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Cyclophosamide Injection

Category: Antineoplastic
Composition- : Each vial contains: Cyclophosphamide eq. to Cyclophosphamide (anhydrous) 200mg ,500mg,1000mg .
It is an antineoplastic and immuno modulating agent. It is bio-transformed in liver to active alkylated metabolite. These metabolites interfere with growth of susceptible rapidly multiplying malignant cells by cross-linking of tumour cell-DNA.

Specification- cyclophosphamide for injection, is a sterile white powder containing cyclophosphamide monohydrate. Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen mustards. Cyclophosphamide is a white crystalline powder with the molecular formula C7H15Cl2N2O2P•H2O and a molecular weight of 279.1. Cyclophosphamide is soluble in water, saline, or ethanol .
pH------------ 3.0 to 9.0
Indication : Cyclophosphamide although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs. The following malignancies are often susceptible to cyclophosphamide treatment:
• Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma.
• Multiple myeloma.
• Leukemias: Chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenous and monocyticleukemia, acute lymphoblastic (stem-cell) leukemia in children cyclophosphamide given during remission is effective in prolonging its duration)..
• Carcinoma of the breast.
Dosage :- Adults and Children:
When used as the only oncolytic drug therapy, the initial course of cyclophosphamide for patients with no hematologic deficiency usually consists of 40 to 50 mg/kg given intravenously in divided doses over a period of 2 to 5 days. Other intravenous regimens include 10 to 15 mg/kg given every 7 to 10 days or 3 to 5 mg/kg twice weekly.
Contraindications:- In patients with history of hypersensitivity to the drug, pregnancy, location.
Precautions:- Special attention to the possible development of toxicity should be exercised in patients being treated with cyclophosphamide if any of the following conditions are present.
• Leukopenia
• Thrombocytopenia
• Tumor cell infiltration of bone marrow
• Previous X-ray therapy
Previous therapy with other cytotoxic agents
Drug interaction: The physician should be alert for possible combined drug actions, desirable or undesirable, involving cyclophosphamide even though cyclophosphamide has been used successfully concurrently with other drugs, including other cytotoxic drugs.Cyclophosphamide treatment, which causes a marked and persistent inhibition of cholinesterase activity, potentiates the effect of succinylcholine chloride.
Since cyclophosphamide has been reported to be more toxic in adrenalectomized dogs, adjustment of the doses of both replacement steroids and cyclophosphamide may be necessary for the adrenalectomized patient.
Adverse Effect-: Sterility in both sexes may occur, amenorrhoea, haemorrhagic cystitis, fibrosis of bladder, nausea, vomitting, anorexia, alopecia, skin rash, pigmentation, leucopenia, thrombocytopenia, intestinal pulmonary fibrosis, anaphylactic reactions.
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