Cyclophosphamide
Uses of Cyclophosphamide
Cyclophosphamide is primarily used to manage various malignant diseases such as lymphoma, leukaemia, and multiple myeloma (type of bone marrow cancer). It belongs to the group of antineoplastic and immunosuppressive medicines.
In addition to these uses, this medicine is also employed to suppress the immune system in patients who have undergone organ transplantation in order to prevent the body from rejecting the new organ.
Side effects of Cyclophosphamide
Myelosuppression (bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets)
Nausea and vomiting
Alopecia (hair loss)
Hemorrhagic cystitis (pain during urination and blood in the pee)
Gonadal dysfunction leading to infertility
How Cyclophosphamide works
Cyclophosphamide is a synthetic antineoplastic agent and a potent immunosuppressive agent.
It operates as a prodrug, essentially an inactive compound that transforms into an active form inside the body. Once administered, this medicine undergoes a transformative process in the liver to become its active metabolites. These active metabolites are strong alkylating agents, meaning they can attach an alkyl group to the guanine base of DNA. This alkylation leads to DNA cross-linking, which inhibits the replication of DNA, thereby disrupting cell division and growth. As this process particularly affects rapidly dividing cells, such as cancerous cells, this medicine proves effective in managing various types of cancer. In addition, this mechanism gives this medicine its immunosuppressive properties, making it useful in managing conditions like organ transplant rejection by curbing excessive immune responses.
Certified content
Written By
BDS, MDS
Reviewed By
Bachelor of Dental Surgery
Expert Advice
Dosage Forms Available
- Cyclophosphamide is available as both oral tablets and an injectable powder for intravenous administration.
Age and Dose Restrictions
- Cyclophosphamide is typically meant for use in adults.
Contraindications
- The medicine is contraindicated in patients with a known hypersensitivity to Cyclophosphamide. Patients with severe bone marrow suppression and those with urinary outflow obstruction should avoid using this medicine.
Other Medications to Avoid
- Cyclophosphamide may interact with alkylating agents (e.g., bendamustine, busulfan), allopurinol and blood thinners (e.g., warfarin, coumadin).
Overdose and Missed Dose
- Overdose of Cyclophosphamide may result in severe toxic reactions. Symptoms may include myelosuppression, nausea, vomiting, and diarrhoea. If you suspect an overdose, seek immediate medical attention.
- If a dose of this medicine is missed, it should be taken as soon as possible. However, the missed dose should be skipped if it is nearly time for the next dose.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening symptoms, please consult your doctor.
- Stay well-hydrated to help manage some side effects like nausea and vomiting.
- Taking the medication after meals can help manage gastrointestinal side effects like nausea and vomiting.
Use in Driving and Operating Machinery
- Cyclophosphamide may cause dizziness or confusion, which can affect your ability to drive or operate machinery. Avoid these activities if you experience these side effects.
Use in Pregnancy and Lactation
- Cyclophosphamide is classified as Pregnancy Category D. It can cause foetal harm and should only be used during pregnancy if the potential benefits outweigh the risks. The medicine is not recommended for use while breastfeeding as it can cause harm to nursing infants.
Caution in Other Conditions
- Caution should be exercised when using Cyclophosphamide in patients with bone marrow depression due to the potential risk of myelosuppression. The medicine should also be used with caution in patients with cardiac disease due to the potential risk of cardiotoxicity.
Special Dietary and Lifestyle Recommendations
- Stay well-hydrated, especially during treatment periods, to help flush the medication from your system and prevent bladder issues.
Frequently asked questions
Can Cyclophosphamide cause secondary cancers?
Long-term use of Cyclophosphamide can increase the risk of developing secondary cancers such as bladder cancer and myelodysplastic syndrome.
What Is the Duration of Treatment with Cyclophosphamide?
The duration of treatment with Cyclophosphamide varies from patient to patient, depending on the condition being managed and the individual's response to treatment. It is vital to follow your doctor's instructions regarding the length of treatment.
Is It Safe to Take Cyclophosphamide daily?
The daily use of Cyclophosphamide depends on the individual patient's condition and the doctor's prescription. It is crucial to follow your doctor's instructions regarding dosage and duration of treatment.
Is Cyclophosphamide a steroid?
No, Cyclophosphamide is not a steroid. It is primarily classified as an antineoplastic and immunosuppressive agent, which means it is used to prevent or inhibit the growth and spread of cancerous cells.
Does the Cyclophosphamide have any effect on sleep?
Cyclophosphamide itself does not directly affect sleep. However, side effects like nausea and discomfort may indirectly affect your sleep quality. Always consult your doctor if you experience serious sleep disturbances.
Does Cyclophosphamide have an effect on appetite?
There is no direct reference indicating that Cyclophosphamide has an effect on appetite. If you notice significant changes in your appetite while taking this medicine, consult your doctor.
Can Cyclophosphamide cause changes in menstruation?
Yes, Cyclophosphamide can lead to amenorrhoea, which is the absence of menstruation in women.
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