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Last Updated on January 15, 2019

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The active ingredient Cyclophosphamide is a cytostatic drug and is used to treat cancer and severe autoimmune diseases. It will help to get this serious disease under control quickly, but then often replaced in the course because of its extreme toxicity by other agents. Cyclophosphamide is related to chemical warfare agent mustard gas the. Read more about effects and use of Cyclophosphamide, side effects and interactions!

How Cyclophosphamide works

The active compound Cyclophosphamide is a so called “prodrug” – it is only converted in the body into the active form, mainly in the liver. This active form is then transported via the blood through the body and so reaches the various tissues. Depending on the type of fabric and its Enzyme equipment Cyclophosphamide acts more or less toxic to the cells: in the soft tissue, nerve tissue and blood progenitor cells, it is less well detoxified and thus against the uninhibited growth, such as occurs in cancer, act. It penetrates the cells and breaks down into two very toxic decomposition products, which attack the enzymes of the cell, and above all the genetic material and damage. The so modified genetic material can not be correctly read and copied what the division more difficult, or at best avoided. This of course applies especially rapidly dividing cells such as cancer cells.

Up, degradation and excretion of Cyclophosphamide

After taking Cyclophosphamide is taken entirely from the gut into the bloodstream and reaches the liver. There is activated and released back into the blood, which brings it to its site of action. The drug is primarily excreted through the kidneys into the urine. Over a period of seven hours in adults and four hours in children of drug is excreted about half.

When is Cyclophosphamide used?

preparations containing the active substance Cyclophosphamide are allowed:

  • to treat cancers of the bone marrow (leukemia, “blood cancer”), the lymphatic system, breast, ovaries, lung, bone and central nervous system
  • for the treatment of autoimmune diseases (Wegener’s granulomatosis, and lupus nephritis)
  • to prepare for a bone marrow transplant

Because of the severe side effects the treatment is kept as short as possible.

How Cyclophosphamide is applied

The chemotherapy drug Cyclophosphamide is usually administered directly as infusion or injection. The infusion time is approximately one-half to two hours. In a few therapeutic schedules the active ingredient can also be added in the form of tablets. These are taken in the morning with plenty of fluids.

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It is important for each chemotherapy that the patient holds very closely to the treatment plan drawn up by the physician. Most treatments include the administration of other chemotherapeutic agents or radiation – the combination increases the chances of recovery usually causing enormous

What are the side effects of Cyclophosphamide?

Like all cytostatics Cyclophosphamide has numerous side effects that occur usually dose-dependent more or less pronounced.

For more than ten percent of patients treated with Cyclophosphamide patients blood formation in the bone marrow is suppressed, reducing the number of blood cells and suppresses the immune system. In addition, there are often, cystitis, blood in the urine and fever.

Common Cyclophosphamide side effects are infections, liver dysfunction, impaired sperm production in the testes, chills, weakness, fatigue and discomfort.

Some side effects such as nausea can be personalized with taking other drugs lessen.

What must be observed during treatment with Cyclophosphamide?

The chemotherapy drug Cyclophosphamide is numerous interactions with other drugs a, particularly those off in the liver or be converted and thus influence the activation of Cyclophosphamide.

Certain medications can inhibit the activation of Cyclophosphamide and thereby reduce its effectiveness. These drugs include agents against fungal infections (Fluconazole, itraconazole), some antibiotics (Chloramphenicol, Ciprofloxacin, sulfamethoxazole) and other cytotoxic agents (busulfan, thiotepa).

Conversely, there are also medications that increase the activation of Cyclophosphamide and thereby increase the risk of side effects. Examples of such drugs are remedies and seizures (phenobarbital, Carbamazepine, Phenytoin), HIV drugs (protease inhibitors such as ritonavir), the gout agent Allopurinol, cimetidine (for heartburn) and the soporific chloral hydrate.

The combination of Cyclophosphamide with hypertension agents (ACE inhibitors such as Ramipril, Enalapril) and diuretics (Hydrochlorothiazide, HCT) can severely damage the hematopoietic system and the immune system.

The suppressing the immune system leading to frequent infections that require treatment with antibiotics partially. The choice of an antibiotic which does not interfere with Cyclophosphamide, is absolutely necessary.

The healing is restricted during the treatment.

Since Cyclophosphamide may also damage healthy cells in the body that occurs in a small percentage of patients, a so-called secondary malignancy on – a tumor due to treatment with Cyclophosphamide

The drug Cyclophosphamide also damages the cells of the germline (eggs and sperm) massively. Prior therapy should therefore be considered to have taken gametes for possible future fertility.

During therapy in men and up to six months after that must be strictly ensured a safe contraception, because Cyclophosphamide leads to DNA damage of germ cells. This miscarriages and birth defects may occur. For the same reason are pregnant, nursing mothers not treated with Cyclophosphamide.

After rigorous risk-benefit assessment by the physician also children, adolescents, patients with renal or hepatic impairment and elderly patients may be treated with Cyclophosphamide in a correspondingly reduced dose.

How to obtain drugs with Cyclophosphamide

The injections and infusions are administered directly by a doctor at the hospital. The need for outpatient therapy Cyclophosphamide tablets are prescription based on the pharmacy.

Since when Cyclophosphamide is known?

The chemotherapy drug Cyclophosphamide was in the 1950s by scientists at the pharmaceutical company Asta Medica (now Baxter Oncology) developed in search of descendants of mustard gas. In 1962 granted patent is now expired, but the active ingredient Cyclophosphamide is still made only by a pharmaceutical manufacturer.