Cyclophosphamide

Active pharmaceutical substance formulated in Jan Aushadhi generic products for Oncology & Critical Care treatment.

🧴 Clinical Application

Administer intravenously over 30 to 60 minutes. Vigorous oral or IV hydration (at least 2 to 3 liters daily) and frequent bladder voiding are mandatory during and for 48 hours after administration. When administering high doses (>1 g/m²), co-administer Mesna (2-mercaptoethane sulfonate) to neutralize urinary acrolein and prevent hemorrhagic cystitis.

⚠️ Side Effects

Common: Alopecia (occurs in >80%), nausea and vomiting, dose-dependent bone marrow suppression, anorexia, amenorrhea/azoospermia. Rare/Severe: Severe hemorrhagic cystitis (acrolein urothelial injury), acute cardiac necrosis (with mega-dose conditioning regimens), pulmonary fibrosis, and secondary acute leukemia.

🛡️ Safety Warnings

Black Box Warning: Hemorrhagic cystitis and urothelial toxicity; ensure aggressive hydration, frequent urination, and Mesna co-administration with high doses. Black Box Warning: Potent immunosuppression and bone marrow failure. High risk of permanent gonadal failure/infertility; offer fertility preservation prior to initiation.