"Cyclophosphamide" is an alkylating compound. It is an anticancer drug. Available as a white or nearly so crystalline powder. More about this drug in more detail.
Cyclophosphamide - manufacturer
This drug is manufactured at the Russian enterprise JSC "Biochemistry". It is located in Saransk on Vasenko street, 15A.
Cost
In any pharmacy you can buy powder No. 1 "Cyclophosphamide". Its price fluctuates around 90-98 rubles.
Description of dosage form
A solution is prepared from this powder. It is intended for intramuscular and intravenous administration
Features of the composition
Each vial of powder contains an active type of substance called "cyclophosphamide". Its quantity is definite. Namely, it contains "Cyclophosphamide" 200 mg of the specified substance in one vial. There are no excipients in this medicinal product.
Description of pharmacological action
Based on the instructions for use, "Cyclophosphamide" is an alkylating cytostatic drug. Its chemical composition is similar to substances such as nitrogen analogues of mustard gas. The pharmacological action of "Cyclophosphan" is to carry out the formation of cross-links between DNA and RNA strands. Also, this drug helps to inhibit protein synthesis.
"Cyclophosphamide" - analogues
In this case, those funds are selected that match the ATX code of the fourth category. Quite peculiar is "Cyclophosphamide". Analogues of this drug exist in considerable quantities. The most common are:
- Endoxan.
- Ifosfamide.
- Alkeran.
- Choloxan
- Ribomustine.
- Lakeran.
The selection of each of these drugs is carried out by a doctor on an individual basis. In this case, the state of he alth and the tolerance of the components are taken into account.
When does it apply?
Let's consider this item in more detail. Quite peculiar is the use of such a drug as "Cyclophosphamide". Instructions for use in this regard will be an indispensable assistant. It indicates that this drug is indicated in the following cases:
- When chronic and acute lymphocytic leukemia occurs.
- If you have multiple myeloma.
- When symptoms of non-Hodgkin's lymphoma appear.
- Whenoccurrence of mycosis fungoides and retinoblastoma.
- In the presence of lymphogranulomatosis, as well as ovarian and breast cancer.
- When symptoms of neuroblastoma appear.
In addition to all this, this drug is used in combination with other anticancer drugs for treatment in the following cases:
- For germ cell tumors.
- For bladder and lung cancer.
- For soft tissue sarcoma.
- When prostate and cervical cancer occurs.
- For Ewing's sarcoma.
- In case of Wilms tumors.
- For reticulosarcoma.
Also, a drug such as "Cyclophosphamide", reviews of which are positive, is effective as an immunosuppressive agent in the manifestation of progressive autoimmune diseases. In this case, the occurrence of psoriatic and rheumatoid arthritis, autoimmune hemolytic anemia, collagenosis, nephrotic syndrome is implied. It also suppresses transplant rejection.
Contraindications
"Cyclophosphamide" has certain contraindications. It cannot be used:
- During the period of breastfeeding and pregnancy.
- When there is a pronounced dysfunction of the bone marrow.
- In case of hypersensitivity.
- When urinary retention.
- If there are active infections.
- During manifestation of cystitis.
With cautionit is necessary to appoint "Cyclophosphamide", the analogues of which are indicated above, in certain cases. Namely, in the presence of the following ailments:
- Nephurolithiasis.
- Severe disease of the heart, liver and kidneys.
- Gout.
- Infiltration with tumor cells in the bone marrow.
- Adrenalectomy.
- Inhibition of bone marrow functionality.
Description of side effects
"Cyclophosphamide", synonyms (analogues) of which are indicated above, may contribute to the occurrence of the following side effects:
- Digestive symptoms may include vomiting, nausea, anorexia, discomfort, stomatitis, abdominal pain, diarrhea or constipation. There are also isolated cases of jaundice and hemorrhagic colitis.
- In the hematopoietic system, manifestations of neutropenia, anemia, thrombocytopenia, leukopenia were observed. On the 7-14th day of admission, the number of platelets and leukocytes may slightly decrease.
- Skin manifestations of alopecia were observed. Hair grows back after the drug is completed. In addition, during the treatment period, a rash may appear on the skin. There may also be skin pigmentation and nail changes.
