Drug Index



Mechanism :

Cyclophosphamide is bio transformed principally in the liver to active alkylating metabolites by microsomal oxidase system. These metabolites interfere with the growth of susceptible rapidly proliferating malignant cells. The mechanism of action is thought to involve cross-linking of tumor cell DNA.

Indication :

• Rhabdomyosarcoma

• Sarcoma

• Neuroblastoma stage IV

• Ewing tumor

• Non-Hodgkin’s lymphoma

• Bone marrow transplantation

• Medulloblastoma

• Neuroectodermal tumors

• Infant brain tumours

• Vasculitis

• Systemic lupus erythematosus

• Nephrotic syndrome

• Juvenile rheumatoid arthritis

Contraindications :

Continued use of cyclophosphamide is contraindicated in patients with severely depressed bone marrow function. Cyclophosphamide is contraindicated in patients who have demonstrated a previous hypersensitivity to it.

Dosing :

Children cancer chemotherapy:

IV Intermittent therapy: 40-50 mg/kg (400-1800 mg/sqm) in divided doses over 2-5 days; at intervals of 2-4 weeks, it may be repeated.

IV Continuous daily therapy: 60-120 mg/sqm/day (1-2.5 mg/kg/day).

Oral Intermittent therapy: 400-1000 mg/sqm divided doses over four to five days.

Oral continuous daily therapy: 50-100 mg/sqm/day.

Juvenile Idiopathic Arthritis/Vasculitis:

10 mg/kg IV every two weeks.

Nephrotic Syndrome:

2-3 mg/kg/day oral up to 12 weeks (if corticosteroids unsuccessful).


500-750 mg/sqm IV monthly; maximum: 1 g/sqm.

Adverse Effect :

Nausea and vomiting, alopecia, myelosuppression, mucositis/enteritis, chemical or hemorrhagic cystitis if administered without mesna or with inadequate hydration and micturition. Rarely cardiotoxicity presenting as CCF, pericardial effusion and tamponade.

Interaction :

Phenobarbital: The rate of metabolism and the leukopenic activity of cyclophosphamide reportedly are increased.
Succinylcholine: Marked and persistent inhibition of cholinesterase activity, potentiates the effect of succinylcholine.
Dexamethasone: Concurrent treatment may increase cyclophosphamide metabolism.
Allopurinol: Administration may decrease cyclophosphamide metabolism.

03/14/2020 03:26:42 Cyclophosphamide
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