Cyclophosphamide
Cyclophosphamide is an antineoplastic agent which has alkylating effect. Its active ingredient is betachloroethyl, linked to a cyclic phosphamide group. The compound as such is inert but phosphamidase enzymes occurring in high amount in neoplastic tissue are capable of accomplishing the cleavage the active group.
Malignant tumours such as pulmonary carcinoma, mammary carcinoma, ovarian carcinoma, malignant lymphogranulomatosis, lymphosarcoma, reticulum cell sarcoma, leukemias and multiple myeloma. Cyclophoshamide is frequently used in combination chemotherapy regimens involving other cytotoxic.
- Bone marrow disorders.
- Hypersensitivity and haemorrhagic cystitis.
- Patients who are pregnant or mother who are breast feeding.
Cyclophosphamide should be given cautiously to patients with any of the
following conditions :
1. Leucopenia.
2. Thrombocytopenia.
3. Tumour cell infiltration on bone marrow.
4. Previous X-ray therapy.
5. Previous therapy with other cytotoxic agents.
6. Impaired hepatic function.
7. Impaired renal function.
Cyclophosphamide may induce permanent sterility in children
Nausea and vomiting may occur. Loss of hair is relatively common. The most
serious side effect is bone marrow depression (leucopenia, thrombocytopenia).
Because of this, the white blood cell count (and possibly also the number of
thrombocytes) should be controlled sufficiently often during the treatment.
Usually a control performed once a week or once every two weeks is adequate.
With a small dosage, a control performed less frequently may be sufficient, if
the white blood cell count is stable. The control of thrombocytes is necessary
only when the number of leukocytes is low.
• Other possible side effect include amenorrhea, azospermia and sterile
haemorrhagic cystitis can be avoided by large amounts of liquid.
• Anorexia
• Interstitial pulmonary fibrosis
• Bladder fibrosis and carcinoma have been reported after long term use of
cyclophosphamide.
• Liver dysfunction.
• Hyperpigmentation.
• Oral ulceration.
It is recommended that the calculated dose of cyclophosphamide be reduced
when it is given in combination with other anti-neoplastic agents or
radiotherapy, and in patients with bone morrow depression.
Sample regimen may serve as guides :
Low dose : 80 to 240 mg/m2 body surface (2 to 6 mg/kg body weight), as a single
dose weekly iv or divided doses orally for 14 days every 28 days.
Medium dose : 400 to 600 mg/m2 body surface
High dose : 800-1600 mg/m2 body surface
As single dose IV at 10-20 days intervals.
Higher doses should be used only at the discretion of a physician in cytotoxic
chemotherapy.
Cyclophosphamide injection
Reconstitute with 10 ml sterile water for injection for 200 mg cyclophosphamide
or 50 mg sterile water for injection for 1000 mg of cyclophosphamide. Shake
vigorously. Do not warm. Solution stable for 2-3 hour.
Cyclophosphamide tablet
Cyclophosphamide tablet should be swallowed whole preferably on an empty
stomach, but if gastric irritation is severe it may be taken with meals.
I vial 200 mg
I vial 1000 mg
Tablet 50 mg.
Store below 25oC. Protect from light.
On Medical prescription only.
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