Select a medication above to begin.
Frindovyx
cyclophosphamide
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments
lymphoma
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Dose: 40-50 mg/kg/total dose IV divided over 2-5 days; Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for stage III-IV lymphoma, Hodgkin lymphoma, lymphocytic lymphoma, mixed-cell type lymphoma, histiocytic lymphoma, Burkitt lymphoma, or mycosis fungoides; admin. in am; maintain adequate hydration
multiple myeloma
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: admin. in am; maintain adequate hydration
leukemia
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for CLL, chronic granulocytic leukemia, AML, or ALL; admin. in am; maintain adequate hydration
solid tumors
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for neuroblastoma, retinoblastoma, breast CA, or ovarian CA; admin. in am; maintain adequate hydration
axillary node positive breast CA, adjuvant tx (off-label)
- [600 mg/m^2/dose IV x1 on day 1 of 21-day cycle]
- Info: give x4 cycles; use w/ doxorubicin; admin. in am; maintain adequate hydration
CML, allogeneic HSCT conditioning tx (off-label)
- [60 mg/kg/dose IV q24h on days -3, -2 prior to transplantation]
- Info: use w/ busulfan; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-afamitresgene autoleucel (off-label)
- [melanoma-associated antigen A4 (MAGE-A4)-positive synovial sarcoma, unresectable or metastatic]
- Dose: 600 mg/m^2/dose IV q24h x3 doses; Start: 7 days prior to afamitresgene autoleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-axicabtagene ciloleucel (off-label)
- [follicular lymphoma, relapsed or refractory]
- Dose: 500 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to axicabtagene ciloleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [large B-cell lymphoma, relapsed or refractory]
- Dose: 500 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to axicabtagene ciloleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-brexucabtagene autoleucel (off-label)
- [mantle cell lymphoma, relapsed or refractory]
- Dose: 500 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to brexucabtagene autoleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [B-cell precursor ALL, relapsed or refractory]
- Dose: 900 mg/m^2/dose IV x1; Start: 2 days prior to brexucabtagene autoleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-ciltacabtagene autoleucel (off-label)
- [multiple myeloma, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to ciltacabtagene autoleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-idecabtagene vicleucel (off-label)
- [multiple myeloma, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to idecabtagene vicleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-lifileucel (off-label)
- [melanoma, unresectable or metastatic]
- Dose: 60 mg/kg/dose IV q24h x2 doses; Start: 8 days prior to lifileucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-lisocabtagene maraleucel (off-label)
- [large B-cell lymphoma, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [CLL/SLL, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [follicular lymphoma, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [mantle cell lymphoma, relapsed or refractory]
- Dose: 300 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to lisocabtagene maraleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-obecabtagene autoleucel (off-label)
- [B-cell precursor ALL, relapsed or refractory]
- Dose: 500 mg/m^2/dose IV q24h x2 doses; Start: 6 days prior to obecabtagene autoleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-tisagenlecleucel (off-label)
- [B-cell precursor ALL, relapsed or refractory]
