Cyclophosphamide

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Endoxan; Belgium: Endoxan; Bulgaria: Endoxan; Czech Republic: Cyclophosphamide, Endoxan; Denmark: Cyclophosphamid, Sendoxan; Estonia: Endoxan; Finland: Sendoxan, Syklofosfamid; France: Endoxan; Germany: Cyclophosphamid, Cyclostin, Endoxan; Greece: Cyclophosphamide, Endoxan, Phosphamex; Hungary: Endoxan; Ireland: Endoxana; Italy: Endoxan; Latvia: Endoxan; Lithuania: Endoxan; Luxembourg: Endoxan; Malta: Cyclophosphamide; Netherlands: Endoxan; Poland: Endoxan; Portugal: Endoxan; Romania: Endoxan; Slovakia: Endoxan; Slovenia: Endoxan; Spain: Genoxal; Sweden: Sendoxan; UK: Cyclophosphamide.

North America

Canada: Procytox; USA: Cyclophosphamide.

Latin America

Argentina: Ciclofosfamida, Ciclokebir; Brazil: Genuxal; Mexico: Cryofaxol, Formitex, Hidrofosmin, Ledoxina.

Asia

Japan: Endoxan.

Drug combinations

Chemistry

Cyclophosphamide: C~7~H~15~Cl~2~N~2~O~2~P H~2~O. Mw: 279.10. (1) 2H-1,3,2-Oxazaphosphorin-2-amine, N,N-bis(2-chloroethyl)tetrahydro-, 2-oxide, monohydrate, (±); (2)(±)-2-[Bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate. CAS-6055-19-2; CAS-50-18-0 (anhydrous).

Pharmacologic Category

Antineoplastic Agents; Alkylating Agents. Miscellaneous Therapeutic Agents; Immunosuppressive Agents. (ATC-Code: L01AA01).

Mechanism of action

Cyclophosphamide is an alkylating agent which prevents cell division by cross-linking DNA strands and decreasing DNA synthesis. Also possesses potent immunosuppressive activity. Has phosphorylating properties which enhance its cytotoxicity.

Therapeutic use

Treatment of Hodgkin’s and non-Hodgkin lymphoma, Burkitt’s lymphoma, chronic lymphocytic leukemia, chronic myelocytic leukemia, acute myelocytic leukemia, acute lymphocytic leukemia, mycosis fungoides, multiple myeloma, neuroblastoma, retinoblastoma, rhabdomyosarcoma, Ewing’s sarcoma; breast, testicular, endometrial, ovarian, and lung cancers, and in conditioning regimens for bone marrow transplantation. Prophylaxis of rejection for kidney, heart, liver, and bone marrow transplants, severe rheumatoid disorders, nephrotic syndrome, Wegener’s granulomatosis, idiopathic pulmonary hemosideroses, myasthenia gravis, multiple sclerosis, systemic lupus erythematosus, lupus nephritis, autoimmune hemolytic anemia, idiopathic thrombocytic purpura, macroglobulinemia, and antibody-induced pure red cell aplasia.

Pregnancy and lactiation implications

Can cause fetal toxicity. Some abnormalities have occurred in infants born to women treated with the drug during pregnancy. Should be used during pregnancy only in life-threatening situations or severe disease. Contraindicated during lactation.

Unlabeled use

Contraindications

Hypersensitivity to cyclophosphamide or any component of the formulation. Pregnancy.

Warnings and precautions

Hazardous agent. May cause cardiotoxicity (may potentiate the cardiotoxicity of anthracyclines). May impair fertility (interferes with oogenesis and spermatogenesis). Hemorrhagic cystitis may occur. Immunosuppression may occur. Secondary malignancies reported. Use with caution in hepatic/renal impairment.

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