Difference between revisions of "Cyclophosphamide (Cytoxan)"
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==General information== | ==General information== | ||
| − | Class/mechanism: Alkylating agent; transformed primarily in the liver to active metabolites which alkylate and crosslink DNA.<ref name="insert">[ | + | Class/mechanism: Alkylating agent; transformed primarily in the liver to active metabolites which alkylate and crosslink DNA.<ref name="insert">[https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=28143049-ae3f-4b4b-be46-7db7dbd603c4 Cyclophosphamide (Cytoxan) package insert]</ref><ref>[[:File:Cyclophosphamide.pdf | Cyclophosphamide (Cytoxan) package insert (locally hosted backup)]]</ref> |
<br>Route: IV, PO | <br>Route: IV, PO | ||
<br>Extravasation: [[irritant]] or [[neutral]], depending on reference; n/a | <br>Extravasation: [[irritant]] or [[neutral]], depending on reference; n/a | ||
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://reference.medscape.com/drug/cytoxan-cyclophosphamide-342214 Medscape],[http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref> | For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://reference.medscape.com/drug/cytoxan-cyclophosphamide-342214 Medscape],[http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref> | ||
| + | |||
| + | ==Diseases for which it is established ''(work in progress)''== | ||
| + | *Non-Hodgkin lymphoma | ||
| + | **[[Follicular lymphoma]] | ||
| + | **[[Mantle cell lymphoma]] | ||
| + | **[[Peripheral T-cell lymphoma]] | ||
==Diseases for which it is used== | ==Diseases for which it is used== | ||
<div style="column-count:3;-moz-column-count:3;-webkit-column-count:3"> | <div style="column-count:3;-moz-column-count:3;-webkit-column-count:3"> | ||
| − | *[[Acquired | + | *[[Acquired hemophilia A]] |
| + | *[[Acute lymphoblastic leukemia, infant]] | ||
*[[Acute myeloid leukemia]] | *[[Acute myeloid leukemia]] | ||
| − | *[[Adult T-cell leukemia | + | *[[Adult T-cell leukemia-lymphoma]] |
*[[Anaplastic glioma]] | *[[Anaplastic glioma]] | ||
*[[Anaplastic large cell lymphoma]] | *[[Anaplastic large cell lymphoma]] | ||
| Line 17: | Line 24: | ||
*[[Breast cancer]] | *[[Breast cancer]] | ||
*[[Burkitt lymphoma]] | *[[Burkitt lymphoma]] | ||
| + | *[[Castleman disease]] | ||
*[[Central nervous system (CNS) cancer]] | *[[Central nervous system (CNS) cancer]] | ||
| − | *[[Chronic lymphocytic leukemia | + | *[[Chronic lymphocytic leukemia]] |
| − | *[[Chronic | + | *[[Chronic myeloid leukemia]] |
*[[CNS lymphoma]] | *[[CNS lymphoma]] | ||
*[[Diffuse large B-cell lymphoma]] | *[[Diffuse large B-cell lymphoma]] | ||
*[[Ewing sarcoma]] | *[[Ewing sarcoma]] | ||
| − | *[[ | + | *[[Gestational trophoblastic neoplasia]] |
*[[Glioblastoma]] | *[[Glioblastoma]] | ||
| + | *[[Graft versus host disease]] | ||
| + | *[[High-grade B-cell lymphoma]] | ||
*[[HIV-associated lymphoma]] | *[[HIV-associated lymphoma]] | ||
| − | *[[Hodgkin lymphoma]] | + | *[[Classical Hodgkin lymphoma]] |
*[[Hodgkin lymphoma, nodular lymphocyte-predominant]] | *[[Hodgkin lymphoma, nodular lymphocyte-predominant]] | ||
*[[Large granular lymphocytic leukemia]] | *[[Large granular lymphocytic leukemia]] | ||
*[[Light-chain (AL) amyloidosis]] | *[[Light-chain (AL) amyloidosis]] | ||
| − | |||
*[[Marginal zone lymphoma]] | *[[Marginal zone lymphoma]] | ||
*[[Mediastinal gray-zone lymphoma]] | *[[Mediastinal gray-zone lymphoma]] | ||
*[[Medulloblastoma]] | *[[Medulloblastoma]] | ||
*[[Multiple myeloma]] | *[[Multiple myeloma]] | ||
| + | *[[Neuroblastoma]] | ||
*[[Osteosarcoma]] | *[[Osteosarcoma]] | ||
| − | |||
*[[Pheochromocytoma]] | *[[Pheochromocytoma]] | ||
*[[Plasma cell leukemia]] | *[[Plasma cell leukemia]] | ||
| Line 42: | Line 51: | ||
*[[Primary mediastinal B-cell lymphoma]] | *[[Primary mediastinal B-cell lymphoma]] | ||
