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Altretamina
Also known as: 645-05-6, Hexamethylmelamine, Hexalen, Hexastat, Hemel, 2,4,6-tris(dimethylamino)-1,3,5-triazine
Molecular Formula
C9H18N6
Molecular Weight
210.28  g/mol
InChI Key
UUVWYPNAQBNQJQ-UHFFFAOYSA-N
FDA UNII
Q8BIH59O7H

A hexamethyl-2,4,6-triamine derivative of 1,3,5-triazine.
Altretamine is an Alkylating Drug. The mechanism of action of altretamine is as an Alkylating Activity.
1 2D Structure

Altretamina

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
2-N,2-N,4-N,4-N,6-N,6-N-hexamethyl-1,3,5-triazine-2,4,6-triamine
2.1.2 InChI
InChI=1S/C9H18N6/c1-13(2)7-10-8(14(3)4)12-9(11-7)15(5)6/h1-6H3
2.1.3 InChI Key
UUVWYPNAQBNQJQ-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CN(C)C1=NC(=NC(=N1)N(C)C)N(C)C
2.2 Other Identifiers
2.2.1 UNII
Q8BIH59O7H
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Hemel

2. Hexalen

3. Hexamethylmelamine

4. Hexastat

5. Hexinawas

2.3.2 Depositor-Supplied Synonyms

1. 645-05-6

2. Hexamethylmelamine

3. Hexalen

4. Hexastat

5. Hemel

6. 2,4,6-tris(dimethylamino)-1,3,5-triazine

7. Melamine, Hexamethyl-

8. N2,n2,n4,n4,n6,n6-hexamethyl-1,3,5-triazine-2,4,6-triamine

9. Altretaminum

10. Altretamina

11. Altretaminum [inn-latin]

12. Ent 50852

13. Nc 195

14. 2,4,6-tris(dimethylamino)-s-triazine

15. Nci-c50259

16. Hmm

17. Altretamine (hexalen)

18. Nsc 13875

19. Htm

20. Hxm

21. 2-n,2-n,4-n,4-n,6-n,6-n-hexamethyl-1,3,5-triazine-2,4,6-triamine

22. S-triazine, 2,4,6-tris(dimethylamino)-

23. 1,3,5-triazine-2,4,6-triamine, N,n,n',n',n'',n''-hexamethyl-

24. Nsc-13875

25. Mls000069621

26. N,n,n',n',n'',n''-hexamethyl-1,3,5-triazine-2,4,6-triamine

27. Nsc13875

28. Q8bih59o7h

29. Smr000058181

30. 645-05-6 (free Base)

