Cycloph 200 Mg (Cyclophosphamide) Injection

Introduction

Cycloph 200 mg (Cyclophosphamide) is a powerful antineoplastic medication used in the treatment of various malignancies and certain non-malignant conditions. As a trusted cytotoxic chemotherapy agent, Cycloph works by interfering with the DNA of cancer cells, preventing their replication and growth. Manufactured by Eskayef Pharmaceuticals Ltd., a leading pharmaceutical company with over 31 years of excellence, and supplied by Orio Pharma, this injection offers healthcare providers a reliable option in their oncological arsenal.

Therapeutic Applications

Malignant Conditions

Cycloph 200 mg demonstrates effectiveness in treating multiple malignancies, including:

Malignant Lymphomas (Stages III and IV): Hodgkin’s disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, and Burkitt’s lymphoma
Multiple Myeloma
Leukemias: Chronic lymphocytic leukemia, chronic granulocytic leukemia, acute myelogenous and monocytic leukemia, and acute lymphoblastic leukemia in children
Advanced Mycosis Fungoides
Neuroblastoma (disseminated disease)
Ovarian Adenocarcinoma
Retinoblastoma
Breast Carcinoma

Non-Malignant Conditions

Cycloph may be prescribed for biopsy-proven “minimal change” nephrotic syndrome in children who don’t respond adequately to corticosteroid therapy or experience intolerable side effects from such treatment. It is not recommended as primary therapy and is not indicated for nephrotic syndrome in adults or other renal diseases.

Mechanism of Action

Cyclophosphamide undergoes biotransformation primarily in the liver through a mixed function microsomal oxidase system, converting it to active alkylating metabolites. These metabolites interfere with the DNA of rapidly proliferating cancer cells by cross-linking tumor cell DNA, thereby inhibiting cell division and leading to cell death. The medication demonstrates excellent bioavailability (>75%) when administered orally, with an elimination half-life of 3-12 hours. While primarily eliminated as metabolites, 5-25% is excreted unchanged in urine.

Dosage and Administration

For Malignant Diseases:

Initial course (adults and children): 40-50 mg/kg intravenously in divided doses over 2-5 days
Alternative intravenous regimens: 10-15 mg/kg every 7-10 days or 3-5 mg/kg twice weekly
Oral dosing: 1-5 mg/kg/day for both initial and maintenance therapy

Dosage adjustments should be made based on evidence of antitumor activity and/or leukopenia. The total leukocyte count serves as an effective guide for regulating dosage, with transient decreases to 2000 cells/mm³ or more persistent reduction to 3000 cells/mm³ generally tolerated without serious infection risk in the absence of marked granulocytopenia.

When used in combination with other cytotoxic agents, dose reduction may be necessary for Cycloph and other medications in the regimen.

For Non-Malignant Diseases:

Minimal Change Nephrotic Syndrome in Children: 2.5-3 mg/kg orally daily for 60-90 days

Drug Interactions

Healthcare providers should be aware of potential interactions with:

Phenobarbital: Chronic administration of high doses may increase metabolism and leukopenic activity of Cycloph
Succinylcholine chloride: Cycloph potentiates its effect due to marked inhibition of cholinesterase activity
Other cytotoxic drugs: Monitor for combined actions, both desirable and undesirable

Anesthesiologists should be alerted if a patient has received Cycloph within 10 days of general anesthesia.

Contraindications

Cycloph is contraindicated in:

Patients with severely depressed bone marrow function
Patients with previous hypersensitivity to cyclophosphamide

Adverse Effects

Digestive System:

Common: Nausea, vomiting, anorexia
Less frequent: Abdominal discomfort, pain, diarrhea
Rare: Hemorrhagic colitis, oral mucosal ulceration, jaundice

Skin and Associated Structures:

Common: Alopecia (hair typically regrows, possibly with different texture/color)
Occasional: Skin rash
Rare: Pigmentation changes, nail changes, Stevens-Johnson syndrome, toxic epidermal necrolysis

Hematopoietic System:

Common: Leukopenia
Occasional: Thrombocytopenia, anemia
Other: Fever without documented infection in neutropenic patients

Urinary System:

Hemorrhagic ureteritis
Renal tubular necrosis

Respiratory System:

Interstitial pneumonitis
Pulmonary fibrosis (with high doses over prolonged periods)

Other:

Anaphylactic reactions
SIADH (syndrome of inappropriate ADH secretion)
Malaise and asthenia

Special Populations

Pregnancy and Lactation:

Pregnancy Category D: Potential for fetal harm exists
Breastfeeding: Cyclophosphamide is excreted in breast milk; discontinuation of nursing or the medication should be considered

Pediatric Use:

Safety profile similar to adult population

Geriatric Use:

Elderly patients may be more susceptible to Cycloph toxicities
Cautious dosing recommended, starting at lower end of dosing range with adjustments based on response

Precautions

Special attention required for patients with:

Leukopenia
Thrombocytopenia
Bone marrow infiltration by tumor cells
Previous radiation therapy
Previous cytotoxic agent therapy
Impaired hepatic function
Impaired renal function

Overdose Management

No specific antidote exists. Treatment involves supportive measures, including appropriate management of infections, myelosuppression, and cardiac toxicity if they occur.

Storage Conditions

Store at temperatures not exceeding 25°C in a dry place. Protect from light and moisture. Do not freeze.

Conclusion

Cycloph 200 mg (Cyclophosphamide) Injection represents a cornerstone in cancer therapy, offering effective treatment for multiple malignancies while requiring careful monitoring for adverse effects. With proper administration and vigilant patient care, this medication provides healthcare providers with a valuable tool in their fight against cancer.

Manufactured by Eskayef Pharmaceuticals Ltd. and supplied by Orio Pharma, ensuring worldwide delivery within 3-7 working days, Cycloph maintains the highest standards of quality and efficacy in oncology treatment.