Cyclophosphamide

Cyclophosphamide is a cytotoxic alkylating agent of the nitrogen mustard group. Cyclophosphamide is anticancerous or antineoplastic drug. All alkylating agent have or can form an alkyl group that becomes covalently bound to cellular constituents. Cyclophosphamide is effective in the treatment of different cancers to slow or stop the growth of abnormal or cancerous cells. Cyclophosphamide is used in combination with different anticancerous drugs to obtain the excellent therapeutic effects and to minimize side effects or toxicities. It also has immunosuppressant properties and Cyclophosphamide is the most potent immunosuppressive agent that has been synthesized.

Brands
ENDOXAN ENDOXAN ENDOXAN ZYCRAM ZYCRAM ZYCRAM CYCLOMIDE CYCLOMIDE CYCLOPHOPHAMIDE CICLOFOSFAMIDA DOSA
Adult Dose
Dose: 2 to 6 mg/kg
Single Dose: 4 (4)
Frequency: As recommended.
Route: IV
Instructions: per week.
Neonatal
Paedriatic
Dose: 1250 to 2330 mg/sq.meter
Single Dose: 1800 (1790)
Frequency: As recommended.
Route: Intra Venous
Instructions: Per Month.
Characteristics
. It is of Synthetic origin and belongs to Nitrogen Mustard. It belongs to Alkylating Agents pharmacological group on the basis of mechanism of action and also classified in Antineoplastic Agent, Alkylating Agent pharmacological group.The Molecular Weight of Cyclophosphamide is 279.00. 289.00% solution of the drug is isotonic.
Contraindications
Cyclophosphamide is contraindicated in conditions like Infections,Myelosuppression.
Effects
The severe or irreversible adverse effects of Cyclophosphamide, which give rise to further complications include Cystitis, Infertility.Cyclophosphamide produces potentially life-threatening effects which include Carcinogenicity, Cardiac arrhythmias, Myelosuppression, Pulmonary Fibrosis, Heart failure, Pulmonary fibrosis. which are responsible for the discontinuation of Cyclophosphamide therapy.The signs and symptoms that are produced after the acute overdosage of Cyclophosphamide include Heart failure., Cardiac arrhythmias, Myelosuppression, Thrombocytopenia, Chemical cystitis.The symptomatic adverse reactions produced by Cyclophosphamide are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Alopecia, Skin rashes, Fall in urinary output, Hyperpigmentation, Alopecia, Skin rashes.
Indications
Cyclophosphamide is primarily indicated in conditions like Cancer, Malignant lymphoma, Multiple myeloma, Organ transplantation, and can also be given in adjunctive therapy as an alternative drug of choice in Carcinoma of male breast, Chronic lymphocytic leukaemia, Chronic lymphocytic lymphoma, Immunosuppression, Retinoblastoma.
Interactions
Cyclophosphamide is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAllopurinolAllopurinol induces the hepatic metabolism of cyclophosphamide or decrease its renal clearenceresult in enhanced myelosuppressive side effects.ModerateClosely monitor for myelosuppression, hemorrhagic cystitis, cardiotoxicity, interstitial pneumonitis and bleeding.AzathioprineCoadministration results in hepatotoxicity,,hepatocellular necrosis and bone marrow suppression.ModerateClose monitoring for signs and symptoms of hepatotoxicity and myelotoxicity is needed.Bovine InsulinBusulphanCaptoprilCarmustineChloramphenicolChlorpromazine (HCl)ClozapineBoth agents act additively thus increases the risk and severity of hematologic toxicityMajorCoadministration is considered contraindicated.DigoxinCyclophosphamide may decrease the absorption of Digoxin. This may only affect digoxin tablets. ModerateRapidMonitor for decreased therapeutic effects of digoxin tablets if Cyclophosphamide is initiated/dose increased, or increased effects if Cyclophosphamide is discontinued/dose decreased. Digoxin absorption will likely return to normal within approximately 1 week after discontinuation of chemotherapy.Doxorubicin (HCl)Doxorubicin (HCl)GlibornurideGliquidoneHalothaneHuman InsulinInsulin GlulisineIsophane insulinMedroxyprogesterone (Acetate)MelphalanMethylprednisoloneNandrolonePorcine InsulinSuxamethonium (Cl)Suxamethonium (Cl)Technetium Tc-99m GluceptateBrain images may show increased activity due to chemotherapeutic neurotoxicity following therapy Cyclophosphamide and Technetium Tc-99m Gluceptate.TolbutamideWarfarin (Na) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Monitoring of hematologic profile
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconstituted soln) Store at room temperature or refrigerator. Use within 6 days if refrigerated and within 24 hrs if kept at room temperature. Oral Soln (reconstituted soln) Store in refrigerator. Use within 6 days if kept at room temperature. Tab Store in a well closed container, at room temperature, Below 25°C.
Warnings
'Cyclophosphamide should be used with caution in patients with any blood disorders, liver disease, kidney disease or allergies, including drug allergies. Avoid touching eyes or inside nose without first washing hands for the duration of this treatment. It should be used with caution while using sharp objects like safety razors or nail cutters and avoid activities such as contact sports in order to lower the chance of getting cut, bruised or injured. Do not have immunizations or vaccinations without consent of the doctor and avoid contact with people who have recently received oral polio vaccine. This medication can lower body''s ability to fight an infection, consult the doctor if signs of an infection such as fever, sore throat, rash or chills appear. Cyclophosphamide is not recommended for use during pregnancy or lactation.'
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