- Dose: 500 mg/m^2/dose IV q24h x2 doses; Start: 6 days prior to tisagenlecleucel tx; Info: for pts 25 yo and younger; use w/ fludarabine; admin. in am; maintain adequate hydration
- [large B-cell lymphoma, relapsed or refractory]
- Dose: 250 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to tisagenlecleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
- [follicular lymphoma, relapsed or refractory]
- Dose: 250 mg/m^2/dose IV q24h x3 doses; Start: 5 days prior to tisagenlecleucel tx; Info: use w/ fludarabine; admin. in am; maintain adequate hydration
granulomatosis w/ polyangiitis (GPA) (off-label)
- [15 mg/kg/dose IV q2wk x3 doses, then 15 mg/kg/dose IV q3wk for at least 3 doses]
- Max: 1200 mg/dose; Info: for induction tx; decr. dose to 12.5 mg/kg/dose in pts 60-70 yo or 10 mg/kg/dose in pts >70 yo; use w/ glucocorticoids; give PCP prophylaxis during tx and for at least 6mo after D/C; admin. in am; maintain adequate hydration
renal dosing
- [granulomatosis w/ polyangiitis (GPA)]
- CrCl <30: decr. usual dose by 2.5 mg/kg/dose
- HD: decr. usual dose by 25%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 25%; no supplement
- [all other indications]
- CrCl <10: decr. usual dose by 25%
- HD: decr. usual dose by 25%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 25%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses, premeds, and dosing incl. toxicity-related dose adjustments
lymphoma
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Dose: 40-50 mg/kg/total dose IV divided over 2-5 days; Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for stage III-IV lymphoma, Hodgkin lymphoma, lymphocytic lymphoma, mixed-cell type lymphoma, histiocytic lymphoma, Burkitt lymphoma, or mycosis fungoides; admin. in am; maintain adequate hydration
multiple myeloma
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info; admin. in am; maintain adequate hydration
leukemia
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for CLL, chronic granulocytic leukemia, AML, or ALL; admin. in am; maintain adequate hydration
solid tumors
- [40-50 mg/kg/total dose IV divided over 2-5 days]
- Alt: 10-15 mg/kg/dose IV q7-10 days; 3-5 mg/kg/dose IV 2x/wk; Info: for neuroblastoma, retinoblastoma, breast CA, or ovarian CA; admin. in am; maintain adequate hydration
allogeneic HSCT conditioning tx (off-label)
- [50 mg/kg/dose IV q24h on days -5, -4, -3, -2 prior to transplantation]
- Info: use w/ busulfan; admin. in am; maintain adequate hydration
lymphodepleting tx, pre-tisagenlecleucel (off-label)
- [3 yo and older]
- Dose: 500 mg/m^2/dose IV q24h x2 doses; Start: 6 days prior to tisagenlecleucel tx; Info: for pts w/ relapsed or refractory B-cell precursor ALL; use w/ fludarabine; admin. in am; maintain adequate hydration
renal dosing
- [adjust dose amount]
- CrCl <10: decr. usual dose by 25%
- HD: decr. usual dose by 50%, on dialysis days admin. after dialysis; no supplement; PD: decr. usual dose by 25%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient, severe
- urinary obstruction
- ANC <1500
- Plt <50,000
- pregnancy 1st trimester
- avoid: breastfeeding during tx and x1wk after D/C
- caution: hypersensitivity to oxazaphosphorines
- caution: hypersensitivity to alkylating agents
- caution: pregnancy 2nd trimester
- caution: pregnancy 3rd trimester
- caution: female pts of reproductive potential
- caution: male pts of reproductive potential
- caution: elderly pts
- caution: peds pts (ethanol- or propylene glycol-containing form)
- caution: alcohol use, concurrent (ethanol-containing form)
- caution: cardiotoxic agent use, concurrent
- caution: cardiotoxic agent use hx
- caution: XRT hx
- caution: high-dose use
- caution: renal impairment
- caution: hepatic impairment
- caution: cardiac dz
- caution: infection, severe
- caution: UTI, active
- caution: performance status, low
Drug Interactions .
