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Related to cyclophosphamide: vincristine


a cytotoxic alkylating agent, one of the nitrogen mustards, used in antineoplastic therapy for a wide variety of conditions, often in combination with other agents; also used as an immunosuppressant to prevent transplant rejection and in the treatment of certain diseases with abnormal immune function.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Endoxana (UK), Procytox (CA)

Pharmacologic class: Alkylating agent, nitrogen mustard

Therapeutic class: Antineoplastic

Pregnancy risk category D


Unclear. Thought to prevent cell division by cross-linking DNA strands, thereby interfering with growth of susceptible cancer cells.


Powder for injection: 500 mg, 1 g, 2 g

Tablets: 25 mg, 50 mg

Indications and dosages

Hodgkin's disease; malignant lymphoma; multiple myeloma; leukemia; advanced mycosis fungoides; neuroblastoma; ovarian cancer; breast cancer; and certain other tumors

Adults: Initially, 40 to 50 mg/kg I.V. in divided doses over 2 to 5 days, or 10 to 15 mg/kg I.V. q 10 days, or 3 to 5 mg/kg I.V. twice weekly.

Children: Initially, 2 to 8 mg/kg or 60 to 250 mg/m2 P.O. or I.V. daily in divided doses for 6 or more days.

Maintenance dosage is 2 to 5 mg/kg or 50 to 150 mg/m2 P.O. twice weekly.

Biopsy-proven nephrotic syndrome in children

Children: 2.5 to 3 mg/kg/day P.O. for 60 to 90 days

Off-label uses

• Severe rheumatologic conditions

• Selected cases of severe progressive rheumatoid arthritis and systemic lupus erythematosus


• Hypersensitivity to drug

• Severe bone marrow depression


Use cautiously in:

• renal or hepatic impairment, adrenalectomy, mild to moderate bone marrow depression, other chronic debilitating illnesses

• females of childbearing age

• pregnant patients

• breastfeeding patients (use not recommended).


• Verify that patient isn't pregnant before administering.

• Follow facility procedures for safe handling, administration, and disposal of chemotherapeutic drugs.

• Administer tablets on empty stomach. If drug causes severe GI upset, give with food.

• Don't cut or crush tablets.

• Know that dosage may need to be decreased if drug is given with other antineoplastics.

• Dilute each 100 mg of powder with 5 ml of sterile water for injection, to yield 20 mg/ml. Further dilute with compatible fluid, such as 5% dextrose injection, 5% dextrose and normal saline solution for injection, 5% dextrose and Ringer's injection, lactated Ringer's injection, or half-normal saline solution for injection.

• For I.V. injection, give each 100 mg over at least 1 minute. When giving dosages above 500 mg diluted in 100 to 250 ml of compatible solution, administer over 20 to 60 minutes.

• Use solution prepared with bacteriostatic water for injection within 24 hours if stored at room temperature or within 6 days if refrigerated.

• To minimize bladder toxicity, increase patient's fluid intake during therapy and for 1 to 2 days afterward. Most adults require fluid intake of at least 2 L/day.

Adverse reactions

CV: cardiotoxicity

GI: nausea, vomiting, diarrhea, abdominal pain or discomfort, stomatitis, oral mucosal ulcers, anorexia, hemorrhagic colitis

GU: urinary bladder fibrosis, hematuria, amenorrhea, decreased sperm count, sterility, acute hemorrhagic cystitis, renal tubular necrosis, hemorrhagic ureteral inflammation

Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression, neutropenia

Hepatic: jaundice

Metabolic: hyperuricemia

Respiratory: interstitial pulmonary fibrosis

Skin: nail and pigmentation changes, alopecia

Other: poor wound healing, infections, allergic reactions including anaphylaxis, secondary cancer


Drug-drug. Allopurinol, thiazide diuretics: increased risk of leukopenia

Digoxin: decreased digoxin blood level

Cardiotoxic drugs (such as cytarabine, daunorubicin, doxorubicin): additive cardiotoxicity

Chloramphenicol: prolonged cyclophosphamide half-life

Phenobarbital: increased risk of cyclophosphamide toxicity

Quinolones: decreased antimicrobial effect

Succinylcholine: prolonged neuromuscular blockade

Warfarin: increased anticoagulant effect

Drug-diagnostic tests. Hemoglobin, platelets, pseudocholinesterase, red blood cells (RBCs), white blood cells: decreased values

Uric acid: increased level

Patient monitoring

• Assess infusion site for signs of extravasation.

• Monitor hematologic profile to determine degree of hematopoietic suppression. Be aware that leukopenia is an expected drug effect and is used to help determine dosage.

• Monitor urine regularly for RBCs, which may precede hemorrhagic cystitis.

Patient teaching

• Tell patient to take tablets on empty stomach. However, if GI upset occurs, instruct him to take them with food.

Advise patient to promptly report unusual bleeding or bruising, fever, chills, sore throat, cough, shortness of breath, seizures, lack of menstrual flow, unusual lumps or masses, flank or stomach pain, joint pain, mouth or lip sores, or yellowing of skin or eyes.

