Hexalen

Generic Name: Altretamine
Product Name: Hexalen

Indication

Hexalen is used in the treatment of advanced stage (stage III and IV) ovarian tumours.
It can be used as first-line therapy, as part of a chemotherapy regime known as H-CAP. Patients who cannot tolerate platinum based therapy may receive Hexalen as part of the HAC regimen.
Hexalen can also be used as second-line therapy after the failure of treatment with cisplatin and/or chemotherapy regimes based on alkylating agents.

Action

Altretamine is a synthetic cytotoxic (cell-killing) agent that is used to fight certain cancers. Its exact mechanism of activity is not well understood, but it is known that Altretamine does not work as an alkylating agent (like cyclophosphamide). Altretamine does not become active until it is metabolised by the liver, but the mechanism of action of the metabolites is not known either.

Dose advice

Doses of Hexalen are calculated based on body surface area. Hexalen is usually used as part of a chemotherapy regime with other agents.
In combination
– 150mg/m2 orally for 14 days in combination with cisplatin and an alkylating agent
– doses are repeated in 28 day cycles, providing there are no toxicities reported between doses
– six courses should be planned, although the optimal number of cycles is unknown
– if nausea and vomiting are uncontrollable, halve dose on day 8 of the cycle
Alone
– 260mg/m2 for 14 or 21 days in a 28 day cycle
– total dose may be given as four divided doses, with meals and at bedtime
– treatment should be discontinued temporarily (14 days or longer) if the following occur: unmanageable nausea and vomiting, leucopaenia (<2000wbc/mm3), granulocyte count <1000/mm3, platelet count <75,000/mm3 or progressive neurotoxicity - discontinue Hexalen indefinitely if neurological symptoms fail to normalise

Schedule

S4

Common side effects

– nausea and vomiting (usually controllable with antiemetic medication)
– diarrhoea
– abdominal cramps
Myelosuppression resulting in:
– increased incidence of infection
– delayed healing
– gingival bleeding
also occurs in many patients.

Neurotoxicity- Peripheral neuropathy and central nervous system symptoms(depression, confusion, disorders of consciousness, ataxia, dizziness,vertigo, hallucinations, anxiety, clumsiness, weakness, numbness in arms and legs and, rarely, seizures) Neurologic toxicity has been reported to be reversible when therapy is discontinued.

Haematologic- Altretamine causes mild to moderate dose-related myelosuppression.

Gastrointestinal- Nausea and vomiting of gradual onset occurs frequently.

Rash.

Uncommon side effects

– rash
– itch
– hair loss
– loss of appetite
– seizures
– decreased renal function
– peripheral neuropathy
Central nervous system effects have been reported, and include:
– depression
– confusion
– alteration in consciousness
– dizziness
– vertigo
– hallucinations

 

For further information talk to your doctor.