Hexalen Side Effects

Generic Name: altretamine

Please note - some side effects for Hexalen may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Hexalen - for the Consumer

Hexalen

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Hexalen:

Nausea; vomiting.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); cough; difficulty walking; dizziness; fever or chills; loss of coordination; mood changes; sores on the mouth or lips; sore throat; tingling or numbness of the hands or feet; unusual bruising or bleeding.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Hexalen Side Effects - for the Professional

Hexalen

Gastrointestinal

With continuous high-dose daily Hexalen® capsules, nausea and vomiting of gradual onset occur frequently. Although in most instances these symptoms are controllable with anti-emetics, at times the severity requires Hexalen® capsules dose reduction or, rarely, discontinuation of Hexalen® capsules therapy. In some instances, a tolerance of these symptoms develops after several weeks of therapy. The incidence and severity of nausea and vomiting are reduced with moderate-dose administration of Hexalen® capsules. In 2 clinical studies of single-agent Hexalen® capsules utilizing a moderate, intermittent dose and schedule, only 1 patient (1%) discontinued Hexalen® capsules due to severe nausea and vomiting.

Neurotoxicity

Peripheral neuropathy and central nervous system symptoms (mood disorders, disorders of consciousness, ataxia, dizziness, vertigo) have been reported. They are more likely to occur in patients receiving continuous high-dose daily Hexalen® (altretamine) capsules than moderate-dose Hexalen® capsules administered on an intermittent schedule. Neurologic toxicity has been reported to be reversible when therapy is discontinued. Data from a randomized trial of Hexalen® capsules and cisplatin plus or minus pyridoxine in ovarian cancer indicated that pyridoxine significantly reduced neurotoxicity; however, it adversely affected response duration suggesting that pyridoxine should not be administered with Hexalen® capsules and/or cisplatin (1).

Hematologic

Hexalen® capsules causes mild to moderate dose-related myelosuppression. Leukopenia below 3000 WBC/mm3 occurred in <15% of patients on a variety of intermittent or continuous dose regimens. Less than 1% had leukopenia below 1000 WBC/mm3. Thrombocytopenia below 50,000 platelets/mm3 was seen in <10% of patients. When given in doses of 8-12 mg/kg/day over a 21 day course, nadirs of leukocyte and platelet counts were reached by 3-4 weeks, and normal counts were regained by 6 weeks. With continuous administration at doses of 6-8 mg/kg/day, nadirs are reached in 6-8 weeks (median).

Data in the following table are based on the experience of 76 patients with ovarian cancer previously treated with a cisplatin-based combination regimen who received single-agent Hexalen® capsules. In one study, Hexalen® capsules, 260 mg/m2/day, was administered for 14 days of a 28 day cycle. In another study, Hexalen® capsules, 6-8 mg/kg/day, was administered for 21 days of a 28 day cycle.

Additional adverse reaction information is available from 13 single-agent altretamine studies (total of 1014 patients) conducted under the auspices of the National Cancer Institute. The treated patients had a variety of tumors and many were heavily pretreated with other chemotherapies; most of these trials utilized high, continuous daily doses of altretamine (612 mg/kg/day). In general, adverse reaction experiences were similar in the two trials described above. Additional toxicities, not reported in the above table, included hepatic toxicity, skin rash, pruritus and alopecia, each occurring in <1% of patients.

Side Effects by Body System - for Healthcare Professionals

Gastrointestinal

Gastrointestinal side effects include nausea and vomiting (33%), and increased alkaline phosphatase (9%).

Nervous system

Nervous system side effects include peripheral sensory neuropathy (31%), anorexia and fatigue (1%), and seizures (1%).

Hematologic

Hematologic side effects include anemia (33%), thrombocytopenia (9%), and leukopenia (5%).

Renal

Renal side effects include serum creatinine levels of 1.6 to 3.75 mg/dl (7%) and increased blood urea nitrogen levels (9%).

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