- Cardiotoxicity may occur in the cardiovascular system when high doses of this drug are administered over a long period of time. This is important to remember. In addition, the emergence of complex, and sometimes fatal, cases of heart failure has been observed. This is due tooccurrence of hemorrhagic type myocarditis.
- In the urinary system, necrosis of the renal canals (up to death), hemorrhagic cystitis or urethritis, bladder fibrosis may occur. In rare cases, when using high doses of this drug, nephropathy, hyperuricemia and impaired renal function may occur. In this case, the presence of epithelial cells in the urine may be observed.
- Respiratory system may show interstitial pulmonary fibrosis.
- In the reproductive system, disturbances in oogenesis and spermatogenesis, as well as sterility, may occur. The last symptom in some cases may be irreversible. In most women, when using this remedy, the development of amenorrhea is observed. After the end of treatment, the regularity of menstruation, as a rule, is restored. In men, taking this drug can lead to oligospermia or azoospermia, as well as varying degrees of testicular atrophy.
- In this case, allergic reactions may also occur. Namely, the manifestation of skin rash, itching, urticaria, anaphylactic reactions.
- You may also experience side effects. That is, flushing of the facial skin, hyperemia, the development of malignant secondary tumors, excessive sweating, headaches.
Forms of interaction
When taking this drug, some elements that promote microsomal oxidation in the liver may causeinduced process of microsomal metabolism of cyclophosphamide. This leads to certain factors. Namely, to a large formation of metabolites of the alkylating type. This reduces the period for which the half-life of cyclophosphamide is carried out, and also increases its activity. The intake of cyclophosphamide, which significantly and long-term inhibits the activity of cholinesterase, enhances the action of suxamethonium. It also helps to reduce or slow down the metabolism of cocaine. As a result, the duration of its effect is enhanced or prolonged and the risk of its toxic effects is increased. This has a negative effect on the body as a whole. In addition, simultaneous use with allopurinol may increase the toxic effect on the bone marrow.
When taking cyclophosphamide with allopurinol, colchicine, probenecid, sulfinpyrazone, it may be necessary to adjust the doses of anti-gout-type drugs in the treatment of gout and hyperuricemia. There may also be an increased risk of nephropathy, which is associated with increased production of uric acid when using cyclophosphamide.
The last substance can cause an increase in anticoagulant activity. Since at the same time in the liver the synthesis of factors that contribute to blood clotting and impaired platelet formation is reduced. However, a decrease in anticoagulant activity may also occur through an unknown type of mechanism.
Cyclophosphamide enhances the cardiotoxic effects of daunorubicin and doxorubicin. Otherimmunosuppressants (chlorambucil, azathioprine, cyclosporine, glucocorticosteroids, mercaptopurine, etc.) may increase the possibility of developing secondary tumors and infections.
Concomitant use of lovastatin in heart transplant patients may increase the risk of diseases such as acute skeletal muscle necrosis and acute renal failure.
If myelosuppressive drugs or radiation therapy are used in combination with this drug, additive bone marrow suppression may occur.
Concomitant use of high doses of cytarabine with a substance such as cyclophosphamide in preparation for a bone marrow transplantation leads to a frequent increase in cardiomyopathy with fatal outcome.
Main criteria
The application process takes into account the following:
- During treatment with this drug, regular blood tests should be performed in order to assess the degree of myelosuppression. In this case, it is especially necessary to pay attention to the amount of platelets and neutrophils.
- You should also regularly carry out a urine test for the presence of red blood cells. Their appearance can contribute to the development of a disease such as hemorrhagic cystitis. If such signs are found, treatment with Cyclophosphamide, the price of which is indicated above, must be stopped.
- If the number of platelets (below 100,000 / μl) and / or leukocytes (<2500 / μl) decreases, this drug should be takenstop.
- If infections occur during therapy with this drug, the course of treatment should be discontinued or interrupted. Or in this case, the dosage should be reduced. Men and women during the treatment process with Cyclophosphamide must use reliable methods of contraception.
- Alcohol should be avoided during treatment with this drug.
- In the event that the first ten days have not elapsed after the operation, which was performed under general anesthesia, and the patient is prescribed "Cyclophosphamide", the price of which is indicated above, the anesthesiologist should be informed about this.
