How should I take cyclophosphamide?
Sep 29, 2021 · Cyclophosphamide is a medication primarily used in the management and treatment of neoplasms, including multiple myeloma, sarcoma, and breast cancer. Cyclophosphamide is a nitrogen mustard that exerts its anti-neoplastic effects through alkylation. This activity reviews the indications, contraindications, mechanism of action, and other key …
What is cyclophosphamide used for?
Dec 07, 2017 · Patients received cyclophosphamide based conditioning chemotherapy prior to infusion of CAR T cells. Results: A total of 25 pediatric/young adult patients were treated with 19-28z CAR T cells. Based on conditioning chemotherapy 17 patients received high dose (3000mg/m2) cyclophosphamide (HD-Cy) and 8 patients received low dose (1500mg/m2) …
What are the limitations of cyclophosphamide for the treatment of hemorrhagic cystitis?
Pre-treatment with cyclophosphamide or OX40 (CD134) costimulation targeting regulatory T cell function enhances the anti-tumor immune effect of adoptively transferred CD8+ T …
Is cyclophosphamide dialyzable?
Mice pretreated with cyclophosphamide were able to overcome infection from a lethal malarial strain. The development of resistance was preceded by increased hypersensitivity to malarial antigens. Hypersensitivity was demonstrable by a delayed footpad swelling technique. Full text
How do you prepare for cyclophosphamide?
Cyclophosphamide should be prepared for parenteral use by infusion by adding Sterile Water for Injection, USP. Cyclophosphamide, constituted in water, is hypotonic and should not be injected directly. Add the diluent to the vial and shake it vigorously to dissolve.
What should I check before giving cyclophosphamide?
Before taking cyclophosphamide, Be sure to mention any of the following: allopurinol (Zyloprim®), cortisone acetate, doxorubicin (Adriamycin®, Doxil®), hydrocortisone (Cortef®), or phenobarbital (Luminal® Sodium). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
How can cyclophosphamide side effects be prevented?
During treatment with this medication, you must drink more fluids than usual and pass urine frequently to help avoid kidney and bladder side effects. Ask your doctor how much you should drink and how often to empty your bladder each day, and follow these instructions carefully.
What should I monitor with cyclophosphamide?
Your doctor will order regular lab tests to check your response to cyclophosphamide and monitor for toxicity. Your blood counts – white blood cells, red blood cells and platelets – will be checked regularly. Your liver enzymes and urine will be checked regularly as well.
Is cyclophosphamide a strong chemo drug?
Cyclophosphamide is one of a number of medications first developed as a chemotherapy drug (a medication used in the treatment of cancer). It was discovered that — in addition to its usefulness in cancer — cyclophosphamide also has a significant ability to suppress the immune system.
Is cyclophosphamide a chemo drug?
Cyclophosphamide (pronounced sigh-clo-fos-fah-mide) is a type of chemotherapy. It is a treatment for a number of different types of cancer. You can have cyclophosphamide on its own, or in combination with other chemotherapy drugs.
How toxic is cyclophosphamide?
Clinically, damage to the bladder (haemorrhagic cystitis), immunosuppression (when not desired) and alopecia are the most significant toxicities associated with cyclophosphamide. Cardiotoxicity is also a possibility when very high doses are given.
Will I lose my hair on cyclophosphamide?
Cyclophosphamide may cause a temporary loss of hair in some people. After treatment has ended, normal hair growth should return, although the new hair may be a slightly different color or texture.Feb 1, 2022
What organ is affected by cyclophosphamide?
Blood in the urine warning: When cyclophosphamide is broken down by your body, it creates substances that irritate your kidneys and bladder. These substances can cause your kidneys or bladder to bleed. If you have blood in your urine and bladder pain, tell your doctor.
Is Cytoxan the same as cyclophosphamide?
Cyclophosphamide is the generic name for the trade name drug Cytoxan or Neosar. In some cases, health care professionals may use the trade name Cytoxan or Neosar when referring to the generic drug name cyclophosphamide. Drug Type: Cyclophosphamide is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.
Is cyclophosphamide an immunotherapy?
