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CYCLOPHOSPHAMIDE

CYCLOPHOSPHAMIDE

It is an alkylating agent which produces highly reactive carbonium ion intermediates which transfer alkyl groups to cellular macromolecules by forming covalent bonds. This results in cross linking/abnormal base pairing/scission of DNA strand. Cross linking f nucleic acids with proteins can also take place. Transformtion into active metabolites occurs in the liver and a wide range of antitumour action is exerted. It has a prominent immunosuppressant property. It is less damaging to platelets.

Indications

Leukaemias, lymphogranulomatosis, lymphosarcoma, reticulum cell sarcoma, Hodgkin’s disease, multiple myeloma. Inoperable solid malignancies. Combination with surgery, radiation & other hemotherapeutics drugs.


Dosage

2-3 mg/kg/day oral; 12-15 mg/kg body wt i.v evey 7-10 days.


Contra-Indications

Acute Urinary tract infection. Pregnancy. Bladder haemorrhage. Myelosup-pression. Lactation.


Special Precautions

Chloramphenicol retards the metabolism of cyclophosphamide. Elderly, debilitated, diabetes. Discontinue if W.B.C. Count is less than 3000. Cardiac, hepatic or renal disease.


Side Effects

Alopecia, gonadal suppression, cardiotoxicity. ulmonary fibrosis.


Drug Interactions

Serioustoxicity in combination with other myelotoxic drugs of radiotherapy. Phenobarbital increase metabolism and leukopenic activity. Doxorubicin and daunorubicin increase risk of cardiotoxicity. Allopurinol and chloramphenicol increase risk of bone marrow toxicity.


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