31. Chebi:24564

32. Ncgc00015100-02

33. Dsstox_cid_2579

34. Dsstox_rid_76641

35. Dsstox_gsid_22579

36. Ent-50852;rb-1515;wr-95704

37. Altretamina [inn-spanish]

38. Cas-645-05-6

39. Hexalen (tn)

40. Ccris 5492

41. Sr-01000000117

42. Hexalen [antineoplastic]

43. Altretamine (usp/inn)

44. Einecs 211-428-4

45. Unii-q8bih59o7h

46. Brn 0195058

47. Ai3-50852

48. Hsdb 7559

49. Altretamine, Solid

50. Altretamine [usan:usp:inn:ban]

51. Kb-913

52. Spectrum_001308

53. Altretamine [mi]

54. Opera_id_1095

55. Prestwick0_000946

56. Prestwick1_000946

57. Prestwick2_000946

58. Prestwick3_000946

59. Spectrum2_000907

60. Spectrum3_000951

61. Spectrum4_001064

62. Spectrum5_001092

63. Altretamine [inn]

64. Lopac-a-8723

65. Chemdiv2_005185

66. Altretamine [hsdb]

67. Altretamine [usan]

68. 2,4, 6-tris(dimethylamino)-1,3,5-triazine

69. A 8723

70. Altretamine [vandf]

71. N~2~,n~2~,n~4~,n~4~,n~6~,n~6~-hexamethyl-1,3,5-triazine-2,4,6-triamine

72. Cambridge Id 5148727

73. Cid_2123

74. Schembl4206

75. Altretamine [mart.]

76. Chembl1455

77. Lopac0_000083

78. Altretamine [usp-rs]

79. Altretamine [who-dd]

80. Bspbio_000912

81. Kbiogr_001388

82. Kbioss_001788

83. Zinc905

84. Mls001076123

85. Divk1c_000772

86. Spectrum1503065

87. Spbio_000754

88. Spbio_003071

89. Bpbio1_001004

90. Gtpl7112

91. Dtxsid4022579

92. Bdbm37631

93. Hms502g14

94. Kbio1_000772

95. Kbio2_001788

96. Kbio2_004356

97. Kbio2_006924

98. Kbio3_002042

99. Altretamine [orange Book]

100. Ninds_000772

101. Bcpp000413

102. Hms1383l15

103. Hms1570n14

104. Hms1922c05

105. Hms2090g17

106. Hms2092h16

107. Hms2097n14

108. Hms2234f09

109. Hms3259i20

110. Hms3260a08

111. Hms3372h17

112. Hms3654h11

113. Hms3714n14

114. Pharmakon1600-01503065

115. Altretamine [usp Monograph]

116. 1,3,5-triazine-2,4,6-triamine, N,n,n',n',n',n'-hexamethyl-

117. Bcp27675

118. Ccg-2238

119. Hy-b0181

120. 2,6-tris(dimethylamino)-s-triazine

121. Tox21_110085

122. Tox21_202784

123. Tox21_500083

124. Ent-50852

125. Mfcd00549245

126. Nsc758231

127. S1278

128. Stk749184

129. S-triazine,4,6-tris(dimethylamino)-

130. Akos001729401

131. Tox21_110085_1

132. 1,3,5-tris(dimethylamino)-s-triazine

133. Bcp9000278

134. Cs-2061

135. Db00488

136. Ks-5247

137. Lp00083

138. Nc00595

139. Nsc-758231

140. Rb-1515

141. Sb73671

142. Sdccgsbi-0050071.p004

143. Idi1_000772

144. Idi1_003900

145. Ncgc00015100-01

146. Ncgc00015100-03

147. Ncgc00015100-04

148. Ncgc00015100-05

149. Ncgc00015100-06

150. Ncgc00015100-07

151. Ncgc00015100-08

152. Ncgc00015100-09

153. Ncgc00015100-10

154. Ncgc00015100-11

155. Ncgc00015100-12

156. Ncgc00015100-14

157. Ncgc00015100-15

158. Ncgc00015100-23

159. Ncgc00021216-03

160. Ncgc00021216-04

161. Ncgc00021216-05

162. Ncgc00021216-06

163. Ncgc00021216-07

164. Ncgc00260330-01

165. Ncgc00260768-01

166. Ac-12006

167. Cas-654-05-6

168. Nci60_000871

169. Wr-95704

170. 2,6-tris(dimethylamino)-1,3,5-triazine

171. Sbi-0050071.p003

172. Db-054676

173. Ab00052308

174. Eu-0100083

175. Ft-0651499

176. Sw102053-5

177. C76020

178. D02841

179. Ab00052308-16

180. Ab00052308-17

181. Ab00052308-18

182. Ab00052308_19

183. Ab00052308_20

184. 645a056

185. A834788

186. Q415242

187. Wln: T6n Cn Enj Bn1&1 Dn1&1 Fn1&1

188. 2,4,6-tris(dimethylamino)-1,3,5-triazine, 96%

189. J-523408

190. Sr-01000000117-2

191. Sr-01000000117-4

192. Sr-01000000117-6

193. Brd-k67043667-001-04-1

194. Brd-k67043667-001-15-7

195. Z57931197

196. N2,n2,n4,n4,n6,n6-hexamethyl-1,3,5-trazne-2,4,6-tramne

197. 1,5-triazine-2,4,6-triamine, N,n,n',n',n'',n''-hexamethyl-

198. Altretamine, United States Pharmacopeia (usp) Reference Standard

199. N-[4,6-bis(dimethylamino)-1,3,5-triazin-2-yl]-n,n-dimethylamine

200. 1,3,5-triazine-2,4,6-triamine, N,n,n',n',n'', N''-hexamethyl-

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 210.28 g/mol