Low-dose cyclophosphamide has been tested in animal models as part of combination immunotherapy with immune therapeutic agents, including different vaccines and immune checkpoint inhibitors.May 1, 2016
How long can you take cyclophosphamide?
The dose itself is based on your height and weight. Most patients are NOT on cyclophosphamide indefinitely. Most physicians will discuss with their patients a time line of how long they will require cyclophosphamide (E.g. 3, 6, or 12 months).
What is cyclophosphamide used for?
Cyclophosphamide Tablets is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatric patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.
What are the side effects of Cyclophosphamide?
Explain to patients that side effects such as nausea, vomiting, stomatitis, impaired wound healing, amenorrhea, premature menopause, sterility and hair loss may be associated with Cyclophosphamide administration. Other undesirable effects (including, e.g., dizziness, blurred vision, visual impairment) could affect the ability to drive or use machines [see Adverse Reactions (6.1, 6.2) ].
Why is neutropenia important?
The degree of neutropenia is particularly important because it correlates with a reduction in resistance to infections. Fever without documented infection has been reported in neutropenic patients.
Where is cyclophosphamide biotransformed?
Cyclophosphamide is biotransformed principally in the liver to active alkylating metabolites by a mixed function microsomal oxidase system. These metabolites interfere with the growth of susceptible rapidly proliferating malignant cells.
What are secondary malignancies?
Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with Cyclophosphamide-containing regimens. The risk of bladder cancer may be reduced by prevention of hemorrhagic cystitis.
Does cyclophosphamide affect fertility?
Male and female reproductive function and fertility may be impaired in patients being treated with Cyclophosphamide Tablets. Cyclophosphamide interferes with oogenesis and spermatogenesis. It may cause sterility in both sexes. Development of sterility appears to depend on the dose of Cyclophosphamide, duration of therapy, and the state of gonadal function at the time of treatment. Cyclophosphamide-induced sterility may be irreversible in some patients. Advise patients on the potential risks for infertility [see Use in Specific Populations (8.3, 8.4) ].
What is VOD in a patient?
Veno-occlusive liver disease (VOD) including fatal outcome has been reported in patients receiving Cyclophosphamide-containing regimens. A cytoreductive regimen in preparation for bone marrow transplantation that consists of Cyclophosphamide in combination with whole-body irradiation, busulfan, or other agents has been identified as a major risk factor. VOD has also been reported to develop gradually in patients receiving long-term low-dose immunosuppressive doses of Cyclophosphamide. Other risk factors predisposing to the development of VOD include preexisting disturbances of hepatic function, previous radiation therapy of the abdomen, and a low performance status.
How is cyclophosphamide given?
It is usually given through a vein by injection or infusion (intravenous, IV) or by mouth in tablet form, depending upon diagnosis. Cyclophosphamide is also approved to be given by a shot into a muscle (IM), into the abdominal lining (intraperitoneal, IP), or into the lining of the lung (intrapleural).
What are the side effects of cyclophosphamide?
Discoloration of the skin or nails. The following are less common side effects (occurring in 10-29%) for patients receiving cyclophosphamide: Loss of fertility: Your ability to conceive or father a child may be affected by cyclophosphamide.
What is the generic name for Cytoxan?
Cyclophosphamide is the generic name for the trade name drug Cytoxan or Neosar. In some cases, health care professionals may use the trade name Cytoxan or Neosar when referring to the generic drug name cyclophosphamide.
Why is chemotherapy given in cycles?
The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells.
What to do if you have a burning sensation when you pee?
You may be at risk of infections so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider. Wash your hands often.
How long does it take for a chemo patient to recover?
Recovery: 21 days. Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts. Hair loss: Temporary - usually begins 3-6 weeks after the start of therapy. Hair will grow back after treatment is completed although the color and/or texture may be different.
Does chemo kill hair?
Chemotherapy will kill all cells that are rapidly dividing. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, are the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.