*[[Prostate cancer]] | *[[Prostate cancer]] | ||
| − | *[[ | + | *[[Rhabdomyosarcoma]] |
*[[T-cell acute lymphoblastic leukemia]] | *[[T-cell acute lymphoblastic leukemia]] | ||
*[[Thymoma]] | *[[Thymoma]] | ||
*[[Transformed lymphoma]] | *[[Transformed lymphoma]] | ||
| + | *[[Urothelial carcinoma]] | ||
*[[Waldenström macroglobulinemia]] | *[[Waldenström macroglobulinemia]] | ||
</div> | </div> | ||
| + | |||
| + | ==Diseases for which it was used== | ||
| + | *[[Non-small cell lung cancer - historical|Non-small cell lung cancer]] | ||
| + | *[[Ovarian cancer - historical|Ovarian cancer]] | ||
| + | *[[Renal cell carcinoma - historical|Renal cell carcinoma]] | ||
| + | *[[Small cell lung cancer - historical|Small cell lung cancer]] | ||
| + | *[[Testicular cancer - historical|Testicular cancer]] | ||
==Patient drug information== | ==Patient drug information== | ||
| − | *[ | + | *[https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=28143049-ae3f-4b4b-be46-7db7dbd603c4 Cyclophosphamide (Cytoxan) package insert]<ref name="insert"></ref> |
| + | *[https://chemocare.com/druginfo/cyclophosphamide.aspx Cyclophosphamide (Cytoxan) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/cyclophosphamide.aspx Cyclophosphamide (Cytoxan) patient drug information (Chemocare)]</ref> | ||
*[http://www.uptodate.com/contents/cyclophosphamide-patient-drug-information Cyclophosphamide (Cytoxan) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/cyclophosphamide-patient-drug-information Cyclophosphamide (Cytoxan) patient drug information (UpToDate)]</ref> | *[http://www.uptodate.com/contents/cyclophosphamide-patient-drug-information Cyclophosphamide (Cytoxan) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/cyclophosphamide-patient-drug-information Cyclophosphamide (Cytoxan) patient drug information (UpToDate)]</ref> | ||
==History of changes in FDA indication== | ==History of changes in FDA indication== | ||
| − | *11 | + | *1959-11-16: initial FDA approval |
| + | *2012-03-31 (oldest label available at Drugs @ FDA): Approved for [[:Category:Lymphomas|malignant lymphomas]] (Stages III and IV of the Ann Arbor staging system), [[Classical Hodgkin lymphoma|Hodgkin’s disease]], lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, [[Diffuse large B-cell lymphoma|histiocytic lymphoma]], [[Burkitt lymphoma]]; [[multiple myeloma]], leukemias: [[Chronic lymphocytic leukemia]], [[Chronic myeloid leukemia|chronic granulocytic leukemia]] (it is usually ineffective in acute blastic crisis), [[Acute myeloid leukemia|acute myelogenous and monocytic leukemia]], [[:Category:Acute lymphoblastic leukemias|acute lymphoblastic (stem-cell) leukemia]] in children (cyclophosphamide given during remission is effective in prolonging its duration); [[Cutaneous T-cell lymphoma|mycosis fungoides]] (advanced disease); [[neuroblastoma]] (disseminated disease); [[Ovarian cancer|adenocarcinoma of ovary]]; [[retinoblastoma]]; [[Breast cancer|carcinoma of the breast]] ''(No supporting studies are cited)'' | ||
| + | ==History of changes in EMA indication== | ||
| + | *1958-10-13: EURD | ||
| + | ==History of changes in PMDA indication== | ||
| + | *2013-03-25: New additional indication and a new dosage for the treatment of [[pheochromocytoma]]. | ||
| + | *2015-06-26: revised indication and a new dosage for the relief of symptoms of [[:Category:Lymphomas|malignant lymphoma]]. | ||
| + | *2019-03-26: New indication for the treatment prior to tumor-specific T-cell infusion therapy. | ||
| + | *2021-08-21: New indication and a new dosage for the treatment of [[Light-chain (AL) amyloidosis|systemic AL amyloidosis]]. | ||
==Also known as== | ==Also known as== | ||
| − | *'''Code names:''' | + | *'''Code names:''' B-518, WR-138719 |
