Cyclomide® (Cyclophosphamide BP), is a “prodrug”; it is converted in the liver to its active form that has chemotherapeutic activity. Cyclomide is a lyophilized powder containing cyclophosphamide monohydrate. It is a synthetic antineoplastic drug chemically related to the nitrogen mustards. The molecular formula of cyclophosphamide is C7H15Cl2N2O2P•H2O and the molecular weight is 279.1. The chemical name for cyclophosphamide is 2-[bis(2-chloroethyl)amino] tetrahydro 2H- 1, 3, 2-oxazaphosphorine 2-oxide monohydrate and the following structural composition
Each vial contains Cyclophosphamide BP 200 mg & 1 gm lyophilized powder for injection.
Mechanism of action
Cyclophosphamide is first converted by the liver into two active metabolites, acrolein and phosphoramide. Phosphoramide mustard forms DNA crosslink between (interstrand crosslinkages) and within (intrastrand crosslinkages) DNA strands at guanine N-7 positions. This is irreversible and leads to cell death.
Bioavailability N/A Protein binding >60%
Half-life 3-12 hours
Cyclophosphamide BP 200 mg & 1 gm 14 Inj. 15
The main use of cyclophosphamide is together with other chemotherapeutic agents in the treatment of lymphomas, some forms of leukemia and some solid tumors. Also indicated in
immunosuppressive treatment in organ transplantations.
Dosage and administration
High-dose regimens (4 to 7 gm/m2 divided over 4 days) are investigational and should be used only with some kind of stem cell rescue (e.g., bone marrow transplantation) and mesna bladder protection.
Possible side effects
Nephrotoxicity, blood and bone marrow toxicity, hepatic toxicity, gastrointestinal tract toxicity, cardiovascular and pulmonary systems toxicity, SIADH (syndrome of inappropriate secretion of antidiuretic hormone, Schwartz-Bartter syndrome) with hyponatraemia and water retention, inflammation of the skin and mucosa, transient blurred vision and attacks of dizziness.
Cyclophosphamide is contraindicated or should be used with precaution in the following conditions: Allergic to cyclophosphamide or any of its ingredients. Pregnant woman or breastfeeding mother. Reduced white blood cell count.Low platelet count (thrombocytopenia). Chronic liver dysfunction. Chronic kidney dysfunction.
When cyclophosphamide is taken with vaccins, with drugs such as ketoprofen, naproxen, doxorubicin, etanercept, phenobarbital, succinylcholine chloride, trastuzumab, pain killers, filgrastim and pegfilgrastim interactions may occur .
Give dose in the morning, maintain ample fluid intake, and have patient empty bladder several times daily to diminish the likelihood of cystitis.
For Cyclomide® 200 mg inj.: To prepare for parenteral use by adding 10 mL of 0.9% sodium chloride solution.
For Cyclomide® 1 gm inj.: To prepare for parenteral use by adding 50 mL of 0.9% sodium chloride solution.
Reconstituted cyclophosphamide solution for injection and further diluted solutions will be physically and chemically stable for up to 48
16 hours when stored bellow 25˚C and should protected from light. To avoid microbiological contamination it is recommended that solutions are used as soon as possible after preparation. If storage is necessary, hold at 2-8˚C for not more than 48 hours.
Stable for 24 hours at room temperature (25oC) or for six days in the refrigeration (2oC-8oC).
Cyclomide® 200 mg injection: Each box contains 1 vial of
Cyclophosphamide BP 200 mg lyophilized powder for injection.
Cyclomide® 1 gm injection: Each box contains 1 vial of
Cyclophosphamide BP 1 gm lyophilized powder for injection.