Overview
cyclophosphamide
alkylating agent
Interaction Characteristics:
- CYP2B6 substrate
- CYP3A4 substrate
- butyrylcholinesterase inhibitor
- cardiotoxic effects
- hyponatremia
- immunosuppressive effects
- immunosuppressive oncologic agent
- methemoglobinemia
- myelosuppressive effects
- myelosuppressive oncologic agent
- nephrotoxicity
Other Info
- some formulations of injectable cyclophosphamide contain ethanol
ethanol (in some formulations)
alcohol
Interaction Characteristics:
- alcohol dehydrogenase pathway substrate
- CNS depression
- hyperuricemic effects
- peripheral neuropathy
Contraindicated
- adenovirus vaccine, live
- BCG live intravesical
- chikungunya vaccine, live
- cholera vaccine, live
- cidofovir
- dengue vaccine, live
- disulfiram
- influenza nasal vaccine, live
- lidocaine topical
- measles/mumps/rubella vaccine, live
- metronidazole
- metronidazole vaginal
- prilocaine topical
- rotavirus vaccine, live
- smallpox vaccine, live
- talimogene laherparepvec
- topiramate
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- acitretin
- aldesleukin
- amikacin
- amikacin inhaled
- astragalus
- bumetanide
- butalbital
- carbidopa
- chloramphenicol
- cladribine oral
- clofarabine
- clonidine
- cocaine
- codeine
- cyclophosphamide
- deferiprone
- dexrazoxane
- diazepam
- diroximel fumarate
- doxylamine
- epirubicin
- etanercept
- ethanol
- etrasimod
- fexinidazole
- flurazepam
- foscarnet
- gabapentin enacarbil
- ganciclovir
- gentamicin
- hydrocodone
- idarubicin
- ifosfamide
- isocarboxazid
- kava
- kratom
- lemborexant
- levodopa
- levoketoconazole
- lorazepam
- mannitol
- metaxalone
- methotrexate
- metoclopramide
- midazolam
- morphine
- natalizumab
- nifurtimox
- oliceridine
- opium
- oxaliplatin
- oxybate
- oxymorphone
- palifermin
- penicillamine
- pentamidine
- phenelzine
- pimecrolimus topical
- polymyxin B
- posaconazole
- primaquine
- procarbazine
- prochlorperazine
- promethazine
- rabies vaccine
- radium Ra 223 dichloride
- ropeginterferon alfa-2b
- secnidazole
- streptomycin
- streptozocin
- succinylcholine
- tacrolimus
- tapentadol
- tenofovir disoproxil
- thalidomide
- thiotepa
- tinidazole
- tiopronin
- tobramycin
- tobramycin inhaled
- tranylcypromine
- triazolam
- valganciclovir
- venlafaxine
- voclosporin
- zuranolone
Monitor/Modify Tx
- 5-HTP
- abemaciclib
- acalabrutinib
- acetazolamide
- acyclovir
- adalimumab
- adefovir dipivoxil
- ado-trastuzumab emtansine
- afamitresgene autoleucel
- albendazole
- alectinib
- alemtuzumab
- alfentanil
- aliskiren
- allopurinol
- alogliptin
- alprazolam
- amantadine
- amiloride
- amitriptyline
- amoxapine
- amphotericin
- anagrelide
- anthrax immune globulin
- anthrax vaccine
- anti-thymocyte globulin
- apalutamide
- apomorphine
- apraclonidine ophthalmic
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- armodafinil
- arsenic trioxide
- artemether/lumefantrine
- asciminib
- asenapine
- aspirin
- atazanavir
- atidarsagene autotemcel
- auranofin
- avelumab
- axicabtagene ciloleucel
- axitinib
- azacitidine
- azathioprine
- azilsartan medoxomil
- baclofen
- balsalazide
- baricitinib
- belantamab mafodotin
- belinostat
- belzutifan
- benazepril
- bendamustine
- benznidazole
- betibeglogene autotemcel
- bevacizumab
- bexarotene
- bezlotoxumab
- binimetinib
- bleomycin
- blinatumomab
- bortezomib
- bosentan
- bosutinib
- botulism immune globulin
