In the U.S.—

In Canada—

Another commonly used name is hexamethylmelamine.

• Antineoplastic

Altretamine ( al-TRET-a-meen) belongs to the group of medicines called antineoplastics. It is used to treat cancer of the ovaries. It may also be used to treat other kinds of cancer, as determined by your doctor.

Altretamine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by altretamine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with altretamine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Altretamine is available only with your doctor's prescription in the following dosage form:

Oral
• Capsules (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For altretamine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to altretamine.

Pregnancy—There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. In addition, many cancer medicines may cause sterility that could be permanent. Although sterility has not been reported with this medicine, it does occur in animals and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are taking altretamine. Tell your doctor right away if you think you have become pregnant while taking altretamine.

Breast-feeding—Because altretamine may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Children—There is no specific information comparing use of altretamine in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of altretamine in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking altretamine, it is especially important that your health care professional know if you are taking any of the following:

• Amphotericin B by injection (e.g., Fungizone) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines—Altretamine may increase the effects of these medicines or radiation therapy on the blood

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Taking altretamine while you are taking MAO inhibitors may cause a severe drop in blood pressure

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Nervous system problems—May be worsened by altretamine

• Infection—Altretamine may decrease your body's ability to fight infection

• Kidney disease—Effects of altretamine may be increased because of slower removal from the body

• Liver disease—Effects may be changed because altretamine is activated and cleared from the body by the liver

This medicine often causes nausea and vomiting. However, it is very important that you continue to receive the medicine even if you begin to feel ill. Taking this medicine after meals will lessen stomach upset. Ask your health care professional for other ways to lessen these effects.

Dosing—

The dose of altretamine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are taking altretamine at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of altretamine, ask your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with altretamine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Altretamine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Altretamine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor or nurseimmediately if any of the following side effects occur:

• Less common or rare
  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness, accompanied by fever or chills;  fever or chills;  lower back or side pain, accompanied by fever or chills;  painful or difficult urination, accompanied by fever or chills;  pinpoint red spots on skin;  unusual bleeding or bruising;  unusual tiredness 
  
  

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Anxiety;  clumsiness;  confusion;  convulsions (seizures);  dizziness;  mental depression;  numbness in arms or legs;  weakness 
  
  

• Rare
  • Skin rash or itching 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your doctor if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Nausea and vomiting 
  
  

• Less common
  • Diarrhea;  loss of appetite;  stomach cramps 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, altretamine is used in certain patients with the following medical condition:

• Cancer of the lung

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.