Cyclophosphamide - Benefits, dosage, side effects

Cyclophosphamide is a drug used to treat cancer, including lymphoma, leukemia, ovarian cancer, retinoblastoma, or breast cancer. In addition, this drug can also be used in the treatment of nephrotic syndrome

Cyclophosphamide works by damaging the DNA of cancer cells, thereby stopping the growth of cancer cells. This drug also works by suppressing the immune system or the immune system, so it can be used as an immunosuppressant drug in the treatment of nephrotic syndrome.

This drug is available in the form of injections and should only be given by a doctor or medical personnel under the supervision of a doctor in a hospital.

Cyclophosphamide trademark: Cyclophosphamide, Cyclophosphamide Monohydrate, Cyclovid

What is Cyclophosphamide

Class	Prescription drugs
Categories	Chemotherapy drugs or immunosuppressant drugs
Benefits	Treats cancer and is used in the treatment of nephrotic syndrome
Used by	Adult
Cyclophosphamide for pregnant and lactating women	Category D: There is positive evidence of risks to the human fetus, but the benefits may outweigh the risks, for example in dealing with life-threatening situations. Cyclophosphamide can be absorbed into breast milk, so it should not be used during breastfeeding, until 1 week after completion of treatment.
Medicine form	Injects

Warning Before Using Cyclophosphamide

Cyclophosphamide will be given by a doctor or medical officer under the supervision of a doctor at the hospital. There are several things that need to be considered before using this drug, namely:

• Tell your doctor about any allergies you have. Cyclophosphamide should not be given to patients who are allergic to this drug or to other chemotherapy drugs, such as busulfan.
• Tell your doctor if you have or are currently suffering from liver disease, kidney disease, lung disease, difficulty urinating, heart disease, weakened immune system, infectious disease, or disorders of the bone marrow, causing anemia, thrombocytopenia, or leukopenia.
• Tell your doctor if you have or have recently had surgery on your adrenal glands, undergoing chemotherapy, or radiotherapy
• Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy. Use effective contraception to prevent pregnancy during treatment with cyclophosphamide for up to 4 months–1 year after completion of treatment.
• Do not breastfeed the baby while on treatment with cyclophosphamide until 1 week after completion of treatment.
• Tell your doctor that you are taking cyclophosphamide if you plan to have dental treatment or surgery.
• As much as possible, avoid close contact with people with infectious diseases that are easily transmitted, such as the flu, while undergoing treatment with cyclophosphamide, because taking this drug can increase your risk of contracting it.
• Tell your doctor if you plan to vaccinate while on cyclophosphamide treatment.
• Report to your doctor immediately if you experience an allergic drug reaction, serious side effect, or overdose after taking cyclophosphamide.

Dosage and Instructions for Use of Cyclophosphamide

The dose of cyclophosphamide given by the doctor will be adjusted to the patient's condition. Cyclophosphamine will be injected into a vein (intravenous / IV). In general, the dosage is as follows:

• Condition: CancerAdult: The dose is 40–50 mg/kgBW divided for 2–5 days and will be repeated after 2–5 weeks of treatment.

• Condition: Breast cancerAdult: The dose is 600 mg/m2 body surface area (LPT), can be combined with other anticancer drugs.

• Condition: Non-Hodgkin lymphomaAdult: The dose is 600–1,500 mg/m2 body surface area (LPT)

• Condition: Nephrotic syndromeAdult: The dose is 2-3 mg/kgBW, can be given for up to 12 weeks when treatment with corticosteroids doesn't work.

How to Use Cyclophosphamide Correctly

Injectable Cyclophosphamide will be given at the hospital. This medicine will be injected directly by a doctor or medical personnel under the supervision of a doctor. Follow the doctor's instructions while on treatment so that the effectiveness of the treatment is maximized.

The doctor will inject the drug into the patient's vein. While using cyclophosphamide, patients are advised to drink lots of water so that they can urinate frequently. This is to prevent interference with the kidneys and bladder.

Continue to continue treatment as recommended by the doctor even though your condition has improved. Do not stop treatment without consulting your doctor first.

During treatment with cyclophosphamide, follow the treatment schedule prescribed by the doctor. You will be asked to do regular blood tests, so that your response to therapy and your condition can be monitored properly.

Interaction of Cyclophosphamide and Other Drugs

The use of cyclophosphamide with other drugs can cause a number of drug interaction effects, namely:

• Increased risk of heart damage if used with doxorubicin
• Increased risk of developing blood disorders when used with ACE inhibitors, natalizumab, zidovudine, or thiazide diuretics
• Increased risk of lung damage when used with amiodarone
• Increased risk of kidney damage if used with amphotericin B
• Increased risk of water poisoning when used with indomethacin
• Increased risk of liver damage if used with azathioprine
• Elevated blood levels of cyclophosphamide which can increase the risk of irritation of the lining of the mouth and stomach (mucositis) when used with protease inhibitors, such as ritonavir-lopinavir
• Increased risk of mucositis and small vein occlusion when used with busulfan
• Increased risk of brain abnormalities or encephalopathy when used with metronidazole
• Decrease in the work of the immune system when used with ciclosporin
• Increased risk of respiratory arrest (apnea) if used with muscle relaxants, such as suxamethonium

Side Effects and Dangers of Cyclophosphamide

Some of the possible side effects after using cyclophosphamide are:

• Nausea or vomiting
• Diarrhea
• stomach ache
• Skin and nails turn darker in color
• Hair loss

Do an examination to the doctor if the side effects above don't go away or get worse. Immediately see a doctor if there is an allergic reaction to the drug or a more serious side effect, such as:

• Thrush in the mouth and tongue that is heavy and doesn't get better
• Disorders in the kidneys and urinary tract, which can be characterized by symptoms such as difficulty or inability to urinate, or little urine, or very infrequent urination
• Heart failure or heart disease, which can be characterized by swelling of the legs, irregular heartbeat, shortness of breath, or chest pain
• Anemia, which can be characterized by weakness, tiredness, lethargy, or pale skin
• Infectious disease, which can be characterized by fever or sore throat that doesn't get better
• Easy bruising, bloody stools, or black stools
• severe abdominal pain, jaundice, or dark urine
• Mental and mood disorders