*'''Generic names:''' CP monohydrate, CPM, cyclophosphamid monohydrate, cyclophosphamide monohydrate | *'''Generic names:''' CP monohydrate, CPM, cyclophosphamid monohydrate, cyclophosphamide monohydrate | ||
*'''Brand names:''' | *'''Brand names:''' | ||
| Line 131: | Line 157: | ||
[[Category:Intravenous medications]] | [[Category:Intravenous medications]] | ||
[[Category:Oral medications]] | [[Category:Oral medications]] | ||
| − | [[Category:Irritant | + | [[Category:Irritant]] |
| − | [[Category:Neutral | + | [[Category:Neutral]] |
[[Category:Alkylating agents]] | [[Category:Alkylating agents]] | ||
| Line 138: | Line 164: | ||
[[Category:Immunosuppressants]] | [[Category:Immunosuppressants]] | ||
| − | [[Category:Acquired | + | [[Category:Acquired hemophilia A medications]] |
| + | [[Category:Acute lymphoblastic leukemia, infant medications]] | ||
[[Category:Acute myeloid leukemia medications]] | [[Category:Acute myeloid leukemia medications]] | ||
| − | [[Category:Adult T-cell leukemia | + | [[Category:Adult T-cell leukemia-lymphoma medications]] |
[[Category:Anaplastic glioma medications]] | [[Category:Anaplastic glioma medications]] | ||
[[Category:Anaplastic large cell lymphoma medications]] | [[Category:Anaplastic large cell lymphoma medications]] | ||
| Line 147: | Line 174: | ||
[[Category:Breast cancer medications]] | [[Category:Breast cancer medications]] | ||
[[Category:Burkitt lymphoma medications]] | [[Category:Burkitt lymphoma medications]] | ||
| + | [[Category:Castleman disease medications]] | ||
[[Category:CNS lymphoma medications]] | [[Category:CNS lymphoma medications]] | ||
[[Category:Chronic lymphocytic leukemia medications]] | [[Category:Chronic lymphocytic leukemia medications]] | ||
| − | [[Category:Chronic | + | [[Category:Chronic myeloid leukemia medications]] |
[[Category:Diffuse large B-cell lymphoma medications]] | [[Category:Diffuse large B-cell lymphoma medications]] | ||
[[Category:Ewing sarcoma medications]] | [[Category:Ewing sarcoma medications]] | ||
[[Category:Follicular lymphoma medications]] | [[Category:Follicular lymphoma medications]] | ||
| + | [[Category:Gestational trophoblastic neoplasia medications]] | ||
[[Category:Glioblastoma medications]] | [[Category:Glioblastoma medications]] | ||
| + | [[Category:Graft versus host disease medications]] | ||
| + | [[Category:High-grade B-cell lymphoma medications]] | ||
[[Category:HIV-associated lymphoma medications]] | [[Category:HIV-associated lymphoma medications]] | ||
| − | [[Category:Hodgkin lymphoma medications]] | + | [[Category:Classical Hodgkin lymphoma medications]] |
[[Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications]] | [[Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications]] | ||
[[Category:Large granular lymphocytic leukemia medications]] | [[Category:Large granular lymphocytic leukemia medications]] | ||
| Line 164: | Line 195: | ||
[[Category:Medulloblastoma medications]] | [[Category:Medulloblastoma medications]] | ||
[[Category:Multiple myeloma medications]] | [[Category:Multiple myeloma medications]] | ||
| + | [[Category:Neuroblastoma medications]] | ||
[[Category:Osteosarcoma medications]] | [[Category:Osteosarcoma medications]] | ||
[[Category:Peripheral T-cell lymphoma medications]] | [[Category:Peripheral T-cell lymphoma medications]] | ||
| Line 171: | Line 203: | ||
[[Category:Primary mediastinal B-cell lymphoma medications]] | [[Category:Primary mediastinal B-cell lymphoma medications]] | ||
[[Category:Prostate cancer medications]] | [[Category:Prostate cancer medications]] | ||
| − | [[Category: | + | [[Category:Rhabdomyosarcoma medications]] |
[[Category:T-cell acute lymphoblastic leukemia medications]] | [[Category:T-cell acute lymphoblastic leukemia medications]] | ||
[[Category:Thymoma medications]] | [[Category:Thymoma medications]] | ||