- brentuximab vedotin
- brexpiprazole
- brexucabtagene autoleucel
- brigatinib
- brimonidine topical
- brivaracetam
- buprenorphine
- busulfan
- butorphanol
- cabazitaxel
- cabozantinib
- candesartan cilexetil
- cannabidiol
- cannabis
- capecitabine
- captopril
- carbamazepine
- carboplatin
- carfilzomib
- cariprazine
- carisoprodol
- carmustine
- celecoxib
- cenobamate
- certolizumab pegol
- chamomile, German
- chikungunya vaccine
- chlophedianol
- chlorambucil
- chlordiazepoxide
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cilostazol
- ciltacabtagene autoleucel
- cisplatin
- citalopram
- cladribine injection
- clindamycin
- clobazam
- clomipramine
- clonazepam
- clorazepate
- clozapine
- cobimetinib
- colchicine
- colistimethate
- copanlisib
- COVID-19 vaccine
- creatine
- crizotinib
- cyclosporine
- cytarabine
- cytomegalovirus immune globulin
- dabrafenib
- dacarbazine
- dactinomycin
- danshen
- dapsone
- daratumumab
- daridorexant
- darifenacin
- darolutamide
- darunavir
- dasatinib
- daunorubicin
- decitabine
- deferasirox
- deferoxamine
- desflurane
- desmopressin
- desvenlafaxine
- deuruxolitinib
- deutetrabenazine
- dexamethasone
- dexbrompheniramine
- dexchlorpheniramine
- dexmedetomidine
- dexmedetomidine injection
- dichlorphenamide
- diclofenac
- diclofenac topical
- dicloxacillin
- difelikefalin
- difenoxin
- diflunisal
- dihydrocodeine
- dinutuximab
- diphenhydramine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- docetaxel
- domperidone
- dostarlimab
- doxepin
- doxepin topical
- doxorubicin
- dronabinol
- dronedarone
- droperidol
- duloxetine
- duvelisib
- ebola vaccine, live
- echinacea
- efavirenz
- efbemalenograstim alfa
- eflapegrastim (G-CSF)
- eflornithine
- elafibranor
- elagolix
- elivaldogene autotemcel
- elranatamab
- enalapril
- enalaprilat
- enasidenib
- encorafenib
- enfortumab vedotin
- entrectinib
- enzalutamide
- epcoritamab
- eribulin
- escitalopram
- esketamine
- eslicarbazepine acetate
- estazolam
- eszopiclone
- ethacrynic acid
- etodolac
- etomidate
- etoposide
- etravirine
- everolimus
- exagamglogene autotemcel
- exenatide
- fam-trastuzumab deruxtecan
- febuxostat
- fedratinib
- felbamate
- fenfluramine
- fenoprofen
- fentanyl
- fesoterodine
- filgrastim (G-CSF)
- flibanserin
- floxuridine
- flucytosine
- fludarabine
- fluorouracil
- fluoxetine
- fluphenazine
- flurbiprofen
- fluvoxamine
- fosamprenavir
- fosinopril
- foslevodopa
- fosphenytoin
- fostamatinib
- furosemide
- gabapentin
- ganaxolone
- garlic
- gemcitabine
- gemtuzumab ozogamicin
- ginkgo
- ginseng, Asian
- givinostat
- glasdegib
- glofitamab
- glycerol phenylbutyrate
- glycopyrrolate
- golimumab
- griseofulvin
- guanfacine
- Haemophilus b vaccine
- haloperidol
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- hydrochlorothiazide
- hydromorphone
- hydroxychloroquine
- hydroxyurea
- hydroxyzine
- ibritumomab tiuxetan
- ibrutinib
- ibuprofen
- ibuprofen lysine
- idecabtagene vicleucel
- idelalisib
- iloperidone
- imatinib
- imetelstat
- immune globulin
- indapamide
- indomethacin
- infliximab
- influenza H5N1 vaccine
- influenza vaccine
- inotuzumab ozogamicin
- interferon beta 1a
- interferon beta 1b
- interferon gamma 1b
- iohexol
- iomeprol
- iopamidol
- irbesartan
- irinotecan
- isatuximab
- isavuconazonium
- isoflurane
- istradefylline
- itraconazole
- ivosidenib
- ixabepilone
- Japanese encephalitis vaccine
