Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM:
Altretamine is an oral drug that is used to treat ovarian cancer. The precise
mechanism by which altretamine exerts its anti-cancer effect is unknown. It was
approved by the FDA in 1990.
PRESCRIPTION: Yes.
GENERIC AVAILABLE: No.
PREPARATIONS: Capsules of 50 mg.
STORAGE: Capsules should be
stored at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Altretamine
is used for the treatment of ovarian cancer that has persisted or has recurred following treatment with other anti-cancer drugs. Although not an approved use, altretamine also has been used for treating lung cancer.
DOSING: The dose of altretamine is based on the patient's height and weight. Altretamine may be taken either for 14 or 21 consecutive days as part of one or more 28 day cycles. The total daily dose generally is split into four oral doses, one oral dose after each meal and at bedtime.
DRUG INTERACTIONS: Altretamine, when given to patients receiving antidepressants of the monoamine oxidase (MAO) inhibitor class, may cause severe orthostatic hypotension (a sudden drop in blood pressure upon standing). Cimetidine (Tagamet) may reduce the elimination of altretamine from the body, increasing its blood levels and the risk of side effects. Pyridoxine (vitamin B6) may reduce the risk of neurotoxicity (see below) but may also reverse the beneficial affect of altretamine in the treatment of ovarian cancer.
PREGNANCY: Altretamine
should not be used by pregnant women.
NURSING MOTHERS: It is not
known whether altretamine is secreted in human milk. Since altretamine may be
toxic to nursing infants, it is recommended that breastfeeding not be done if
the mother is being treated with altretamine.
SIDE EFFECTS: Nausea and vomiting of gradual onset occur frequently with altretamine. Peripheral neuropathy (abnormal
function of the sensory nerves of the arms and legs giving rise to symptoms such as numbness, tingling, etc.) and central nervous system symptoms (mood disorders, disorders of consciousness, ataxia, dizziness, vertigo) have been reported; these effects appear to be reversible. White blood cell counts and platelet counts may drop with
altretamine treatment, increasing the risk of infection and bleeding, respectively.
There are many types of ovarian cancer, epithelial carcinoma is the most common. Women with a family history of ovarian cancer have an increased risk of developing the disease. Some ovarian cancer symptoms include abdominal pain, nausea, diarrhea, constipation, and abnormal vaginal bleeding, however, they usually do not present until the disease has progressed. Early diagnosis is important for successful treatment.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
*Ovarian cancer facts medically edited by Melissa Conrad Stöppler, MD
Most ovarian growths in women under age 30 are benign,
fluid-filled cysts.
There are several types of ovarian cancer.
The exact causes of ovarian cancer are unknown.
Risk factors that increase the chance of developing ovarian
cancer include a family history of
cancer, being over 55
years of age, and never being
pregnant.
The ovarian cancer symptoms and signs can be vague but may include abdominal swelling, pressure, or pain, frequent urination or urinary urgency,
back pain, leg pain, unusual vaginal bleeding, and feeling full quickly.
There are no routine screening tests for ovarian cancer.
A physical
examination (including pelvic exam), ultrasound, X-rays, ...
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