Cyclophosphamide (PROCYTOX)

Breast cancer, sarcoma, myeloma, lymphoma, gynecologic malignancies, many other uses

Breast cancer, sarcoma, myeloma, lymphoma, gynecologic malignancies, many other uses

• Dose - Oral: Many dosing regimens, please refer to specific chemotherapy protocol
• Given as monotherapy or in combination with other chemotherapy agents

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Available as 25 and 50 mg tablets. Tablets should NOT be crushed or broken. Store at room temperature.

Alkylating agent

Take with or without food

If a dose is missed, patients should be instructed to seek guidance from their healthcare team on how to proceed.

Common: Myelosuppression, Nausea, Vomiting, Alopecia, Hemorrhagic cystitis.

Less Common: Cardiac dysfunction, Hepatotoxicity, Fatigue, Hyperuricemia, Secondary malignancies.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential and platelets, BUN, serum electrolytes, serum creatinine, urinalysis, liver function tests.

During treatment: CBC & differential and platelets, BUN, serum electrolytes, serum creatinine, urinalysis, liver function tests. Monitor for signs/symptoms of hemorrhagic cystitis or other urinary/renal toxicity, pulmonary toxicity, cardiac toxicity, hepatic toxicity, secondary malignancies, and/or wound healing impairment.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• To minimize bladder toxicity, patients should increase normal fluid intake. Morning administration may be preferred to ensure adequate hydration throughout the day; do not administer at bedtime.
• SIADH (syndrome of inappropriate secretion of ADH)1 may occur in patients receiving cyclophosphamide, resulting in hyponatremia, dizziness, confusion or agitation, unusual tiredness or weakness.

BC Cancer. BC Cancer Drug Manual. Cyclophosphamide. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Cyclophosphamide_monograph_1June2013_formatted.pdf.  Updated June 1, 2013. Accessed January 22, 2024.

Lexicomp. Cyclophosphamide Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at:  https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6674?cesid=5NbCLd02Abl&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DcycloPHOSphamide%26t%3Dname%26acs%3Dtrue%26acq%3Dcyclopho. Updated January 31, 2024. Accessed January 31, 2024.

Cancer Care Ontario. Cyclophosphamide Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44226. Updated June 2019. Accessed January 22, 2024Bristol-Myers Squibb Canada. Cyclophosphamide Product Monograph. Montreal, Canada. Date of preparation November 2, 2004