- ketamine
- ketoprofen
- ketorolac
- lacosamide
- lamotrigine
- lapatinib
- lasmiditan
- leflunomide
- lenalidomide
- lenvatinib
- levetiracetam
- levomilnacipran
- levorphanol
- lifileucel
- linagliptin
- linezolid
- liraglutide
- lisinopril
- lisocabtagene maraleucel
- lithium
- lofexidine
- lomustine
- lonafarnib
- loncastuximab tesirine
- lopinavir/ritonavir
- lorlatinib
- losartan
- lovotibeglogene autotemcel
- lumacaftor/ivacaftor
- lumateperone
- lurbinectedin
- lutetium Lu 177 dotatate
- lutetium Lu 177 vipivotide tetraxetan
- lymphocyte immune globulin, anti-thymocyte globulin
- magnesium citrate
- magnesium salicylate
- margetuximab
- mavacamten
- meclofenamate
- mefenamic acid
- melatonin
- meloxicam
- melphalan
- meningococcal vaccine
- meperidine
- mercaptopurine
- meropenem
- mesalamine
- mesalamine rectal
- methadone
- methazolamide
- methocarbamol
- methohexital
- methsuximide
- methyldopa
- metolazone
- metyrapone
- midostaurin
- milnacipran
- mirdametinib
- mirtazapine
- mitapivat
- mitomycin
- mitotane
- mitoxantrone
- mobocertinib
- modafinil
- moexipril
- mogamulizumab
- molindone
- momelotinib
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nabumetone
- nafcillin
- nalbuphine
- naltrexone
- naproxen
- nefazodone
- nelarabine
- nelfinavir
- neomycin
- nevirapine
- nilotinib
- niraparib
- nusinersen
- obecabtagene autoleucel
- obinutuzumab
- odevixibat
- ofatumumab
- olanzapine
- olaparib
- olmesartan medoxomil
- olsalazine
- olutasidenib
- omaveloxolone
- opicapone
- orphenadrine
- osimertinib
- oxaprozin
- oxazepam
- oxcarbazepine
- oxybutynin
- oxycodone
- oxytocin
- paclitaxel
- pacritinib
- palbociclib
- paliperidone
- pamidronate
- panobinostat
- paromomycin
- paroxetine
- passion flower
- pazopanib
- pegfilgrastim (G-CSF)
- peginterferon alfa 2a
- peginterferon beta 1a
- pegloticase
- pemetrexed
- pentazocine
- pentobarbital
- pentostatin
- perampanel
- perindopril
- perphenazine
- pertuzumab
- pexidartinib
- phenobarbital
- phenytoin
- pimozide
- pioglitazone
- piroxicam
- pirtobrutinib
- plazomicin
- pneumococcal vaccine
- polatuzumab vedotin
- poliovirus vaccine
- polyethylene glycol
- polyethylene glycol/electrolytes
- pomalidomide
- ponatinib
- pralatrexate
- pramipexole
- prednisone
- pregabalin
- primidone
- probenecid
- proguanil
- propafenone
- propofol
- pyrimethamine
- quazepam
- quetiapine
- quinapril
- quizartinib
- ramipril
- ramucirumab
- rasagiline
- rasburicase
- remifentanil
- remimazolam
- repotrectinib
- respiratory syncytial virus vaccine
- Rho(D) immune globulin
- ribavirin
- ribociclib
- rifabutin
- rifampin
- rifamycin
- rifapentine
- ripretinib
- risperidone
- ritonavir
- rituximab
- romidepsin
- ropinirole
- rosiglitazone
- rucaparib
- rufinamide
- ruxolitinib
- ruxolitinib topical
- sacituzumab govitecan
- salsalate
- sargramostim (GM-CSF)
- sarilumab
- satralizumab
- saxagliptin
- scopolamine
- selegiline transdermal
- selinexor
- selumetinib
- sertraline
- sevoflurane
- sipuleucel-T
- sirolimus
- sirolimus albumin-bound
- sitagliptin
- smallpox/mpox vaccine, live
- solifenacin
- somatropin
- sorafenib
- sotorasib
- sparsentan
- spironolactone
- St. John's wort
- stiripentol
- succimer
- sufentanil
- sulfasalazine
- sulfate bowel prep
- sulindac
- sumatriptan
- sunitinib
- suvorexant
- suzetrigine
- tafasitamab
- tagraxofusp
- talazoparib
- talquetamab
- tamoxifen