Molecular Formula C9H18N6
XLogP32.7
Hydrogen Bond Donor Count0
Hydrogen Bond Acceptor Count6
Rotatable Bond Count3
Exact Mass210.15929460 g/mol
Monoisotopic Mass210.15929460 g/mol
Topological Polar Surface Area48.4 Ų
Heavy Atom Count15
Formal Charge0
Complexity148
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameHexalen
PubMed HealthAltretamine (By mouth)
Drug ClassesAntineoplastic Agent
Drug LabelHEXALEN (altretamine) capsules, is a synthetic cytotoxic antineoplastic s-triazine derivative. HEXALEN capsules contain 50mg of altretamine for oral administration. Inert ingredients include lactose, anhydrous and calcium stearate. Altretamine,...
Active IngredientAltretamine
Dosage FormCapsule
RouteOral
Strength50mg
Market StatusPrescription
CompanyEisai

2 of 2  
Drug NameHexalen
PubMed HealthAltretamine (By mouth)
Drug ClassesAntineoplastic Agent
Drug LabelHEXALEN (altretamine) capsules, is a synthetic cytotoxic antineoplastic s-triazine derivative. HEXALEN capsules contain 50mg of altretamine for oral administration. Inert ingredients include lactose, anhydrous and calcium stearate. Altretamine,...
Active IngredientAltretamine
Dosage FormCapsule
RouteOral
Strength50mg
Market StatusPrescription
CompanyEisai

4.2 Therapeutic Uses

Antineoplastic

O'Neil, M.J. (ed.). The Merck Index - An Encyclopedia of Chemicals, Drugs, and Biologicals. Whitehouse Station, NJ: Merck and Co., Inc., 2006., p. 57


Altretamine is indicated for use as a single agent in the palliative treatment of patients with persistent or recurrent epithelial ovarian cancer following first-line therapy with a cisplatin- and/or alkylating agent-based combination. /Included in US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


Altretamine, in combination therapy, is considered reasonable medical therapy at some point in the management of small cell lung carcinoma (Evidence rating: IA). /Not included in US product label/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


4.3 Drug Warning

Secondary malignancies are potential delayed effects of many antineoplastic agents, although it is not clear whether the effect is related to their mutagenic or immunosuppressive action. The effect of dose and duration of therapy is also unknown, although risk seems to increase with long-term use. Although information is limited, available data seem to indicate that the carcinogenic risk is greatest with the alkylating agents.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


The bone marrow depressant effects of altretamine may result in an increased incidence of microbial infection, delayed healing, and gingival bleeding. Dental work, whenever possible, should be completed prior to initiation of therapy or deferred until blood counts have returned to normal. Patients should be instructed in proper oral hygiene during treatment, including caution in use of regular toothbrushes, dental floss, and toothpicks.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


Adverse events ... indicating the need for medical attention /occurring/ at an incidence more frequent: Anemia (unusual tiredness); leukopenia (fever or chills; cough or hoarseness; lower back or side pain; painful or difficult urination); neurotoxicity, including central nervous system (CNS) effects (anxiety; clumsiness; confusion; dizziness; mental depression; weakness; seizures); neurotoxicity, including peripheral neuropathy (numbness in arms or legs); thrombocytopenia (unusual bleeding or bruising; black, tarry stools; blood in urine or stools; pinpoint red spots on skin). Incidence /occurring/ rarely Hepatotoxicity; skin rash or itching.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


/Altretamine is/ contraindicated in patients with known sensitivity to altretamine.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


For more Drug Warnings (Complete) data for ALTRETAMINE (11 total), please visit the HSDB record page.


