• Malignancies:

    • Non-Hodgkin lymphoma
    • Hodgkin lymphoma
    • Chronic lymphocytic leukemia (CLL)
    • Multiple myeloma
    • Breast cancer
    • Ovarian cancer
    • Neuroblastoma
    • Sarcomas
  • Non-oncologic/Off-label Uses:
    • Severe lupus nephritis
    • ANCA-associated vasculitis (e.g., GPA, MPA)
    • Multiple sclerosis (off-label)
    • Conditioning regimens for bone marrow transplant

 Dose:

  • IV and Oral formulations
  • Highly individualized dosing based on:
    • Disease type
    • BSA (mg/m²) or body weight (mg/kg)
    • Single agent vs. combination chemotherapy
    • Frequency: Daily, every 1–3 weeks, or monthly

 Common Regimens:

  • Cancer: 300–600 mg/m² IV every 2–3 weeks
  • Autoimmune (e.g., lupus nephritis):
    • 500–1000 mg IV monthly x 6 months

Always ensure aggressive hydration and mesna use with high-dose IV therapy to prevent

  • PO: 25 mg, 50 mg
  • IM: Vials (powder for reconstitution) – 200 mg, 500 mg, 1 g, 2 g
  • Routes: Oral and IV only
  • Administer IV slowly over 30–60 minutes
  • Hydration + MESNA needed at high doses
  • Oral: Take with food, early in the day to reduce bladder toxicity
  • Monitor blood counts regularly
  • Class: Alkylating agent (nitrogen mustard)
  • Mechanism of Action:
    • Metabolized in liver to phosphoramide mustard → alkylates DNA → crosslinking → cell death
    • Cell cycle non-specific (affects resting & dividing cells)
  • Prodrug, activated by CYP2B6, 2C9
  • Excreted via kidneys
  • Nausea/vomiting (moderate to high emetogenicity)
  • Alopecia
  • Fatigue
  • Myelosuppression (neutropenia, thrombocytopenia, anemia)
  • Active severe infections
  • Urinary outflow obstruction
  • Severe bone marrow suppression
  • Hypersensitivity to cyclophosphamide
  • Allopurinol: ↑ risk of bone marrow suppression
  • Anthracyclines (e.g., doxorubicin): additive cardiotoxicity
  • Live vaccines: Avoid
  • Warfarin: ↑ INR with some cases
  • CYP inducers/inhibitors may alter activation

                                   Drug Status

Availability
Pregnancy
Breastfeeding
Schedule
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Cycloxan 1g Injection 1’s Zydus Healthcare Sai Pharma
Cycloxan 500mg Injection 1’s Zydus Healthcare Sai Pharma
Cycloxan 200mg Injection 1’s Zydus Healthcare Sai Pharma
Cyphos 500mg Injection 1’s Getwell Pharma Nairobi Enterprises
Endoxan 200mg Injection 1’s Zydus Healthcare Sai Pharma
Endoxan 500mg Injection 1’s Zydus Healthcare Sai Pharma
Endoxan 1g Injection 1’s Zydus Healthcare Sai Pharma
Endoxan 50mg Tablet 50’s Zydus Healthcare Sai Pharma
Oncomide 200mg Injection 1’s PSM Pharma PSM Pharma
Oncomide 500mg Injection 1’s PSM Pharma PSM Pharma
Oncomide 1g Injection 1’s PSM Pharma PSM Pharma