Medications and Drugs
GENERIC NAME: cyclophosphamide
BRAND NAME: Cytoxan
DRUG CLASS AND MECHANISM: Cyclophosphamide is a drug that
is used primarily for treating several types of cancer. In order to
work, cyclophosphamide first is converted by the liver into two
chemicals, acrolein and phosphoramide. Acrolein and phosphoramide are
the active compounds, and they slow the growth of cancer cells by
interfering with the actions of deoxyribonucleic acid (DNA) within
the cancerous cells. It is, therefore, referred to as a cytotoxic
drug. Unfortunately, normal cells also are affected,
and this results in serious side effects. Cytoxan also suppresses the
immune system and is also referred to as immunosuppressive.
GENERIC AVAILABLE: Yes
PRESCRIPTION: Yes
PREPARATIONS: Powder for intravenous injection (100 mg),
tablets of 25 and 50 mg.
STORAGE: Powder and tablets should be stored at room
temperature, 15-30°C (59-86°F). Solutions prepared with
bacteriostatic water are usable up to 24 hours if stored at room
temperature and up to 6 days if stored in the refrigerator.
PRESCRIBED FOR: Cyclophosphamide is used for the treatment
of several types of cancers and often in combination with other drugs
to treat breast cancer, leukemia and ovarian cancer. It also is
approved for treating nephrotic syndrome (a disease of the kidneys)
in children. Unapproved uses include the treatment of Wegener's
granulomatosis, severe rheumatoid arthritis, lupus
erythematosus,
advanced mycosis fungoides, and a number of forms of vasculitis.
DOSING: The usual initial dose for adults and children is
40-50 mg/kg administered intravenously over 3-5 days in divided
doses. The usual oral dose is 1-5 mg/kg daily. Subsequent maintenance
doses are adjusted based on the response of the tumor to treatment
and the side effects.
DRUG INTERACTIONS: Allopurinol
(Zyloprim) enhances the
ability of cyclophosphamide to reduce production of blood cells from
the bone marrow. (See below.)
Cyclophosphamide increases the occurrence of heart failure that is
caused by doxorubicin (Adriamycin), increases the action of blood
thinners such as coumarin (Coumadin), and decreases the effects of
quinolone antibiotics (Cipro).
PREGNANCY: Use of cyclophosphamide during pregnancy may
affect the fetus. Fetuses exposed to cyclophosphamide may be born
with missing fingers, toes and a poorly-developed heart. Exposure in
the second or third trimester may be less risky.
NURSING MOTHERS: Cyclophosphamide is excreted in breast
milk and could cause serious problems in the nursing infant.
SIDE EFFECTS: Side effects of cyclophosphamide include
hair loss, vomiting, diarrhea, mouth sores, sterility and jaundice.
Cyclophosphamide causes kidney failure, and it also may affect the
heart and lungs. Cyclophosphamide suppresses production of blood
cells from the bone marrow, including white blood cells (leukopenia),
red blood cells (anemia) and platelets (thrombocytopenia). Leukopenia
reduces the ability of the body to fight infection, thrombocytopenia
impairs the ability of blood to clot, and anemia reduces the ability
of blood to carry oxygen.
Cyclophosphamide also may cause inflammation of the urinary bladder
with bleeding (hemorrhagic cystitis). This can result in lower
abdominal pain from the bladder, problems urinating due to blood
clots, and anemia due to loss of blood.
Reference: FDA Prescribing Information
Last Editorial Review: 1/16/2000 1:01:00 PM
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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- IV Drug Infusion FAQs - Learn what to expect during an intravenous (IV) drug infusion of medicine and avoid the confusion of what to expect. Information on what to bring, questions to ask the staff, and follow-up are included.
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