4.4 Drug Indication

For use as a single agent in the palliative treatment of patients with persistent or recurrent ovarian cancer following first-line therapy with a cisplatin and/or alkylating agent-based combination.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Altretamine is a novel antineoplastic agent. The precise mechanism by which altretamine exerts its cytotoxic effect is unknown, although a number of theoretical possibilities have been studied. Structurally, altretamine resembles the alkylating agent triethylenemelamine, yet in vitro tests for alkylating activity of altretamine and its metabolitics have been negative. Altretamine has been demonstrated to be efficacious for certain ovarian tumors resistant to classical alkylating agents. Metabolism of altretamine is a requirement of cytotoxicity. Synthetic monohydroxymethylmelamines, and products of altretamine metabolism, in vitro and in vivo, can form covalent adducts with tissue macromolecules including DNA, but the relevance of these reactions to antitumor activity is unknown.


5.2 MeSH Pharmacological Classification

Antineoplastic Agents, Alkylating

A class of drugs that differs from other alkylating agents used clinically in that they are monofunctional and thus unable to cross-link cellular macromolecules. Among their common properties are a requirement for metabolic activation to intermediates with antitumor efficacy and the presence in their chemical structures of N-methyl groups, that after metabolism, can covalently modify cellular DNA. The precise mechanisms by which each of these drugs acts to kill tumor cells are not completely understood. (From AMA, Drug Evaluations Annual, 1994, p2026) (See all compounds classified as Antineoplastic Agents, Alkylating.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
ALTRETAMINE
5.3.2 FDA UNII
Q8BIH59O7H
5.3.3 Pharmacological Classes
Established Pharmacologic Class [EPC] - Alkylating Drug
5.4 ATC Code

L - Antineoplastic and immunomodulating agents

L01 - Antineoplastic agents

L01X - Other antineoplastic agents

L01XX - Other antineoplastic agents

L01XX03 - Altretamine


5.5 Absorption, Distribution and Excretion

Route of Elimination

Human urinary metabolites were Ndemethylated homologues of altretamine with <1% unmetabolized altretamine excreted at 24 hours.


Rapidly and well-absorbed following oral administration; however, because of rapid hepatic metabolism, peak plasma concentrations are variable.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


... The inter-hand intrapatient variability of the bioavailability of altretamine after oral administration represents an important drawback for effective clinical use of this drug. The variability appears to be mostly related to the first-pass effect and therefore may be overcome by intravenous administration of the drug. Attempts to administer the drug intravenously have not been successful in the past...

PMID:7656502 Damia G et al; Clin Pharmacokinet 28 (6): 439-48 (1995)


Because it is highly lipid-soluble, altretamine is distributed to tissues with a high lipid component (e.g., omentum and subcutaneous tissues).

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


Protein binding: Free fractions: Altretamine: 6%; Pentamethylmelamine: 25%; Tetramethylmelamine: 50%.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


For more Absorption, Distribution and Excretion (Complete) data for ALTRETAMINE (10 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

Biotransformation /is/ Hepatic. Metabolism is required for activity. Altretamine undergoes rapid and extensive demethylation, catalyzed by cytochrome P450 enzymes.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


The covalent binding of hexamethylmelamine (HMM) and its metabolites was studied in liver, tumor, blood, kidney, spleen, lung, brain, heart, and small intestine after a single ip injection of 2,4,6-14C-hexamethylmelamine (50 mg/kg) to C57Bl/6J female mice bearing 20-day-old M5076/73A ovarian cancer. ... HMM metabolism was also studied. Tissue distribution of pentamethylmelamine (PMM), 2,2,4,6-tetramethylmelamine (TMM), and 2,4,6-trimethylmelamine (TriMM) was determined at the three times considered. At 2 hr the drug was already extensively metabolized, TriMM being the major metabolite among those determined.

