Drug Interaction - summary

+ Altretamine

Cimetidine +

an inhibitor of microsomal metabolism increased altretamins half life and toxicity in a rat model

MAOI+

concurrent altretamine may cause severe orthostatic hypotension after 4 days to 7 days of concomittant therapy.

4 patients all > 60 years of age, experienced symptomatic hypotension after 4 to 7 days of concomittant therapy

Most common-

Nausea and vomiting

Peripheral neuropathy

CNS symptoms and myelosuppression

Hypersensity to the drug.

Pre-existing severe bone marrow suppression or severe neurological toxicity

Warnings-

Neurotoxicity -Altretamine causes mild to moderate neuropathy, peripheral neuropathy and CNS symptoms eg, mood disoreders, disoredes of consciousness

Nausea and vomiting- with continuous high dose daily altretamine , nausea and vomiting of gradual onset occur frequently in most instances, these symtoms are controllable with antiemetics, however dose reduction may be required

Pregnancy - Advice women to avoid becoming pregnant

Lactation- Recommended that breast feeding is discontined

Children- Safety and efficacy not established

Indication-

Recurrent ovarian cancer

Dosage-

May be administered for 14 to 21 consecitive days in a 28 day cycle at a dose of 260mg/m2 /day

Give a total daily dose as 4 divided oral doses after meals and bed time

Oral doses to be taken  after meals and bed time

Pregnancy

Advice women to avoid becoming pregnant.

Lactation

Recommended that breast feeding is discontined

Children-

Safety and efficacy not established