InjectionClinical Overview
Cyclophosphamide Injection (500mg) is an oxazaphosphorine nitrogen mustard alkylating prodrug on the WHO Model List of Essential Medicines. In the liver, CYP2B6 oxidizes it to 4-hydroxycyclophosphamide, which spontaneously decomposes into phosphoramide mustard (the active alkylating moiety that forms crosslinks at guanine N-7 positions in DNA) and acrolein (a toxic metabolite excreted in urine). Indicated for non-Hodgkin and Hodgkin lymphomas, acute and chronic leukemias, breast cancer, ovarian cancer, neuroblastoma, and severe autoimmune diseases (lupus nephritis).
Active Pharmaceutical Ingredients
Verified Clinical References
Usage Guidelines
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.
General Administration Advice: Adhere strictly to the prescribed dosage, frequency, and treatment course. For oral medications, swallow with sufficient water. Never stop antibiotics, psychiatric medications, or antihypertensives abruptly without clinical direction.
Possible 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.
*Note: Individual physiological responses vary. While many patients experience few or no side effects, notify your treating physician if adverse reactions persist or if hypersensitivity (angioedema, skin rash, dyspnea) occurs.
Precautions & 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.
Schedule H (Prescription Required)
This medication is scheduled under statutory drug regulatory frameworks (CDSCO / Drugs & Cosmetics Rules). Dispensing requires a valid medical prescription from a registered medical practitioner. Self-medication or unsupervised dosage adjustment carries significant clinical risks.
Medical Disclaimer: Statutory Clinical Disclaimer: The information provided is for educational and price-transparency purposes only and does not constitute medical advice, oncological diagnosis, or chemotherapy protocol guidance. Cancer therapies require specialized administration under the direct supervision of a registered medical oncologist in an accredited healthcare facility.