Cyclomide 1G - Injection Cyclophosphamide - 1000mg/vial 1 Injection(s) / Injection EDCL Introduction: Cyclomide 1G is used in the treatment of different kinds of cancers. It is also used to treat kidney disease known as nephrotic syndrome in children after other treatments have not worked. It may be also used to treat other conditions, as determined by the doctor. Cyclomide 1G should be taken with food preferably in morning but at the same time every day to get the most benefit. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to... Uses of Cyclomide 1G: CancerNephrotic syndrome Side effects of Cyclomide 1G: VomitingNauseaHair lossFeverBlood in urineDiarrheaDecreased white blood cell count (neutrophils) How to use Cyclomide 1G: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Cyclomide 1G is to be taken with food. How Cyclomide 1G works: Cyclomide 1G is an anti-cancer medication. It is an alkylating agent which works by damaging the genetic material (DNA and RNA) of the cancer cells, thereby stopping their growth and multiplication. This is how it works against cancer. Indication: Bone marrow transplantation, malignancies, lymphomas, brain cancer, leukemia, systemic lupus erythematosus, minimal change disease, severe rheumatoid arthritis, wegener's granulomatosis, multiple sclerosis, multiple myeloma, carcinoma of the breast, ovarian carcinoma, neuroblastoma, retinoblastoma. Administration: Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken w/ meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole. IV Preparation Maximum concentration of cyclophosphamide is limited to 20 mg/mL because of solubility IV push: Reconstitute with NS (do not use SWI, because it is hypotonic) Infusion: Reconstitute with SWI to concentration of 20 mg/mL May dilute further with D5W, NS, lactated Ringer solution, or other compatible fluids IV Administration Infusions may be administered over 1-2 hours Doses >500 mg up to ~1 g may be administered over 20-30 minutes... Adult Dose: Malignant Diseases IV (intermittent therapy): 40-50 mg/kg (400-1800 mg/m²) divided over 2-5 days; may be repeated at intervals of 2-4 weeks IV (continuous daily therapy): 60-120 mg/m²/day (1-2.5 mg/kg/day) PO (intermittent therapy): 400-1000 mg/m² divided over 4-5 days PO (continuous daily therapy): 50-100 mg/m²/day or 1-5 mg/kg/day Nephrotic Syndrome 2-3 mg/kg/day for up to 12 weeks when corticosteroids unsuccessful Non-Hodgkin Lymphoma 600-1500 mg/m² IV with other antineoplastics (part of CHOP regimen); dose intensification possible Breast Cancer 600 mg/m² IV with other antineoplastics; dose intensification possible Child Dose: Malignant Diseases IV (intermittent therapy): 40-50 mg/kg (400-1800 mg/m²) divided over 2-5 days; may be repeated at intervals of 2-4 weeks IV (continuous daily therapy): 60-120 mg/m²/day (1-2.5 mg/kg/day) PO (intermittent therapy): 400-1000 mg/m² divided over 4-5 days PO (continuous daily therapy): 50-100 mg/m²/day uvenile Idiopathic Arthritis/Vasculitis 10 mg/kg IV every 2 weeks Nephrotic Syndrome 2-3 mg/kg/day for up to 12 weeks when corticosteroids unsuccessful Systemic Lupus Erythematosus 500-750 mg/m² IV monthly; not to exceed 1 g/m² Contraindication: Bladder haemorrhage. Patients with bone-marrow aplasia, acute infection, drug- or radiation-induced urothelial toxicity. Porphyria. Pregnancy and lactation. Mode of Action: Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle but its main action is blockage at the G2 stage. It arrests cell division by alkylating the DNA in a dose-dependent manner. It also exerts immunosuppressive effects possibly due to a cytotoxic effect on lymphocytes. Precaution: Blood disorders. Elderly or debilitated patients. Diabetic patients. Renal or hepatic impairment or who have gone adrenaloctomy. Previous treatment with x-ray or cytotoxic agents. Monitor haematological profile and presence of RBCs in urine regularly. Maintain adequate hydration and frequent micturition to reduce the risk of cystitis. Lactation: Drug excreted in breast milk; do not nurse Side Effect: Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis. Potentially Fatal: Anaphylactic reactions, bone marrow failure, severe immunosuppression, urotoxicity, cardiotoxicity, hyponatraemia, haemorrhagic cystitis. Pregnancy Category Note: Pregnancy Based on mechanism of action and published reports of effects in pregnant patients or animals, drug can cause fetal harm when administered to pregnant woman; exposure to cyclophosphamide during pregnancy may cause fetal malformations, miscarriage, fetal growth retardation, and toxic effects in the newborn; drug is teratogenic and embryo-fetal toxic in mice, rats, rabbits and monkeys; advise pregnant women and females of reproductive potential of the potential risk to the fetus Verify the pregnancy status of females of reproductive potential prior to the initiation of therapy Contraception Therapy can cause fetal harm; advise females of reproductive potential to use... Interaction: Increased risk of cardiotoxicity w/ doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis w/ protease inhibitors. May increase haematotoxicity and/or immunosuppression w/ ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity w/ amiodarone. May increase nephrotoxicity w/ amphotericin B. May result to acute water intoxication w/ indometacin. May increase risk of hepatotoxicity w/ azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis w/ busulfan. May increase risk of haemorrhagic cystitis w/ previous or concomitant radiotherapy. May result to acute encephalopathy w/ metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May...