Cyclophosphamide

Administration

  • Type: Antineoplastic/immune modulating agent
  • Dosage Forms:
  • Routes of Administration: IV, oral
  • Common Trade Names:

Adult Dosing

  • Vasculitis: 2 mg/kg PO daily OR 15mg/kg IV q2 weeks x3 then q3 weeks. Adjust dose to avoid severe leukopenia
  • Lupus nephritis: 1g/m(2) IV monthly
  • Neuropsychiatric lupus: 0.75 g/m(2) IV q1mo x 1 year, then q3mo x 3 years
  • Oncologic uses: Typically much higher doses (e.g. 40 to 50 mg/kg IV over several days)

Pediatric Dosing

Special Populations

Contraindications

  • Allergy to class/drug
  • Urinary outflow obstruction

Adverse Reactions

Serious

  • Malignancy: leukemia, bladder, renal pelvis, dermis, angiosarcoma
  • Pericardial effusion, cardiac tamponade
  • Cardiac toxicity, CHF
  • SJS/TEN
  • Interstitial pneumonia, pulmonary fibrosis
  • Infection/sepsis
  • Bladder fibrosis/contracture, hemorrhagic cystitis,
  • Azoospermia

Common

  • Alopecia, skin pigmentation changes, rash, nail damage
  • Nausea/vomiting, diarrhea, anorexia
  • Leukopenia, neutropenia
  • Amenorrhea

Pharmacology

  • Half-life: 3-12h
  • Metabolism: Hepatic
  • Excretion: Renal

Mechanism of Action

  • Alkylating agent, cross-links strands of DNA and RNA, inhibits protein synthesis

Comments

See Also

References