Neoclomide

Cyclophosphamide ·Healthcare Pharmaceuticals Ltd.·Tablet

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Packages & prices

Pack	Price	Details
Unit Price	৳	Unit Price: BDT 31.00 (30's pack: BDT 930.00)

Administration

Intravenous (Adult)-

Malignancies:

Low dose regimen: 2-6 mg/kg wkly as a single dose;
Moderate dose regimen: 10-15 mg/kg wkly as a single dose;
High dose regimen: 20-40 mg/kg as a single dose every 10-20 days.

Alternatively,

80-300 mg/m² daily as a single dose, or
300-600 mg/m² wkly as a single dose, or
600-1,500 mg/m² as a single dose or
Short infusion at 10- to 20-day intervals.

Oral (Child)-

Nephrotic syndrome:

2 mg/kg daily for 8-12 wk.
Max cumulative dose: 168 mg/kg.
Max duration: 90 days.

Oral (Adult)-

Malignancies:

Low dose regimen: 2-6 mg/kg wkly in divided dose.
Alternatively, 100-300 mg daily in divided doses, or
50-250 mg/m² daily or 80-300 mg/m² daily in divided doses.

Effects

Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.

Symptoms: Urotoxicity, myelosuppression, cardiotoxicity (including cardiac failure), stomatitis, veno-occlusive hepatic disease.

Management: Supportive treatment. May consider haemodialysis. Cystitis prophylaxis with mesna may be useful for urotoxicity.

Indications

Malignant Diseases:

Cyclophosphamide is indicated for the treatment of:

Malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin's disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt's lymphoma
Multiple myeloma
Leukemias: chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenousand monocytic leukemia, acute lymphoblastic (stem-cell) leukemia (cyclophosphamide given during remission is effective in prolonging its duration)
Mycosis fungoides (advanced disease)
Neuroblastoma (disseminated disease)
Adenocarcinoma of the ovary
Retinoblastoma
Carcinoma of the breast

Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs.

Minimal Change Nephrotic Syndrome in Pediatric Patients:

Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy.

Pharmacology

Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle. It prevents cell division by cross-linking deoxyribonucleic acid (DNA) strands and reducing DNA synthesis. It also exerts a potent immunosuppressive effect.

Precautions

Patient with DM, severe immunosuppression, acute porphyria, pre-existing CV disease or those at risk for cardiotoxicity. Renal and hepatic impairment. Lactation.