Cyclophosphamide
Cytostatic · Alkylating agent
Indications
Malignant lymphomas, leukaemias, multiple myeloma, mycosis fungoides, neuroblastoma, ovary adenocarcinoma, retinoblastoma, breast carcinoma.
Dosage
INJECTION: Adults & Children: IV: 40-50 mg/kg in divided doses over 2-5 days, or 10-15 mg/kg for 7-10 days, or 3-5 mg/kg. ORAL: Adults & Children: 1-5 mg/kg/day.
Administration
IV: May be administered IP, intrapleurally, IVPB, or continuous intravenous infusion, may also be administered slow IVP in doses <1 gm. IV infusions may be administered over 1-24 hours. Doses >500 mg to approximately 2 g may be administered over 20-30 min. To minimize bladder toxicity, increase normal fluid intake during and for 1-2 days after cyclophosphamide dose. Most adult patients will require a fluid intake of at least 2 litre/day. High-dose regimens should be accompanied by vigorous hydration with or without mesna therapy. Reconstitute vials with SWI, NS, or D5W to a concentration of 20 mg/mL. Compatibility: Stable in D5LR, D5W, D5NS, LR, ½NS, NS. Stability: Store at or below 25°C (77°F). Do not use cyclophosphamide if there are signs of melting. Solutions for injection are stable for 24 hours at room temperature or up to 6 days under refrigeration. However, reconstituted…
Adverse Effects
Nausea, vomiting, reticule-endothelial suppression, urothelial toxicity, myelosuppression, immunosuppression, impaired sperm production infections, haemolytic uraemic syndrome, mucosal inflammation, alopecia, hepatic dysfunction, fever, asthenia, haematuria, cystitis. Secondary malignancies, cardiac and pulmonary toxicity, renal dysfunction, hyponatraemia.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Bladder haemorrhage, acute UTI. Myelosuppression. Acute infection, bone marrow aplasia, acute urothelial toxicity, haemorrhagic cystitis. Precautions: Renal and hepatic impairment. Monitor blood counts. Elderly, debilitated, diabetes. Risk of irreversible infertility.
Interactions
Radiotherapy, doxorubicin, sulphonylureas, other cytotoxics, other myelosuppressants, oral hypoglycaemics, allopurinol, suxamethonium.
Advice to Patient
Take oral form 1 hour before or 2 hours after meals. To prevent GI upset, take with meals. Swallow whole tablet. Do not take at night. If there is headache, severe vomiting and nasal congestion or cold symptoms, consult prescriber for suitable analgesic, antiemetic and decongestant. Contact prescriber if there is trouble or pain with urination, fast heartbeat, chest pain, palpitations, unusual rash, easy bruising or bleeding, menstrual abnormalities, constant nausea, vomiting, difficulty in breathing, swelling of extremities, unusual fatigue. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Urinate frequently to prevent bladder irritation. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Using soft toothbrush, cotton swabs, regular mouth care may help to prevent mouth…
Pharmacokinetics
Absorption: Oral: Well absorbed. Metabolism: Hepatic to active metabolites acrolein, 4-aldophosphamide, 4-hydroperoxycyclophosphamide, and nor-nitrogen mustard. Bioavailability: >75%. Half-life elimination: IV: 3 to 12 hours; Children: 4 hours; Adults: 6 to 8 hours. Time to peak: Oral: Approx 1 hour; IV: Metabolites: 2 to 3 hours. Excretion: Urine (10 to 20% as unchanged drug); feces (4%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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