Adult Dosing
Malignant diseases
- Usually in the range of 1-5 mg/kg/day PO
- Note: Adjust dosage according to evidence of antitumor activity and/or leukopenia
Goodpastures syndrome [Non-FDA Approved]
- 2-4 mg/kg/day PO given qd (reduce dose in patients over 60 years). This oral dose is generally continued for 3 months
Pediatric Dosing
Malignant diseases
- Usually in the range of 1-5 mg/kg/day PO
- Note: Adjust dosage according to evidence of antitumor activity and/or leukopenia
Minimal change nephrotic syndrome
- 2.5-3 mg/kg/day PO x 60-90 days. Max: 90 days
- Taper and discontinue adrenocorticosteroid therapy during the course of cyclophosphamide therapy
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <10 mL/min: Reduce dose by 25%; carefully monitor patients for renal toxicity
- HD: Give 50% of dose as supplement
Hepatic Dose Adjustment
- Use with caution, dose adjustments not defined
- Secondary malignancies, including urinary bladder, myeloproliferative, or lymphoproliferative malignancies have developed in patients treated with cyclophosphamide alone or in combination with other antineoplastic drugs and/or modalities. Second malignancy may develop several years after the discontinuation of therapy
- Cyclophosphamide can cause fetal harm when administered to a pregnant woman. If cyclophosphamide is used during pregnancy, or if a woman becomes pregnant during therapy, she should be apprised of the potential hazard to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant
- Cyclophosphamide may cause irreversible sterility in both sexes. It may interfere with cogenesis and spermatogenesis
- Hemorrhagic cystitis, which can be rarely severe and fatal, may develop in patients treated with cyclophosphamide. Fibrosis of the urinary bladder, sometimes extensive, also may develop with or without accompanying cystitis. Increase fluid intake and frequent voiding may be useful in preventing cystitis
- Instances of cardiac dysfunction have occurred
- Serious, sometimes fatal, infections may develop due to immunosuppression. Anaphylactic reactions, including death have also been reported
- Avoid use as primary therapy in biopsy proven "minimal change" nephrotic syndrome in children; not indicated for nephrotic syndrome in adults or for any other renal disease
- Adjustment of the doses of replacement steroids and cyclophosphamide may be necessary in adrenalectomized patients
- Monitor uric acid, CBC with differential count and renal/hepatic/cardiac function; observe for hematuria and dysuria
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Leukopenia
- Thrombocytopenia
- Recent XRT
- Adrenalectomy
- Previous therapy with cytotoxic drugs
- Debilitated patients
- Wound healing
Pregnancy Category:D
Breastfeeding: Most sources consider breastfeeding to be contraindicated with antineoplastic therapy. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 October 2010). According to manufacturer's data, cyclophosphamide is excreted in breast milk. Manufacturer recommends discontinuation of nursing or discontinuation of therapy, by analyzing risk and benefit ratio in nursing mothers.
US Trade Name(s)
US Availability
cyclophosphamide (generic)
Canadian Trade Name(s)
Canadian Availability
Procytox
UK Trade Name(s)
UK Availability
cyclophosphamide (generic)
Australian Trade Name(s)
Australian Availability
Cycloblastin
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Cyclophosphamide 25 MG TABS [Bottle] (ROXANE)
30 mg = $62.82
90 mg = $179.19 - Cyclophosphamide 50 MG TABS [Bottle] (ROXANE)
30 mg = $110.2
90 mg = $307.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.