[[Category:Transformed lymphoma medications]] | [[Category:Transformed lymphoma medications]] | ||
| + | [[Category:Urothelial carcinoma medications]] | ||
[[Category:Waldenström macroglobulinemia medications]] | [[Category:Waldenström macroglobulinemia medications]] | ||
| + | |||
| + | [[Category:Non-small cell lung cancer medications (historic)]] | ||
| + | [[Category:Ovarian cancer medications (historic)]] | ||
| + | [[Category:Renal cell carcinoma medications (historic)]] | ||
| + | [[Category:Small cell lung cancer medications (historic)]] | ||
| + | [[Category:Testicular cancer medications (historic)]] | ||
[[Category:FDA approved in 1959]] | [[Category:FDA approved in 1959]] | ||
| + | [[Category:EMA approved in 1958]] | ||
[[Category:PMDA approved drugs]] | [[Category:PMDA approved drugs]] | ||
[[Category:WHO Essential Cancer Medicine]] | [[Category:WHO Essential Cancer Medicine]] | ||
Latest revision as of 11:37, 6 January 2024
General information
Class/mechanism: Alkylating agent; transformed primarily in the liver to active metabolites which alkylate and crosslink DNA.[1][2]
Route: IV, PO
Extravasation: irritant or neutral, depending on reference; n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape,UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is established (work in progress)
- Non-Hodgkin lymphoma
Diseases for which it is used
- Acquired hemophilia A
- Acute lymphoblastic leukemia, infant
- Acute myeloid leukemia
- Adult T-cell leukemia-lymphoma
- Anaplastic glioma
- Anaplastic large cell lymphoma
- B-cell acute lymphoblastic leukemia
- Bladder cancer
- Breast cancer
- Burkitt lymphoma
- Castleman disease
- Central nervous system (CNS) cancer
- Chronic lymphocytic leukemia
- Chronic myeloid leukemia
- CNS lymphoma
- Diffuse large B-cell lymphoma
- Ewing sarcoma
- Gestational trophoblastic neoplasia
- Glioblastoma
- Graft versus host disease
- High-grade B-cell lymphoma
- HIV-associated lymphoma
- Classical Hodgkin lymphoma
- Hodgkin lymphoma, nodular lymphocyte-predominant
- Large granular lymphocytic leukemia
- Light-chain (AL) amyloidosis
- Marginal zone lymphoma
- Mediastinal gray-zone lymphoma
- Medulloblastoma
- Multiple myeloma
- Neuroblastoma
- Osteosarcoma
- Pheochromocytoma
- Plasma cell leukemia
- Post-transplant lymphoproliferative disorder
- Primary mediastinal B-cell lymphoma
- Prostate cancer
- Rhabdomyosarcoma
- T-cell acute lymphoblastic leukemia
- Thymoma
- Transformed lymphoma
- Urothelial carcinoma
- Waldenström macroglobulinemia
Diseases for which it was used
- Non-small cell lung cancer
- Ovarian cancer
- Renal cell carcinoma
- Small cell lung cancer
- Testicular cancer
Patient drug information
- Cyclophosphamide (Cytoxan) package insert[1]
- Cyclophosphamide (Cytoxan) patient drug information (Chemocare)[3]
- Cyclophosphamide (Cytoxan) patient drug information (UpToDate)[4]
History of changes in FDA indication
- 1959-11-16: initial FDA approval
- 2012-03-31 (oldest label available at Drugs @ FDA): Approved for malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin’s disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt lymphoma; multiple myeloma, leukemias: Chronic lymphocytic leukemia, chronic granulocytic leukemia (it is usually ineffective in acute blastic crisis), acute myelogenous and monocytic leukemia, acute lymphoblastic (stem-cell) leukemia in children (cyclophosphamide given during remission is effective in prolonging its duration); mycosis fungoides (advanced disease); neuroblastoma (disseminated disease); adenocarcinoma of ovary; retinoblastoma; carcinoma of the breast (No supporting studies are cited)
History of changes in EMA indication
- 1958-10-13: EURD
History of changes in PMDA indication
- 2013-03-25: New additional indication and a new dosage for the treatment of pheochromocytoma.
