Dangerous Drug: Cyclophosphamide(sye kloe foss’ fa mide)
Procytox (CAN)
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Nitrogen mustard derivative
Therapeutic Actions
Cytotoxic: Interferes with the replication of susceptible cells. Not specific to cell cycle.
Immunosuppressive: Lymphocytes are especially sensitive to drug effects.
Indications
Treatment of malignant lymphomas, multiple myeloma, leukemias, mycosis fungoides, neuroblastoma, adenocarcinoma of the ovary, retinoblastoma, carcinoma of the breast; used concurrently or sequentially with other antineoplastic drugs
Treatment of minimal change nephrotic syndrome in children
Unlabeled uses: Severe rheumatologic conditions, Wegener granulomatosis, steroid-resistant vasculitis, SLE, numerous other cancers, juvenile idiopathic arthritis
Contraindications and Cautions
Contraindicated with allergy to cyclophosphamide, pregnancy, lactation.
Use cautiously with radiation therapy; tumor cell infiltration of the bone marrow; adrenalectomy with steroid therapy; infections, especially varicella-zoster; hematopoietic depression, impaired hepatic or renal function.
Available Forms
Tablets—25, 50 mg; injection—500 mg, 1 g, 2 g
Dosages
Consult current chemotherapeutic reference for appropriate protocol, and individualize dosage based on hematologic profile and response.
Adults
Induction therapy: 40–50 mg/kg IV given in divided doses over 2–5 days or 1–5 mg/kg/day PO.
Alternative dosing: 1–5 mg/kg/day PO, 10–15 mg/kg IV every 7–10 days, or 3–5 mg/kg IV twice weekly.
Pediatric patients
Minimal change nephrotic syndrome: 2.5–3 mg/day PO for 60–90 days.
Patients with renal impairment
CrCl less than 10 mL/min, reduce dose to 75% of usual dose.
Patients with hepatic impairment
Bilirubin 3.1–5 mg/dL or AST more than 180 mg/dL, give 75% of dose. Bilirubin more than 5 mg/dL, do not give.
Pharmacokinetics
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