PMID:6411375 Garattini E, Colombo T et al; Cancer Chemother Pharmacol 11 (1): 51-5 (1983)


... In all animal species, including humans, altretamine undergoes oxidative N-demethylation with the formation of hydroxymethyl derivatives as intermediates. Hydroxymethylmelamines are believed to be responsible for the cytotoxic and antitumour activity of the drug. ...

PMID:7656502 Damia G et al; Clin Pharmacokinet 28 (6): 439-48 (1995)


In the rat 40% of a dose of 25 mg/kg of hexamethylmelamine or pentamethylmelamine was excreted in the urine as metabolites, more than 95% of which were N2N4-dimethylmelamine and monomethylmelamine. Biliary excretion of hexamethylmelamine or pentamethylmelamine and their N-demethylated metabolites accounted for less than 2% of the administered dose. Only 3% was excreted with the feces, suggesting that there is intestinal reabsorption of a portion of the methylmelamines passing into the bile. Conjugates of methylmelamines with glucuronic acid or sulphate were found only in minute quantities in the urine or bile of rats treated with hexamethylmelamine or pentamethylmelamine. However a conjugation product of pentamethylmelamine, of as yet unknown nature, is a major metabolite after pentamethylmelamine treatment.

PMID:6814076 Colombo T, Broggini M et al; Xenobiotica 12 (5): 315-21 (1982)


5.7 Biological Half-Life

4.7-10.2 hours


Elimination /half-life/-Beta-phase: Range, 4.7 to 10.2 hours.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


5.8 Mechanism of Action

The precise mechanism by which altretamine exerts its cytotoxic effect is unknown although it is classified as an alkylating anti-neoplastic agent. Through this mechanism, the drug is metabolized into alkylating agents by N-demethylation. These alkylating species consequently damage tumor cells.


The exact mechanism of action is unknown. Although altretamine structurally resembles an alkylating agent, it has not been found to have alkylating activity in vitro. There is some evidence that it may inhibit DNA and RNA synthesis.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007.


The hexamethylmelamine analogue trimelamol (tris-hydroxymethyl[trimethyl]melamine) and its equicytotoxic stable analogues CB 7547, CB 7639 and CB 7669 have been used to clarify the mechanism of action for the N-(hydroxymethyl)melamines as antitumour agents. Two main mechanisms have been proposed and explored: (i) formation of a reactive iminium species forming covalent adducts with DNA; and (ii) local formaldehyde release leading to cytotoxic damage. 32P-postlabelling and thermal denaturation experiments showed these compounds to be interactive with cytosine and guanine. Trimelamol gave rise to DNA-interstrand crosslinks in naked plasmid DNA and in cultured cell lines, whereas the analogues failed to do so under a variety of experimental conditions. Along with our observations that cell lines with acquired resistance to the N-(hydroxymethyl)melamines showed no significant cross-resistance to classical bifunctional alkylating agents, DNA crosslinking may play only a minor role in their mechanism of action. In cultured cell lines treatment with formaldehyde, trimelamol and CB 7639 gave rise to high levels of DNA-protein crosslinks with a gradual disappearance over a 24 hr period. Along with ... earlier observations that resistance to trimelamol coincides with cross-resistance to formaldehyde, /investigators/ conclude that formaldehyde-release may be an important factor in their cytotoxicity. Further, the cytotoxicity of trimelamol or formaldehyde towards human ovarian cancer cells was not influenced by glutathione depletion. /N-(hydroxymethyl)melamines/

PMID:7763301 Coley H, Brooks N et al; Biochem Pharmacol 49 (9): 1203-12 (1995)


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