♦Cyclophosphamide

(cy-klo-foss’-fa-mide)

Cytoxan,

Neosar

Pregnancy Category D

Mechanism of Action

Cyclophosphamide is a cell cycle-nonspecific nitrogen mustard derivative that acts as an alkylating agent by interfering with DNA replication and transcription of RNA, ultimately resulting in the disruption of nucleic acid function.

Indications

Acute or chronic lymphocytic leukemia, acute myeloblastic leukemia, breast cancer, Hodgkin’s disease, lymphoma, multiple myeloma, mycosis fungoides, neuroblastoma, ovarian cancer, retinoblastoma.

Metabolism/Excretion

Metabolized in the liver and excreted in the urine. Half-life: 4 to 6 hours.

Dosage Range

Adult

♦ Induction (for patients with no hematologic deficiencies): 40 to 50 mg/kg is usually administered IV in divided doses over a course of 2 to 5 days. If the patient has bone marrow deficiency, reduce the initial loading dose by 33% to 50%. PO, give 1 to 5 mg/kg daily.

♦ Maintenance: Various IV dosing schedules include 10 to 15 mg/kg (350 to 550 mg/m²) every 7 to 10 days and 3 to 5 mg/kg (110 to 185 mg/m²) twice weekly.

Pediatric

♦ Induction: PO or IV, 2 to 8 mg/kg or 60 to 250 mg/m² daily.

♦ Maintenance: PO, 2 to 5 mg/kg or 50 to 150 mg/m², administered twice weekly.

Drug Preparation/Stability

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