Cyclophosphamide

Administration

• Type: Antineoplastic/immune modulating agent
• Dosage Forms:
• Routes of Administration: IV, oral
• Common Trade Names:

Adult Dosing

• Vasculitis: 2 mg/kg PO daily OR 15mg/kg IV q2 weeks x3 then q3 weeks. Adjust dose to avoid severe leukopenia
• Lupus nephritis: 1g/m(2) IV monthly
• Neuropsychiatric lupus: 0.75 g/m(2) IV q1mo x 1 year, then q3mo x 3 years
• Oncologic uses: Typically much higher doses (e.g. 40 to 50 mg/kg IV over several days)

Special Populations

• Pregnancy Rating: D
• Lactation risk: Infant risk has been demonstrated
• Renal dosing:
• Hepatic dosing:

Contraindications

• Allergy to class/drug
• Urinary outflow obstruction

Adverse Reactions

Serious

• Malignancy: leukemia, bladder, renal pelvis, dermis, angiosarcoma
• Pericardial effusion, cardiac tamponade
• Cardiac toxicity, CHF
• SJS/TEN
• Interstitial pneumonia, pulmonary fibrosis
• Infection/sepsis
• Bladder fibrosis/contracture, hemorrhagic cystitis,
• Azoospermia

Common

• Alopecia, skin pigmentation changes, rash, nail damage
• Nausea/vomiting, diarrhea, anorexia
• Leukopenia, neutropenia
• Amenorrhea

Pharmacology

• Half-life: 3-12h
• Metabolism: Hepatic
• Excretion: Renal

Mechanism of Action

• Alkylating agent, cross-links strands of DNA and RNA, inhibits protein synthesis