Cyclophosphamide

Dosage Forms

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Tablet

50 mg

Powder for injection

1 g

Uses

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Malignant lymphomas
Multiple myeloma
Leukaemias
Mycosis fungiodes
Neuroblastoma
Ovarian adenocarcinoma
Retinoblastoma
Breast cancer

Dose and Duration

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Dose must be individualised depending on the therapeutic indication, the scheme of a combination therapy, the patient's general state of health and organ function, and the results of laboratory monitoring (in particular, blood cell monitoring)

Usual dosage regimens are

80‒300 mg/m² daily as a single IV dose or in divided doses

OR

300-600 mg/m2 as a single IV dose weekly

In combination therapy with cytotoxics of similar toxicity, reduce dose or increase dosing interval

Give IV infusion very slowly to reduce administration rate dependent side effects (e.g. swelling, headache)

Contraindications

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Hypersensitivity to cyclophosphamide
Acute infections
Bone marrow aplasia
Urinary tract infection
Acute urothelial toxicity from cytotoxic agents or radiation

Side Effects

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Myelosuppression
Haematuria (blood in urine)
Haemorrhagic cystitis (bladder damage)
Immunosuppression, infections
Anaphylaxis
Nausea and vomiting
Liver damage
Alopecia (hair loss)
Impairment of spermatogenesis
Fever
Asthenia
Mucosal inflammation

Interactions

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Clozapine (increased risk of agranulocytosis)
Suxamethonium (increased effects of suxamethonium)

Patient Instructions

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Take plenty of fluids during treatment to reduce the risk of urinary tract side effects
Report immediately any rash or allergic reactions

Pregnancy

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Do not use

Breastfeeding

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Discontinue breastfeeding

Storage

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Store between 2‒8°C

⚠️ Caution

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Monitor complete blood count before, during and after treatment
Adequate hydration before, during and after treatment is necessary to minimise risk of urinary tract toxicity
Treat any infections appropriately
Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines