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">[http://packageinserts.bms.com/pi/pi_cytoxan.pdf Cyclophosphamide (Cytoxan) package insert]</ref><ref>[[Media:Cyclophosphamide.pdf | Cyclophosphamide (Cytoxan) package insert (locally hosted backup)]]</ref>
+
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: no information, 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==
−
*[[Acute lymphocytic leukemia]]
+
<div style="column-count:3;-moz-column-count:3;-webkit-column-count:3">
−
*[[Bone cancer]]
+
*[[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]]
 
*[[Breast cancer]]
−
*[[Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL)]]
+
*[[Burkitt lymphoma]]
−
*[[Hodgkin 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]]
 
*[[Multiple myeloma]]
−
*[[Non-Hodgkin lymphoma]]
+
*[[Neuroblastoma]]
 +
*[[Osteosarcoma]]
 +
*[[Pheochromocytoma]]
 +
*[[Plasma cell leukemia]]
 +
*[[Post-transplant lymphoproliferative disorder]]
 +
*[[Primary mediastinal B-cell lymphoma]]
 +
*[[Prostate cancer]]
 +
*[[Rhabdomyosarcoma]]
 +
*[[T-cell acute lymphoblastic leukemia]]
 
*[[Thymoma]]
 
*[[Thymoma]]
−
*[[Transplant conditioning regimens]]
+
*[[Transformed lymphoma]]
 +
*[[Urothelial carcinoma]]
 +
*[[Waldenström macroglobulinemia]]
 +
</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==
−
*[http://chemocare.com/chemotherapy/drug-info/cyclophosphamide.aspx Cyclophosphamide (Cytoxan) patient drug information (Chemocare)]<ref>[http://chemocare.com/chemotherapy/drug-info/cyclophosphamide.aspx Cyclophosphamide (Cytoxan) patient drug information (Chemocare)]</ref>
+
*[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==
 +
*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==
−
Alkyloxan, Biodoxan, Carloxan, Ciclofosfamida, Ciclofosfamida Filaxis, Ciclofosfamida Martian, Ciclokebir, Cyclam, Cycloblastin, Cycloblastine, Cyclo Cell, Cycloferon, Cyclomide, Cyclophar, Cyclophospham, Cyclophosphamid, cyclophosphamide monohydrate, Cyclophosphamid Farmos, Cyclophosphan, Cyclophosphan Lens, Cyclostin, Cycloxan, Cycram, Cydoxan, Cyklofosfamid, Cytophosphan, Cytoxan, Cytoxan Lyophilized, Endoxan, Endoxan-N, Endoxana, Endoxan Asta, Formitex, Genoxal, Genuxal, Hidrofosmin, Ledoxan, Ledoxina, Lyophilized Cytoxan, Neosar, Oncomide, Oncophos, Procytox, Revimmune, Sendoxan, Syklofosfamid, Trav Cyclophosphamide, Tymtran, Zycram
+
*'''Code names:''' B-518, WR-138719
 +
*'''Generic names:''' CP monohydrate, CPM, cyclophosphamid monohydrate, cyclophosphamide monohydrate
 +
*'''Brand names:'''
 +
{| class="wikitable" style="text-align:center;"
 +
!colspan="8" align="center" style="background-color:#0066FF"| '''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==
 
==References==
 
<references/>
 
<references/>
  
−
[[Category:Drug index]]
+
[[Category:Drugs]]
−
[[Category:Chemotherapy]]
+
[[Category:Intravenous medications]]
 +
[[Category:Oral medications]]
 +
[[Category:Irritant]]
 +
[[Category:Neutral]]
 +
 
 
[[Category:Alkylating agents]]
 
[[Category:Alkylating agents]]
−
[[Category:Acute lymphocytic leukemia medications]]
+
[[Category:Nitrogen mustards]]
−
[[Category:Bone cancer medications]]  
+
[[Category:Immunosuppressants]]
 +
 
 +
[[Category:Acquired hemophilia A medications]]
 +
[[Category:Acute lymphoblastic leukemia, infant medications]]
 +
[[Category:Acute myeloid leukemia medications]]
 +
[[Category:Adult T-cell leukemia-lymphoma medications]]
 +
[[Category:Anaplastic glioma medications]]
 +
[[Category:Anaplastic large cell lymphoma medications]]
 +
[[Category:B-cell acute lymphoblastic leukemia medications]]
 +
[[Category:Bladder cancer medications]]
 
[[Category:Breast cancer medications]]
 
[[Category:Breast cancer medications]]
−
[[Category:Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL) medications]]
+
[[Category:Burkitt lymphoma medications]]
−
[[Category:Hodgkin lymphoma medications]]
+
[[Category:Castleman disease medications]]
 +
[[Category:CNS lymphoma medications]]
 +
[[Category:Chronic lymphocytic leukemia medications]]
 +
[[Category:Chronic myeloid leukemia medications]]
 +
[[Category:Diffuse large B-cell lymphoma medications]]
 +
[[Category:Ewing sarcoma medications]]
 +
[[Category:Follicular lymphoma medications]]
 +
[[Category:Gestational trophoblastic neoplasia medications]]
 +
[[Category:Glioblastoma medications]]
 +
[[Category:Graft versus host disease medications]]
 +
[[Category:High-grade B-cell lymphoma medications]]
 +
[[Category:HIV-associated lymphoma medications]]
 +
[[Category:Classical Hodgkin lymphoma medications]]
 +
[[Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications]]
 +
[[Category:Large granular lymphocytic leukemia medications]]
 +
[[Category:Light-chain (AL) amyloidosis medications]]
 +
[[Category:Mantle cell lymphoma medications]]
 +
[[Category:Marginal zone lymphoma medications]]
 +
[[Category:Mediastinal gray-zone lymphoma medications]]
 +
[[Category:Medulloblastoma medications]]
 
[[Category:Multiple myeloma medications]]
 
[[Category:Multiple myeloma medications]]
−
[[Category:Non-Hodgkin lymphoma medications]]
+
[[Category:Neuroblastoma medications]]
 +
[[Category:Osteosarcoma medications]]
 +
[[Category:Peripheral T-cell lymphoma medications]]
 +
[[Category:Pheochromocytoma medications]]
 +
[[Category:Plasma cell leukemia medications]]
 +
[[Category:Post-transplant lymphoproliferative disorder medications]]
 +
[[Category:Primary mediastinal B-cell lymphoma medications]]
 +
[[Category:Prostate cancer medications]]
 +
[[Category:Rhabdomyosarcoma medications]]
 +
[[Category:T-cell acute lymphoblastic leukemia medications]]
 
[[Category:Thymoma medications]]
 
[[Category:Thymoma medications]]
−
[[Category:Transplant medications]]
+
[[Category:Transformed lymphoma medications]]
 +
[[Category:Urothelial carcinoma 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:EMA approved in 1958]]
 +
[[Category:PMDA approved drugs]]
 +
[[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)

Diseases for which it is used

Diseases for which it was used

Patient drug information

History of changes in FDA indication

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

  1. ↑ 1.0 1.1 1.2 Cyclophosphamide (Cytoxan) package insert
  2. ↑ Cyclophosphamide (Cytoxan) package insert (locally hosted backup)
  3. ↑ Cyclophosphamide (Cytoxan) patient drug information (Chemocare)
  4. ↑ Cyclophosphamide (Cytoxan) patient drug information (UpToDate)
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