Indications & Uses
Cycloph is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
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.
Side Effects
Side effects of Neoclomide are grouped below by the body system affected or the type of reaction, and within each group they are listed from most to least common. Digestive system: Nausea and vomiting are common during Neoclomide therapy. Loss of appetite (anorexia) may occur, and less often abdominal discomfort or pain and diarrhea. There have been isolated reports of hemorrhagic colitis, ulceration of the mouth lining and jaundice during treatment. These effects generally settle once Neoclomide is stopped. Skin and its structures: Hair loss (alopecia) is common in patients treated with Neoclomide. The hair can be expected to grow back after treatment, or even while treatment continues, although it may differ in texture or color. Skin rash occurs occasionally. Skin pigmentation and nail changes can occur. Very rare reports of Stevens-Johnson syndrome and toxic epidermal necrolysis have been received during post-marketing surveillance; because these were spontaneous reports, a definite causal link to cyclophosphamide has not been established. Hematopoietic system: Leukopenia (a low white blood cell count) occurs in patients treated with Neoclomide. It is related to the dose and can be used as a guide to dosing. Leukopenia below 2000 cells/mm3 develops commonly in patients given an initial loading dose, and less often in patients maintained on smaller doses. The degree of neutropenia is particularly important because it goes hand in hand with reduced resistance to infection. Fever without a documented infection has been reported in neutropenic patients. Thrombocytopenia (low platelets) or anemia develops occasionally. These blood effects can usually be reversed by lowering the dose or interrupting treatment. Recovery from leukopenia usually begins 7 to 10 days after therapy is stopped. Urinary system: Hemorrhagic ureteritis and renal tubular necrosis have been reported in patients treated with Neoclomide. Such lesions usually resolve once therapy is stopped. Respiratory system: Interstitial pneumonitis has been reported in post-marketing experience. Interstitial pulmonary fibrosis has been reported in patients receiving high doses of Neoclomide over a prolonged period. Other: Anaphylactic reactions have been reported, and death has also been reported in association with this event. Possible cross-sensitivity with other alkylating agents has been reported. SIADH (syndrome of inappropriate ADH secretion) has been reported with the use of Neoclomide. Malaise and asthenia (weakness) have been reported in post-marketing experience.
Cautions & Contraindications
Warnings & Precautions
Special attention to the possible development of toxicity should be exercised in patients being treated with Neoclomide 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 Impaired hepatic function Impaired renal function
Contraindications
Cyclophosphamide should not be continued in patients whose bone marrow function is severely depressed. It must not be given to anyone who has previously shown hypersensitivity to the drug.