosing schedule and provide supportive care as needed to manage treatment-related side effects. Patients should avoid exposure to infectious agents and receive appropriate vaccinations as recommended by their healthcare provider.
Dietary Considerations
There are no specific dietary restrictions associated with altretamine therapy. However, patients are encouraged to maintain a balanced diet and adequate hydration to support overall health and mitigate potential side effects of chemotherapy, such as nausea, vomiting, and fatigue. Patients may benefit from dietary modifications or nutritional supplements under the guidance of a registered dietitian or healthcare provider.
Possible Side Effects
Common side effects of altretamine may include myelosuppression (e.g., neutropenia, thrombocytopenia, anemia), gastrointestinal toxicity (e.g., nausea, vomiting, diarrhea, abdominal pain), neurotoxicity (e.g., peripheral neuropathy, dizziness, headache), and allergic reactions (e.g., rash, itching, swelling). Patients should report any new or worsening symptoms to their healthcare provider promptly.
Storage and Disposal
Altretamine capsules should be stored at room temperature (20°C to 25°C; 68°F to 77°F) in a dry place away from moisture and heat. Keep the medication out of reach of children and pets. Unused medication and expired capsules should be disposed of properly according to local regulations or guidelines for pharmaceutical waste disposal.
Conclusion
Altretamine is an oral cytotoxic chemotherapy agent indicated for the treatment of advanced ovarian cancer that has recurred or progressed despite previous chemotherapy regimens. By interfering with DNA synthesis and function in rapidly dividing cancer cells, altretamine helps inhibit tumor growth and improve clinical outcomes in affected patients. Healthcare providers should educate patients about the proper use of altretamine and monitor them regularly for adverse effects to ensure safe and effective treatment outcomes.
Important Note: Always consult with a healthcare professional for personalized medical advice and guidance regarding the use of given drug, especially regarding dosing, administration, and potential side effects. Your healthcare provider can provide tailored recommendations based on your individual medical history, current medications, and specific treatment needs. Never self-adjust your given drug regimen or discontinue treatment without first consulting your healthcare provider. If you have any questions or concerns about given drug or its use, talk to your doctor or pharmacist for further information and assistance.