- 2015-06-26: revised indication and a new dosage for the relief of symptoms of malignant lymphoma.
- 2019-03-26: New indication for the treatment prior to tumor-specific T-cell infusion therapy.
- 2021-08-21: New indication and a new dosage for the treatment of systemic AL amyloidosis.
Also known as
- Code names: B-518, WR-138719
- Generic names: CP monohydrate, CPM, cyclophosphamid monohydrate, cyclophosphamide monohydrate
- Brand names:
| Synonyms | |||||||
|---|---|---|---|---|---|---|---|
| Alkyloxan | Biodoxan | Carloxan | Ciclofosfamida | Ciclokebir | Cicloxal | Clafen | Claphene |
| Cyclam | Cycloblastin | Cycloblastine | CYCLO-cell | Cycloferon | Cyclomide | Cyclophar | Cyclophospham |
| Cyclophosphamid | Cyclophosphane | Cyclostin | Cyclostine | Cyclotox | Cycloxan | Cycram | Cydoxan |
| Cyklofosfamid | Cyphos | Cytophosphan | Cytoxan | Cytoxan Lyophilized | Endoxan | Endoxan-N | Endoxana |
| Enduxan | Formitex | Fosfaseron | Genoxal | Genuxal | Hidrofosmin | Ledoxan | Ledoxina |
| Mitoxan | Neophos | Neosar | Oncomide | Oncophos | Procytox | Revimmune | Sendoxan |
| Siklofos | Syklofosfamid | Tymtran | Zuviphos | Zycram | Zytoxan | ||
References
Categories:
- Drugs
- Intravenous medications
- Oral medications
- Irritant
- Neutral
- Alkylating agents
- Nitrogen mustards
- Immunosuppressants
- Acquired hemophilia A medications
- Acute lymphoblastic leukemia, infant medications
- Acute myeloid leukemia medications
- Adult T-cell leukemia-lymphoma medications
- Anaplastic glioma medications
- Anaplastic large cell lymphoma medications
- B-cell acute lymphoblastic leukemia medications
- Bladder cancer medications
- Breast cancer medications
- Burkitt lymphoma medications
- Castleman disease medications
- CNS lymphoma medications
- Chronic lymphocytic leukemia medications
- Chronic myeloid leukemia medications
- Diffuse large B-cell lymphoma medications
- Ewing sarcoma medications
- Follicular lymphoma medications
- Gestational trophoblastic neoplasia medications
- Glioblastoma medications
- Graft versus host disease medications
- High-grade B-cell lymphoma medications
- HIV-associated lymphoma medications
- Classical Hodgkin lymphoma medications
- Hodgkin lymphoma, nodular lymphocyte-predominant medications
- Large granular lymphocytic leukemia medications
- Light-chain (AL) amyloidosis medications
- Mantle cell lymphoma medications
- Marginal zone lymphoma medications
- Mediastinal gray-zone lymphoma medications
- Medulloblastoma medications
- Multiple myeloma medications
- Neuroblastoma medications
- Osteosarcoma medications
- Peripheral T-cell lymphoma medications
- Pheochromocytoma medications
- Plasma cell leukemia medications
- Post-transplant lymphoproliferative disorder medications
- Primary mediastinal B-cell lymphoma medications
- Prostate cancer medications
- Rhabdomyosarcoma medications
- T-cell acute lymphoblastic leukemia medications
- Thymoma medications
- Transformed lymphoma medications
- Urothelial carcinoma medications
- Waldenström macroglobulinemia medications
- Non-small cell lung cancer medications (historic)
- Ovarian cancer medications (historic)
- Renal cell carcinoma medications (historic)
- Small cell lung cancer medications (historic)
- Testicular cancer medications (historic)
- FDA approved in 1959
- EMA approved in 1958
- PMDA approved drugs
- WHO Essential Cancer Medicine