Cyclophosphamide

ইঙ্গিত

Cancer

Neoclomide, although effective on its own in susceptible malignancies, is more often used at the same time as, or in sequence with, other antineoplastic drugs. The following malignancies are often susceptible to Neoclomide 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 and Burkitt's lymphoma. Multiple myeloma. Leukaemias: chronic lymphocytic leukaemia, chronic granulocytic leukaemia (it is usually ineffective in acute blastic crisis), acute myelogenous and monocytic leukaemia, and acute lymphoblastic (stem-cell) leukaemia in children (Neoclomide given during remission is effective in prolonging its duration). Mycosis fungoides (advanced disease). Neuroblastoma (disseminated disease). Adenocarcinoma of the ovary. Retinoblastoma. Carcinoma of the breast. Nonmalignant disease: biopsy-proven "minimal change" nephrotic syndrome in children. Neoclomide is useful in carefully selected cases of biopsy-proven "minimal change" nephrotic syndrome in children, but it should not be used as primary therapy. In children whose disease fails to respond adequately to appropriate adrenocorticosteroid therapy, or in whom adrenocorticosteroid therapy produces or threatens to produce intolerable side effects, Neoclomide may induce a remission. Neoclomide is not indicated for the nephrotic syndrome in adults or for any other renal disease.

⚠️ কোনো ওষুধ গ্রহণের আগে সর্বদা নিবন্ধিত চিকিৎসকের পরামর্শ নিন।

ফার্মাকোলজি

Cyclophosphamide is converted mainly in the liver into active alkylating metabolites through a mixed function microsomal oxidase system. These metabolites interfere with the growth of susceptible, rapidly proliferating malignant cells. Its mechanism of action is thought to involve cross-linking of tumor cell DNA. Cyclophosphamide is well absorbed after oral administration, with a bioavailability greater than 75%. The unchanged drug has an elimination half-life of 3 to 12 hours. It is eliminated mainly as metabolites, though 5% to 25% of the dose is excreted in urine as unchanged drug. Several cytotoxic and noncytotoxic metabolites have been identified in urine and in plasma. Metabolite concentrations in plasma reach a peak 2 to 3 hours after an intravenous dose. Plasma protein binding of the unchanged drug is low, but some metabolites are bound to a greater extent, more than 60%. No single metabolite has been shown to be responsible for either the therapeutic or the toxic effects of cyclophosphamide. Although elevated metabolite levels have been observed in patients with renal failure, increased clinical toxicity in such patients has not been demonstrated.

Pregnancy & Breastfeeding

Pregnancy Category D. Cyclophosphamide passes into breast milk. Because of the potential for serious adverse reactions in a nursing infant, along with evidence in humans that the drug may pose a tumor risk, the mother and her doctor should decide together whether to stop breastfeeding or stop the medicine, weighing how important the drug is for her treatment.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

ডোজ নির্দেশিকা

⚠️ শুধুমাত্র সরকারি উৎস থেকে নির্দেশিকা পরিসীমা। ব্যক্তিগতকৃত ডোজের জন্য আপনার ডাক্তারের পরামর্শ নিন।

Adults: Treatment of malignant diseases (adults and children): When cyclophosphamide is used as the only oncolytic drug, the initial course for patients with no hematologic deficiency usually consists of 40 to 50 mg/kg given intravenously in divided doses over 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. Oral cyclophosphamide is usually given in the range of 1 to 5 mg/kg/day for both initial and maintenance dosing. Many other intravenous and oral cyclophosphamide regimens have been reported. Doses must be adjusted according to evidence of antitumor activity and/or leukopenia. The total leukocyte count is a good, objective guide for regulating the dose. A transient fall in the total white blood cell count to 2000 cells/mm3 (following short courses), or a more persistent reduction to 3000 cells/mm3 (with continuing therapy), is tolerated without serious risk of infection provided there is no marked granulocytopenia. When cyclophosphamide is included in combined cytotoxic regimens, it may be necessary to reduce the dose of cyclophosphamide as well as that of the other drugs. Cyclophosphamide and its metabolites are dialyzable, although there are probably quantitative differences depending on the dialysis system used. Patients with compromised renal function may show some measurable changes in the pharmacokinetic parameters of cyclophosphamide metabolism, but there is no consistent evidence that the cyclophosphamide dose needs to be modified in patients with renal function impairment. Treatment of nonmalignant diseases. Biopsy proven "minimal change" nephrotic syndrome in children: An oral dose of 2.5 to 3 mg/kg daily for 60 to 90 days is recommended. In males, the incidence of oligospermia and azoospermia increases if cyclophosphamide treatment lasts longer than 60 days. Treatment beyond 90 days increases the probability of sterility. Adrenocorticosteroid therapy may be tapered and discontinued during the course of cyclophosphamide therapy.

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No side-effect data recorded yet.

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