Altretamine Disease Interactions

The use of altretamine is contraindicated in patients with severe bone marrow suppression. Altretamine induces mild to moderate dose-related myelosuppression. If white blood cell counts fall below 2000/mm3 and/or platelet counts fall below 75,000/mm3 during altretamine therapy, subsequent doses should be withheld at least 14 days and altretamine restarted at 200 mg/m2/day. Clinical monitoring of hematopoietic function is recommended prior to each course of altretamine and the dose should be adjusted as clinically indicated.

The use of altretamine is contraindicated in patients with severe neurological impairment. Peripheral neuropathy as well as central nervous system symptoms of ataxia, vertigo, mood disorders, and disorders of consciousness has been noted during administration of altretamine. However, altretamine has been administered safely to patients with cisplatin-associated neuropathy and to patients administered other alkylating agents. Clinical monitoring of neurologic function should be performed prior to the initiation of each course of therapy and the dose adjusted as clinically indicated in these patients.

Altretamine is well-absorbed following oral administration in humans, but undergoes rapid and extensive demethylation in the liver, producing variation in altretamine plasma levels. Patients with liver disease may be at higher risk for adverse effects from altretamine. Caution is recommended when using this drug in patients with hepatic impairment as the pharmacokinetics of altretamine has not been evaluated.