- tarlatamab
- tazemetostat
- teclistamab
- tecovirimat
- telavancin
- telmisartan
- telotristat ethyl
- temazepam
- temozolomide
- temsirolimus
- tenofovir alafenamide
- teplizumab
- teriflunomide
- thioguanine
- thioridazine
- thiothixene
- tiagabine
- tick-borne encephalitis vaccine
- tipranavir
- tisagenlecleucel
- tivozanib
- tizanidine
- tocilizumab
- tofacitinib
- tolcapone
- tolmetin
- tolterodine
- topotecan
- torsemide
- tovorafenib
- trabectedin
- tramadol
- trametinib
- trandolapril
- trastuzumab
- trazodone
- treosulfan
- triamterene
- trifluridine
- trihexyphenidyl
- trimethoprim
- trospium
- typhoid vaccine
- upadacitinib
- vaborbactam
- vaccinia immune globulin
- valacyclovir
- valbenazine
- valerian
- valproic acid
- valsartan
- vamorolone
- vancomycin
- vandetanib
- vasopressin
- vemurafenib
- venetoclax
- vigabatrin
- vilazodone
- viloxazine
- vinblastine
- vincristine
- vinorelbine
- vorasidenib
- vortioxetine
- warfarin
- zaleplon
- zanidatamab
- zanubrutinib
- zenocutuzumab
- ziconotide
- zidovudine
- ziprasidone
- ziv-aflibercept
- zoledronic acid
- zolpidem
- zonisamide
Caution Advised
- abatacept
- abrocitinib
- adagrasib
- almotriptan
- amiodarone
- amlodipine
- anakinra
- anifrolumab
- aprepitant
- articaine
- atorvastatin
- avacopan
- baclofen intrathecal
- basiliximab
- beclomethasone inhaled
- beclomethasone nasal
- belatacept
- belimumab
- belumosudil
- benzocaine topical
- berberine
- berotralstat
- betamethasone
- bicalutamide
- bimekizumab
- brimonidine ophthalmic
- brodalumab
- bromocriptine
- brompheniramine
- budesonide
- budesonide inhaled
- budesonide nasal
- budesonide rectal
- bupivacaine
- bupivacaine liposomal
- buspirone
- butamben
- canakinumab
- capivasertib
- carbinoxamine
- cefotetan
- ceritinib
- cetirizine
- chloroprocaine
- chlorpheniramine
- chlorzoxazone
- cimetidine
- ciprofloxacin
- clarithromycin
- clemastine
- clobetasol ophthalmic
- clofazimine
- clopidogrel
- clotrimazole oropharyngeal
- cobicistat
- conivaptan
- corticotropin
- cortisone
- cranberry
- crovalimab
- cyclobenzaprine
- cyproheptadine
- danazol
- danicopan
- dantrolene
- deflazacort
- desipramine
- deucravacitinib
- dexamethasone ophthalmic
- difluprednate ophthalmic
- diltiazem
- dimenhydrinate
- dimethyl fumarate
- diosmin
- diphenoxylate
- dupilumab
- eculizumab
- efgartigimod alfa
- eletriptan
- elotuzumab
- emapalumab
- entacapone
- erythromycin
- ethinyl estradiol (contraceptive)
- ethosuximide
- fidanacogene elaparvovec
- fingolimod
- fluconazole
- fludrocortisone
- flunisolide nasal
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluticasone furoate
- fluticasone propionate
- fosaprepitant
- frovatriptan
- fruquintinib
- givosiran
- glecaprevir
- goldenseal
- grapefruit
- grazoprevir
- guselkumab
- hydrocortisone
- hydrocortisone ophthalmic
- hyoscyamine
- imipramine
- inebilizumab
- iptacopan
- isoniazid
- ivacaftor
- ixekizumab
- ketoconazole
- larotrectinib
- lazertinib
- lebrikizumab
- lefamulin
- lenacapavir
- letermovir
- levocetirizine
- lidocaine
- lomitapide
- loteprednol ophthalmic
- lovastatin
- loxapine
- lurasidone
- maribavir
- mavorixafor
- meclizine
- mepivacaine
- meprobamate
- methylprednisolone
- metyrosine
- mifepristone
- miglustat
- mirikizumab
- mirvetuximab soravtansine
- mometasone implant
- mometasone inhaled
- mometasone nasal
- monomethyl fumarate