• Instruct patient to drink 2 to 3 L of fluids daily (unless prescriber has told him to restrict fluids).

• Tell patient that drug may cause hair loss, but that hair usually grows back after treatment ends.

• Advise female patient to use barrier contraception during therapy and for 1 month afterward.

• Advise breastfeeding women not to breastfeed while taking this drug.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

cy·clo·phos·pha·mide (CTX),

An alkylating agent with antitumor activity and uses similar to those of its parent compound, nitrogen mustard (mechlorethamine hydrochloride); also a suppressor of B-cell activity and antibody formation.
Farlex Partner Medical Dictionary © Farlex 2012


A cytotoxic, immunosuppressive, antineoplastic drug, C7H15Cl2N2O2P, used in the treatment of Hodgkin and non-Hodgkin lymphomas and various other forms of cancer, including multiple myeloma, breast cancer, and certain types of leukemia.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Cytoxan®, Neosar® Oncology An alkylating chemotherapeutic used for lymphomas, CAs, and for immunosuppression in nephrotic syndrome Adverse effects BM suppression, cystitis, alopecia, N&V Contraindications Hypersensitivity, marked thrombocytopenia, leukopenia, hemorrhagic cystitis, lung toxicity related to previous therapy with an alkylating agent
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


An alkylating agent with antitumor activity and uses similar to those of its parent compound, nitrogen mustard (mechlorethamine hydrochloride); also a suppressor of B-cell activity and antibody formation.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


A drug that substitutes an open chain hydrocarbon radical for a hydrogen atom in a cyclic organic compound. It is an alkylating agent and is used as an anticancer drug for its alkylating action on the guanine molecule in DNA. The margin between the effective dose and the dangerous dose is narrow. Side effects include loss of hair, sterility, sickness and vomiting and depression of blood formation by the bone marrow. The drug is on the WHO official list. A brand name is Endoxana.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


Drugs that prevent or reduce the immune response. They are used in the treatment of a variety of severe inflammations such as uveitis, scleritis, keratoconjunctivitis sicca, Behçet's syndrome, sympathetic ophthalmia, and to prevent corneal graft rejection. They include the corticosteroids (e.g. prednisolone), ciclosporin (cyclosporine), tacrolimus, and cytotoxic agents (e.g. azathioprine, chlorambucil, cyclophosphamide, methotrexate). It must be noted that immunosuppressants render the patient more susceptible to infection because immunity is reduced.
Millodot: Dictionary of Optometry and Visual Science, 7th edition. © 2009 Butterworth-Heinemann


Alkylating agent with antitumor activity and uses similar to those of its parent compound, nitrogen mustard.
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
However, the group that received chlorophyllin in the lowest dose associated to cyclophosphamide showed higher rates of birth defects, which were statistically significant.
The cyclophosphamide metabolite, acrolein, induces cytoskeletal changes and oxidative stress in Sertoli cells.
After 24 hours of cyclophosphamide injection, animals were anesthetized with inhalatory isoflurane (3%).
In this test, the percentage of neutrophil adhesion in normal control and CP control rats were 28.47 +2.06 and 13.25+1.18 respectively which revealed a highly significant decrease in neutrophil adhesion with administration of Cyclophosphamide. (p<0.001) Levamisole and Gymnema sylvestre (50mg/kg) increased % neutrophil adhesion to a significant extent in CP induced immunosuppressed rats when compared with that of CP control group but in comparison to Control rats, this effect was not significant.(Table2) With Levamisole, GSE-25mg/kg and GSE-50 mg/kg, the percentage NA were 24.52[+ or -]1.27, 16.92 [+ or -]1.45 and 21.83 [+ or -] 1.34 respectively.
Williams, E Butler, GC Roman, Treatment of myelopathy in Sjogren's syndrome with a combination of prednisone and cyclophosphamide Arch Neurol 2001; 58(5): 815-9.
[16] The drugs found to cause xerosis in this study were cyclophosphamide, carboplatin, ifosfamide, mesna and vincristine.
Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5-fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen.
Neph were more likely to choose Cyclophosphamide for Scenario A, whereas Rheum were more likely than Neph to use Rituximab together with Cyclophosphamide for both Scenarios A and B.
After core biopsy she was diagnosed with breast cancer and received systemic neoadjuvant chemotherapy of cyclophosphamide (500mg/[m.sup.2])-docetaxel (75mg/[m.sup.2])-pharmorubicin (90mg/[m.sup.2]) regimen every 3 weeks.
Unfortunately, subsequent MRI after cyclophosphamide on 4/2016 showed progressive periventricular, mid, and also a component of superficial/juxtacortical white matter T2/FLAIR hyperintensity, the latter of which is more apparent within the frontal lobes.
She was treated with one cycle of bortezomib, doxorubicin, and dexamethasone and then, due to noncompliance, switched to four cycles of bortezomib, cyclophosphamide, and dexamethasone (CyBorD).