CYCLOPHOSPHAMIDE

Cyclophosphamide is a chemotherapy medicine first developed during the 1950s by scientists at the pharmaceutical company Boehringer Ingelheim. It was introduced for clinical use in 1959 and has since become an important treatment for several cancers and autoimmune disorders. Its approval by regulatory authorities, including the U.S. Food and Drug Administration (FDA), represented a major advancement in cancer therapy. Today, cyclophosphamide is widely used in oncology and rheumatology because of its ability to act against rapidly dividing cells. Clinical studies have shown that cyclophosphamide can inhibit the growth of different cancers, including breast cancer, lymphoma, leukaemia, and multiple myeloma. Its role in treating autoimmune conditions such as lupus and rheumatoid arthritis has also been extensively investigated. Ongoing clinical research continues to evaluate new indications, dosing approaches, and combination therapies to enhance treatment outcomes.

Cancer Treatment (breast cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, leukaemia, ovarian cancer) Autoimmune Disorders (lupus nephritis, rheumatoid arthritis, systemic vasculitis) Bone Marrow Transplantation (pre-chemotherapy) Immunosuppressive Therapy (for certain autoimmune conditions)

Cyclophosphamide is available in the form of a tablet and injections. The recommended Cyclophosphamide dose for tablets is 50mg and injection is 1gm, 200mg, 500mg, 1000mg . Depending on your age, weight, and disease condition, your doctor will determine your appropriate dose and duration. Do not stop using this medicine unless your doctor instructs you.

Common side effects include: Nausea and vomiting Hair loss (alopecia) Fatigue Loss of appetite Increased susceptibility to infections Bladder irritation and blood in urine (especially with high doses) Less common but serious side effects include liver toxicity, cardiomyopathy, and lung fibrosis. Immediate medical attention is required if any unusual symptoms or severe side effects occur.

Cyclophosphamide may cause severe bone marrow suppression, leading to neutropenia and thrombocytopenia. Monitoring blood counts during treatment is essential. The drug is teratogenic, meaning it can cause birth defects or miscarriage, and should not be used during pregnancy unless absolutely necessary. Increased risk of infections: Since cyclophosphamide weakens the immune system, it may increase susceptibility to infections, particularly bacterial, fungal, or viral. Risk of secondary malignancies: Long-term use of cyclophosphamide has been associated with an increased risk of secondary cancers, such as leukaemia and bladder cancer.

Treatment with this medicine may lead to immune suppression, bone marrow failure, cardiotoxicity, renal toxicity, pulmonary toxicity, and secondary malignancies. Inform your doctor if you have pre-existing kidney disease, immune conditions, cardiac disorders, or liver diseases. Hydration is critical when receiving cyclophosphamide intravenously to reduce the risk of hemorrhagic cystitis, a condition that can damage the bladder.

Inform the doctor of any existing kidney, liver, or heart dysfunction and all medications being taken for other medical conditions. This drug causes immune suppression; disclose any immunocompromised state or immunity-related disorders to your doctor. Cyclophosphamide should be avoided in pregnant patients and those who are breastfeeding. Patients undergoing treatment with this medicine may experience dizziness and blurred vision. Exercise caution before driving or operating heavy machinery.

Baxter, Electronic medicines compendium (emc), [ Revised on June 2016] [ Accessed on 8th April 2021], https://www.medicines.org.uk/emc/product/1815/smpc Baxter, US Food and Drug Administration, [ Revised on May 2013] [ Accessed on 7th April 2021], https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/012141s090,012142s112lbl.pdf KD Tripathi, Essentials of Medical Pharmacology, Anticancer drugs, 7th edition, 2013, 860.