- A patient after an adrenalectomy has undergone an adrenalectomy, it is necessary to adjust the dosage of both glucocorticosteroids, which are used for the replacement therapy process, and a drug such as the drug Cyclophosphamide.
Necessary Precautions
This drug should only be taken under the supervision of a physician experienced in chemotherapy. Strict adherence to the dosage regimen is also necessary. This should especially be done in combination therapy. It is also not necessary to double the next dose if the previous one was missed. In the preparation of this drug for use in newborns, it is strongly not recommended to use diluents that contain benzyl alcohol. Since this can lead to the development of a toxic lethal syndrome. Namely tothe occurrence of metabolic acidosis, CNS depression, respiratory failure, renal failure, hypotension, seizures, intracranial hemorrhage.
During the entire treatment course it is recommended to carry out a blood transfusion (1 time per week 100-125 ml). This is necessary in order to prevent diseases such as hyperuricemia and nephropathy, which is caused by the formation of an increased amount of uric acid. Such symptoms often appear at the beginning of the treatment period. Also, before therapy with this drug and during 72 hours after taking it, it is recommended to carry out a certain amount of fluid intake (about 3 liters per day), the use of allopurinol (in special cases) and agents that alkalinize urine. To prevent manifestations of hemorrhagic cystitis, it is often necessary to empty the bladder and take Uromitexan. If the initial signs of this disease appear, then the treatment course with the indicated drug should be stopped until the symptoms that have arisen are completely eliminated.
To reduce the symptoms of dyspeptic type, you can take cyclophosphamide during the first day in small doses. Complete or partial alopecia, which can occur during the treatment period, is reversible and after the end of the course, the function of normal hair growth is restored. However, their color and texture may be subject to change.
If you have chills, fever, cough or hoarseness, pain in your lower back or side, painful or difficult urination, bleedingor bleeding, black stools, blood in stools or urine, seek immediate medical attention.
The possibility of thrombocytopenia leads to the need for special care when performing activities such as invasive procedures and dental interventions. In this case, the skin and mucous membranes and sites of intravenous injections should be regularly examined. This is to look for signs of bleeding. It is also necessary to limit the frequency of venipuncture and abandon intramuscular injections. It is necessary to control the content of blood in feces, vomit, urine. For these patients, it is necessary to carry out the process of shaving, manicure, brushing teeth, using toothpicks, etc. with extreme caution. At the same time, falls and other damage should be strictly avoided. It is also forbidden to take acetylsalicylic acid and alcohol, which increase the risk of gastrointestinal bleeding. In this case, it is necessary to postpone the vaccination schedule (after 3-12 months from the end of the last chemotherapy course). In this case, it is desirable to exclude contact with infectious patients. During treatment, adequate contraceptive measures must be used.
If this product comes into contact with mucous membranes or skin, wash the area thoroughly with plain water or soap, respectively.
When breastfeeding and pregnancy
In this regard, there are peculiar limitations that "Cyclophosphamide" has. Instruction indicatesthat the use of this drug during pregnancy is contraindicated. In this case, the category of exposure to the fetus is designated "D" by the FDA. For the period of treatment, it is necessary to stop breastfeeding.
Overdose
In this case, there are certain nuances. The presence of a specific antidote for overdose of this drug is unknown. This is a true fact. In case of overdose, supportive measures should be implemented, including an appropriate course of treatment for infectious diseases, as well as the occurrence of cardiotoxicity and / or myelosuppression.
Storage conditions
In this regard, a drug such as Cyclophosphamide requires certain conditions. Instructions for use states that it must be stored at a temperature not exceeding 10 ° C in a place that is dry and protected from light. At the same time, children's access to it should be limited.
Expiration date
There is a certain period of time during which you can use a drug such as "Cyclophosphamide". Instructions for use indicate that its shelf life is 3 years. In this case, a certain condition must be observed. It lies in the fact that it is strictly forbidden to use this drug after the expiration of the specified period.
Implementation
In this direction, there is also a condition that "Cyclophosphamide" has. Instructions for use indicate that this drug is dispensed in pharmacies only by prescription.
Conclusion
This text contains a lot of useful information. Namely, what is "Cyclophosphamide", instructions for use, the price of this drug. However, please note that before using this medicine, you should consult a qualified doctor.
