Cyclophosphamide

Indications & Dose:

lymphogranulomatosis, lymphosarcoma, reticulum cell sarcoma. Hodgkin’s disease, multiple myeloma, retinoblastoma, carcinoma of the breast, adrenocarcinoma of the ovary. Inoperable solid malignancies. Combination with surgery, radiation and other therapeutic measures. Minimal change nephrotic syndrome in children

DOSE 
Malignancy: l

• BY INJECTION

i.v : 40-50mg/kg in div. doses over 2-4 days or 10- 15mg/kg every 7-10 days or 3-5mg/kg twice weekly. 

Minimal change nephrotic syndrome: 

2.5-3mg/kg daily orally

Contraindications:

ypersensitivity, severely depressed bone marrow. Bladder haemorrhage, acute urinary tract infection, myelosuppression.
Pregnancy & breast-feeding contraindicated.

Side Effects:

Leukaemia, cardiomyopathy, myocardial necrosis, immune suppression, nausea and vomiting, impaired wound healing, sexual dysfunction,hepatotoxicity, pneumonitis, pulmonary fibrosis, SIADH cellulitis, hyperkalemia, porphyria and anaphylaxis, haematuria, visual blurring, facial burning with i.v. administration, teratogenic effect, haemorrhagic cystitis, bone marrow depression, hyponatremia, sterility, inapprorpiate secretion of ADH. Alopecia and increased skin pigmentation.

Cautions:

Leukopenia, thrombocytopenia, tumour cell infilteration of bone marrow, adrenalectomy, previous radiotherapy. 

Precautions:

Diabetes, elderly, hepatic, cardiac or renal impairment, acute systemic or urinary infections. To stop the drug if leucocyte count is less than 3000/cu. mm. Carcinogenic potential, infection, adequate contraception, previous X-ray or cytotoxic therapy.

Old age: May be used in reduced dose

Interaction:

Drugs

Chloramphenicol: Decreased efficacy of cyclophosphamide due to increase in half-life and decrease in metabolite concentration, increased risk of bone marrow toxicity.

Thiazide diuretics: Increased efficacy, anti-neoplastic induced leukopenia may be prolonged.

Anticoagulants: Increase in anti-coagulant effect.

Digoxin: Decreased serum levels of digoxin.

Doxorubicin: Doborubicin induced cardiac toxicity potentiated.

Succinylcholine: Neuromuscular blockade prolonged.

Allopurinol Increased risk of bone marrow toxicity.

Phenobarbitone: Increased metabolism and leukopenic activity.

Myelotoxic drugs, Radiotherapy: Serious toxicity.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: