Cyclophosphamide

Cyclophosphamide

is cytotoxic chemotherapy ( Alkylating agent nitrogen mustard )

It can be used for the treatment of:

Chronic lymphocytic leukaemia.

Hodgkin's and non-Hodgkin's lymphoma.

Solid tumours.

dosages:
40 to 50 mg/kg I.V. in divided doses over 2 to 5 days;
or 10 to 15 mg/kg I.V. q 10 days;
or 3 to 5 mg/kg I.V. twice weekly

When giving doses above 500 mg diluted in 100 to 250 mL compatible solution, administer by intermittent I.V. infusion over 20 to 60 minutes.

Prehydrate patient with 500 to 1,000 mL normal saline solution I.V before therapy.

Acrolein, a metabolite of cyclophosphamide, can cause haemorrhagic cystitis.This can affect 10% of patients

The drug mesna binds to acrolein and reduces its toxicity. Mesna has a shorter half-life than cyclophosphamide; it needs to be
given several times after a dose of cyclophosphamide.

Other prophylaxis measures include bladder irrigation and maintaining urine output above 100 mL/hour.

Do not give live vaccines to patients taking cytotoxic drugs; there is a risk of overwhelming sepsis and severe local reactions.

Cyclophosphamide inhibits pseudocholinesterase; do not give suxamethonium.

Allopurinol potentiates the bone marrow toxicity due to cyclophosphamide.