Cyclophosphamide Pharmacology

Cyclophosphamide

About Cyclophosphamide
A nitrogen mustard alkylating agent, Oxazophorines group, Antineoplastic , Antirheumatic..
Mechanism of Action of Cyclophosphamide
This alkylating drug produces the death of cancer cells by an alkylation mechanism. This is a pro
drug which converted to alkyl groups (aldophosphamide and phospharamide mustard) in the liver. These groups can cyclize in an aqueous environment to form a highly electrophilic "immonium ion" that can covalently bind to the N-7 nitrogen of guanine in DNA, which is a major site of action. Consequently it produce a cross linking of DNA when both alkyl groups react pairs of guanine residues in DNA. This breaks the DNA sequence, which results cell death. These agents can also react chemically with other cellular components containing nucleophilic group i.e. sulf hydryl, amino, hydroxyl, carboxyl and phosphate groups. Its action is cell cyclic and non specific. So it acts on the divided as well as resting cells. It has prominent immunosuppressant activity. .
Pharmacokinets of Cyclophosphamide
Absorption - Completely absorbed after oral and intravenous administration.
Distribution - Widely distributed in the body.50% bound to the plasma proteins. It enters to the cerebrospinal fluid.
Metabolism - It is metabolized to its active forms i.e.aldophosphamide and phospharamide mustard in the liver. It is again metabolized to its inactive metabolites.
Excretion - Excreted via urine and foecus.15 to 30% is excreted as unchanged form.
Onset of Action for Cyclophosphamide
N/A
Duration of Action for Cyclophosphamide
N/A
Half Life of Cyclophosphamide
N/A
Side Effects of Cyclophosphamide
1. Cardiotoxicity
2. Anorexia
3. Vomiting
4. Nausea
5. Stomatitis
6. Mucositis
7. Hepatotoxicity
8. Hemorrhagic cystitis
9. Leucopenia
10. Thrombocytopenia
11. Anemia
12. Pulmonary fibrosis
13. Reversible alopecia
14. Anaphylaxis
15. Secondary malignant disease
16. Nausea
17. Darkening of the skin and nails.
18. Facial flushing
19. Dizziness
20. Runny eyes and nose
21. Dizziness
Contra-indications of Cyclophosphamide
1. Hypersensitivity to this drug
2. Bone marrow suppression
Special Precautions while taking Cyclophosphamide
1. Impaired renal function
2. Hepatic failure
3. Leucopenia
4. Thrombocytopenia
5. Dependant on chemotherapy and radiation therapy
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Cyclophosphamide
1. Lymphoblastic lymphoma
2. Hodgkins disease
3. Neuroblastoma
4. Retinoblastoma
5. Malignant lymphoma
6. Multiple myeloma
7. Mycosis fungoides
8. Sarcomas
9. Polymyositis
10. Rheumatoid arthritis
11. Wegner`s granulomatosis
12. Nephrotic syndrome
13. Systemic lupus erythematosus
Interactions for Cyclophosphamide
Chloramphenicol: Decreased efficacy of cyclophosphamide due to increase in half-life and decrease in metabolite concentration, increased risk of bone marrow toxicity.
Thiazide diuretics: Increased efficacy, anti-neoplastic induced leukopoenia may be prolonged.
Anticoagulants: Increase in anticoagulant effect.
Digoxin: Decreased serum levels of digoxin.
Doxorubicin: Doxorubicin induced cardiac toxicity potentiated.
Succinylcholine: Neuromuscular blockade prolonged.
Allopurinol: Increased risk of bone marrow toxicity.
Phenobarbitone: Increased metabolism and leukopenic activity.
Myelotoxic drugs, Radiotherapy: Serious toxicity.
Typical Dosage for Cyclophosphamide
Oral-
Adults - 60mg/kg daily for 2 to 4 days.
Intravenous-
Adults-2 to 6 mg/kg weekly as a single low-dose regimen.
10 to 15 mg/kg weekly as a single moderate-dose regimen.
20 to 40 mg/kg as a single high- dose regimen every 10 to 20 days.
Schedule of Cyclophosphamide
G
Storage Requirements for Cyclophosphamide
Keep from heat and direct light. In the case of solution keep in freezer, avoid freezing. Keep out of reach of children.
Effects of Missed Dosage of Cyclophosphamide
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Cyclophosphamide
Give symptomatic and supportive treatment.

Home Delivery for Cyclophosphamide in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including cyclophosphamide.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for cyclophosphamide and other medicines and health products. Home delivery services for cyclophosphamide may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take cyclophosphamide only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for cyclophosphamide before they complete the sale. You can get this information while placing the order for cyclophosphamide with the pharmacy.

Cyclophosphamide is a generic medicine name and there are several brands available for it. Some of the brands for cyclophosphamide might be better known than cyclophosphamide itself. If the pharmacy that's willing to deliver medicines to your home doesn't have cyclophosphamide in stock, you can ask for one of the branded alternatives for cyclophosphamide.