Indications and Usage For Cyclophosphamide
- Malignant Diseases
Cyclophosphamide Tablets is indicated for the treatment of: • 1. malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin’s disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt’s lymphoma • 1. multiple myel… - Minimal Change Nephrotic Syndrome in Pediatric Patients:
Cyclophosphamide Tablets is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatric patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy. Limitations of Use: The safety and effectiveness of Cyclo…
Cyclophosphamide Dosage and Administration
- Hydration and Important Administration Instructions
During or immediately after the administration of Cyclophosphamide Tablets, adequate amounts of fluid should be ingested or infused to force diuresis in order to reduce the risk of urinary tract toxicity. Therefore, Cyclophosphamide Tablets should be taken in the morning. Cyclophosphami… - Recommended Dosage for Malignant Diseases
Adults and Pediatric Patients The recommended dose of Cyclophosphamide Tablets is in the range of 1 mg per kg to 5 mg per kg orally once daily for both initial and maintenance dosing. Other regimens of oral Cyclophosphamide have been reported. Dosages should be adjusted bas…
Dosage Forms and Strengths
- Tablets: • 1. 25 mg of Cyclophosphamide, USP. Tablets are white with blue flecks and imprinted with 25 on one side and BXT on the other. • 1. 50 mg of Cyclophosphamide, USP. Tablets are white with blue flecks and imprinted with 50 on one side and BXT on the other.
Contraindications
- Cyclophosphamide Tablets are contraindicated in patients with: • 1. A history of severe hypersensitivity reactions to Cyclophosphamide, any of its metabolites, or to other components of the product. Anaphylactic reactions including death have been reported with Cyclophosphamide. Cross-sensitivity with other alkylating agents can occur. • 1. In patients with urinary outflow obst…
Warnings and Precautions
- Myelosuppression, Immunosuppression, Bone Marrow Failure and Infections
Cyclophosphamide can cause myelosuppression (leukopenia, neutropenia, thrombocytopenia and anemia), bone marrow failure, and severe immunosuppression which may lead to serious and sometimes fatal infections, including sepsis and septic shock. Latent infections can be reactivat… - Urinary Tract and Renal Toxicity
Hemorrhagic cystitis, pyelitis, ureteritis, and hematuria have been reported with Cyclophosphamide. Medical and/or surgical supportive treatment may be required to treat protracted cases of severe hemorrhagic cystitis. Discontinue Cyclophosphamide therapy in cas…
Adverse Reactions
- The following adverse reactions are discussed in more detail in other sections of the labeling. • 1. Hypersensitivity [see Contraindications (4)] • 1. Myelosuppression, Immunosuppression, Bone Marrow Failure, and Infections [see Warnings and Precautions (5.1)] • 1. Urinary Tract and Renal Toxicity [see Warnings and Precautions (5.2)] • 1. Cardiotoxicity [see Warnings and Precautions …
Drug Interactions
- Cyclophosphamide is a pro-drug that is activated by cytochrome P450s [see Clinical Pharmacology (12.3)]. An increase of the concentration of cytotoxic metabolites may occur with: • 1. Protease inhibitors: Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites. Use of protease inhibitor-based regimens was found to be associated wit…
Use in Specific Populations
- Pregnancy
Risk Summary Based on its mechanism of action and published reports of effects in pregnant patients or animals, Cyclophosphamide Tablets can cause fetal harm when administered to a pregnant woman [see Clinical Pharmacology (12.1) and Nonclinical Toxicology (13.1)].Exposure … - Lactation
Risk Summary Cyclophosphamide is present in breast milk. Neutropenia, thrombocytopenia, low hemoglobin, and diarrhea have been reported in infants breastfed by women treated with Cyclophosphamide. Because of the potential for serious adverse reactions in a breastfed child fr…
Overdosage
- No specific antidote for Cyclophosphamide is known. Overdosage should be managed with supportive measures, including appropriate treatment for any concurrent infection, myelosuppression, or cardiac toxicity should it occur. Serious consequences of overdosage include manifestations of dose dependent toxicities such as myelosuppression, urotoxicity, card…
Cyclophosphamide Description
- Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen mustards. The chemical name for Cyclophosphamide is 2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate, and has the following structural formula: Cyclophosphamide has a molecular formula of C7H15Cl2N2O2P•H2O and a molecular weight o…