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Methenamine (hexamethylenetetramine, hexamine, urotropine) is a compound discovered in 1859, which is still currently being used as an urinary antiseptic. Methenamine is higly soluble in water and polar solvents, and its molecular constitution is similar to adamantane compounds with tetrahedral cage like structure. At acidic conditions, methenamine decomposes to formaldehyde and ammonia. Recently, methenamine gained a renewal of interest due to antibiotic resistant bacteria urinary tract infections; interestingly, bacteria can not gain resistance to formaldehyde. In 1968, David and Burkitt reported remarkable regression of 6 4 Burkitt Lymphoma patients in 8 subjects who were treated with septicemine (a solution containing 6.3 grams of methenamine iodomethylate and 1 gram of methenamine sodium benzoate in 100 cc distilled water). Unfortunately, these striking observations did not gain interest in the medical community; despite in experimental models, methenamine synergized with hyperthermia, radiation, and chemotherapy to block cancer growth. As the hypoxic core of tumors have an acidic pH, it would be plausible to expect that methenamine would selectively target dormant, non-proliferative, and treatment-resistant cancer clones in large tumors. Moreover, previous data suggests that methenamine can be safely used intravenously and for treatment of infections of the central nervous system. It may therefore be an effective adjuvant in treatment of systemic cancers and glioblastoma. This article is protected by copyright. All rights reserved.
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Name: Clinical and experimental pharmacology & physiology
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An anti-infective agent most commonly used in the treatment of urinary tract infections. Its anti-infective action derives from the slow release of formaldehyde by hydrolysis at acidic pH. (From Martindale, The Extra Pharmacopoeia, 30th ed, p173)
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