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Cyclophosphamide

Brand and Other Names: Cyclophosphamide
Mechanism of Action:

The mechanism of action is thought to involve cross-linking of tumor cell DNA.

Indications:

Cyclophosphamide is indicated for use in:

  • Malignant lymphomas (e.g., Hodgkin’s disease, Burkitt’s lymphoma)
  • Multiple myeloma
  • Leukemias (e.g., CLL, CML, AML, ALL)
  • Mycosis fungoides
  • Neuroblastoma
  • Adenocarcinoma of the ovary
  • Retinoblastoma
  • Breast carcinoma
Route: oral
Dose:

Malignant diseases: 1–5 mg/kg/day orally

Pediatric nephrotic syndrome: 2 mg/kg/day orally for 8–12 weeks (max 168 mg/kg)

Adverse Reactions:
  • Neutropenia, febrile neutropenia
  • Nausea, vomiting, diarrhea
  • Alopecia

Postmarketing:

  • Serious cardiac events, hemorrhagic cystitis, infertility, severe infections
  • Pulmonary issues, liver damage, neurotoxicity
Contraindication:

Known hypersensitivity to cyclophosphamide and urinary outflow obstruction.

Warnings and Precautions:

Major Risks:

  • Myelosuppression and serious infections
  • Hemorrhagic cystitis and other urinary tract toxicities
  • Cardiotoxicity (e.g., myocarditis, arrhythmias)
  • Pulmonary toxicity (e.g., fibrosis, pneumonitis)
  • Secondary malignancies
  • Veno-occlusive liver disease
  • Embryo-fetal toxicity
  • Impairment of fertility in both males and females
  • Hyponatremia and SIADH-like symptoms
See package insert for full prescribing information.