Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!



altretamine (al-tret-a-meen)

Hexalen, imageHexastat

Other Names:



Therapeutic: antineoplastics


Management of ovarian cancer unresponsive to treatment with other agents.


Mechanism unknown, but may disrupt DNA and RNA synthesis. Therapeutic Effects: Death of rapidly replicating cells, particularly malignant ones.

Adverse Reactions/Side Effects

CNS: SEIZURES, fatigue. GI: nausea, vomiting, anorexia, hepatic toxicity. GU: renal toxicity. Derm: alopecia, pruritus, skin rash. Endo: gonadal suppression. Hemat: anemia, leukopenia, thrombocytopenia. Neuro: peripheral neuropathy.


Examination and Evaluation

  • Be alert for new seizures or increased seizure activity. Document the number, duration, and severity of seizures, and report these findings to the physician immediately.

  • Assess signs of peripheral neuropathy such as numbness, tingling, and decreased muscle strength. Establish baseline electroneuromyographic values using EMG and nerve conduction at the beginning of drug treatment whenever possible, and reexamine these values periodically to document drug-induced changes in peripheral nerve function.

  • Watch for signs of leukopenia (fever, sore throat, signs of infection), thrombocytopenia (bruising, nose bleeds, bleeding gums), or unusual weakness and fatigue that might be due to anemia. Report these signs to the physician or nursing staff.

  • Monitor signs of renal toxicity, including blood or pus in urine, decreased urine output, weight gain from fluid retention, and fatigue. Report these signs to the physician or nursing staff.


  • For patients who are medically able to begin exercise, implement appropriate resistive exercises, and aerobic training to maintain muscle strength and aerobic capacity during cancer chemotherapy, or to help restore function after chemotherapy.

Patient/Client-Related Instruction

  • Advise patient to guard against infection (frequent hand washing, etc.), and avoid crowds and contact with persons with contagious diseases.

  • Advise patient about the likelihood of GI reactions (nausea, vomiting, loss of appetite). Instruct patient or family and caregivers to report severe or unexpected GI reactions, and also to report signs of hepatotoxicity, including abdominal pain, severe nausea and vomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, and unusual bleeding or bruising.

  • Advise patient that rash and other skin reactions (itching, hair loss) are likely. Report severe or unexpected skin reactions to the physician.


Absorption: Well absorbed following oral administration. Requires metabolism for conversion to antineoplastic compounds.

Distribution: Reaches high concentrations in liver, kidney, and small intestine. Poor penetration into brain.

Metabolism and Excretion: Mostly metabolized by the liver to compounds with antineoplastic activity.

Half-life: 4.7–10.2 hr.

|Download (.pdf)|Print

TIME/ACTION PROFILE (effects on blood counts)


Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.