Cyclophosphamide

Drug #205

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.

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Primary 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.

Molecular Weight: 279 · Solubility in Water: 1 in 50 ml · Solubility in Alcohol: 1 in 1 · Non-proprietary name: Cyclophosphamide · Isotonic value: 289.

Pharmacokinetics

Absorption: Cyclophosphamide has an oral bioavailability is 80% (±5%), pre-systemic (first-pass) metabolism accounts for 8%.

Distribution: Cyclophosphamide has a volume of distribution is 48.7±7.2 litre. plasma protein binding is 12-24%.

Elimination: it is metabolised via hepatic, plasma half-life is 3-12 hr, renal excretion is < 20%.

Indications

Cyclophosphamide is primarily indicated in conditions like Cancer, Malignant lymphoma, Multiple myeloma, Organ transplantation.

Cyclophosphamide is also indicated for secondary conditions like Carcinoma of male breast, Chronic lymphocytic leukaemia, Chronic lymphocytic lymphoma, Immunosuppression, Retinoblastoma.

Contraindications

Cyclophosphamide is contraindicated in conditions like Infections, Myelosuppression.

Dosage

Cyclophosphamide's dosage details are as follows:

Dose	Single Dose	Frequency	Route	Instructions
Adult Dosage
4 mg/kg	4 mg/kg	—	IV	per week.
4 mg/ kg	4 mg/ kg	—	PO	In div.doses per week.
Paediatric Dosage (20kg)
1790 mg/sq.meter	1790 mg/sq.meter	—	Intra Venous	Per Month.
730 mg/sq.meter	730 mg/sq.meter	—	Oral	On Days 1-5 every month
Neonatal Dosage (3kg)
No data.

Drug Interactions

Unknown20 interactions

4 interactions

Major1 interaction

Moderate3 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Cyclophosphamide in overdosage may give rise to further complications which include Cystitis , Infertility .

Cyclophosphamide produces potentially life-threatening effects which include Carcinogenicity, Cardiac arrhythmias, Myelosuppression , Pulmonary Fibrosis , Heart failure, Pulmonary fibrosis. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Cyclophosphamide are Heart failure. , Cardiac arrhythmias, Myelosuppression , Thrombocytopenia , Chemical cystitis.

Cyclophosphamide is known to cause more or less tolerable side effects which are usually transient. These include Alopecia, Fall in urinary output, Hyperpigmentation , Nausea, Skin rashes, Vomiting .

Warnings / Precautions

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.

Interference in Pathology

Cyclophosphamide may interfere in the diagnosis of Monitoring of hematologic profile.

Available Brands

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Single Ingredient

Inj

1 g

Inj

1000 mg 200 mg 500 mg

Storage Conditions

Cyclophosphamide should be stored Inj (reconstituted soln). Oral Soln (reconstituted soln). Tab.

Drug Classification

1.2.4 — Disease modifying antirheumatic drugs
2.8.2 — Cytotoxic (anti-neoplastic) drugs

Manufacturers

Manufacturers of Cyclophosphamide in Pakistan:

Al-Habib GHANI BROTHERS Pharmedic S.Ejazuddin