- nadofaragene firadenovec intravesical
- naratriptan
- naxitamab
- netupitant
- nicardipine
- nirogacestat
- nortriptyline
- ocrelizumab
- osilodrostat
- ozanimod
- pegcetacoplan
- peppermint
- pheniramine
- pibrentasvir
- ponesimod
- pozelimab
- prednisolone
- prednisolone ophthalmic
- procaine
- protriptyline
- pyrilamine
- quercetin
- ramelteon
- ranolazine
- ravulizumab
- regorafenib
- remdesivir
- resveratrol
- rilonacept
- risankizumab
- ritlecitinib
- rizatriptan
- ropivacaine
- rotigotine transdermal
- rozanolixizumab
- safinamide
- secukinumab
- selegiline
- selpercatinib
- siltuximab
- siponimod
- spesolimab
- sutimlimab
- tasimelteon
- tetrabenazine
- tetracaine
- tezepelumab
- ticagrelor
- tildrakizumab
- tolvaptan
- tralokinumab
- triamcinolone
- trifluoperazine
- trimethobenzamide
- trimipramine
- triprolidine
- trofinetide
- tuberculin purified protein derivative
- tucatinib
- ublituximab
- ustekinumab
- vedolizumab
- verapamil
- vilobelimab
- vonoprazan
- voriconazole
- voxelotor
- xanomeline
- zileuton
- zilucoplan
- zolmitriptan
Adverse Reactions .
Serious Reactions
- myelosuppression
- bone marrow failure
- immunosuppression
- infection, serious
- secondary malignancy
- urotoxicity
- hemorrhagic cystitis
- urinary bladder fibrosis
- renal impairment
- renal failure
- SIADH
- cardiotoxicity
- CHF
- arrhythmia
- pneumonitis
- pulmonary fibrosis
- pulmonary toxicity, severe
- hepatic veno-occlusive dz
- hepatotoxicity
- sterility
- anaphylaxis
- hypersensitivity rxn
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- erythema multiforme
- GI hemorrhage
- pancreatitis
- neurotoxicity
- impaired wound healing
Common Reactions
- neutropenia
- febrile neutropenia
- fever
- alopecia
- nausea
- vomiting
- diarrhea
- anorexia
- stomatitis
- abdominal pain
- rash
- skin pigmentation
- nail changes
- leukopenia
- thrombocytopenia
- anemia
- amenorrhea
- sterility
- jaundice
- impaired wound healing
Safety/Monitoring .
Monitoring Parameters
pregnancy test, Cr at baseline; CBC w/ diff; urinalysis
Ethanol Content
contains 0.0448 g ethanol per 50 mg dose; avoid or minimize alcohol use, caution advised w/ concomitant CNS depressant use; CNS depression and/or intoxication sx may occur
Look/Sound-Alike Drug Names
cyclophosphamide confused with: cycloSPORINE
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use in 1st trimester, weigh risk/benefit in 2nd and 3rd trimesters; risk of teratogenicity in 1st trimester based on human data; risk of intrauterine growth restriction and neonatal pancytopenia in 2nd and 3rd trimesters based on limited human data
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and up to 1y after D/C in female pts and during tx and x4mo after D/C in male pts
Lactation
Clinical Summary
avoid breastfeeding during tx and x1wk after D/C; possible risk of infant harm, incl. myelosuppression, based on limited human data; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for cyclophosphamide: liver; CYP450: 2A6, 2B6 (primary), 2C9, 2C18, 2C19, 3A4, 3A5 substrate; Info: prodrug converted to active metabolites; for active metabolites: oxidation, beta-elimination; CYP450: none
Excretion: urine primarily (10-20% unchanged), bile 4%; Half-life: 3-12h
Subclass: Alkylating Agents, Nitrogen Mustards ; DMARDs, Conventional
Mechanism of Action
alkylates and crosslinks DNA
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.