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Author: Admin | 2025-04-28
Most adult patients will require a fluid intake of at least 2 L/day. High-dose regimens should be accompanied by vigorous hydration with or without mesna therapy. Morning administration may be preferred to ensure adequate hydration throughout the day.Hematopoietic stem cell transplant (off-label use): Approaches to reduction of hemorrhagic cystitis include infusion of 0.9% NaCl 3 L/m2/24 hours, infusion of 0.9% NaCl 3 L/m2/24 hours with continuous 0.9% NaCl bladder irrigation 300 to 1000 mL/hour, and infusion of 0.9% NaCl 1.5 to 3 L/m2/24 hours with intravenous mesna. Hydration should begin at least 4 hours before cyclophosphamide and continue at least 24 hours after completion of cyclophosphamide. The daily mesna dose (as a percentage of cyclophosphamide dose) may vary; refer to protocol and/or primary literature for mesna dose. Mesna can be administered as a continuous 24-hour intravenous infusion or be given in divided doses every 4 hours. Mesna should begin at the start of treatment, and continue at least 24 hours following the last dose of cyclophosphamide.Oral: Tablets are not scored and should not be cut, chewed, or crushed. Swallow capsules whole; do not open, crush, or chew. To minimize bladder toxicity, increase normal fluid intake. Morning administration may be preferred to ensure adequate hydration throughout the day; do not administer tablets/capsules at bedtime. Avoid exposure to broken capsules; if contact occurs, wash hands immediately and thoroughly. StorageInjection powder for reconstitution: Store intact vials of powder at ≤25°C (77°F). Exposure to excessive temperatures during transport or storage may cause active ingredient to melt (vials with melting may have a clear to yellow viscous liquid which may appear as droplets); do not use vials with signs of melting. Solutions reconstituted in sterile water for injection should be further diluted immediately. According to the manufacturer, reconstituted solutions in normal saline (NS) are stable for 24 hours at room temperature and for 6 days refrigerated at 2°C to 8°C (36°F to 46°F). Solutions diluted for infusion in 1/2NS are stable for 24 hours at room temperature and for 6 days refrigerated and solutions diluted in D5W or D5NS are stable for 24 hours at room temperature and for 36 hours refrigerated (according to product labeling).Capsules: Store at 20°C to 25°C (68°F to 77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F).Tablets: Store tablets at ≤25°C (77°F); brief excursions are permitted up to 30°C (86°F); protect from temperatures >30°C (86°F). Cyclophosphamide Images cyclophosphamide 25 mg cyclophosphamide 50 mg cyclophosphamide 25 mg cyclophosphamide 50 mg cyclophosphamide 50 mg cyclophosphamide 25 mg Drug InteractionsAllopurinol: May enhance the adverse/toxic effect of Cyclophosphamide. Specifically, bone marrow suppression. Monitor therapyAmiodarone: Cyclophosphamide may enhance the adverse/toxic effect of Amiodarone. Specifically, the risk of pulmonary toxicity may be enhanced. Monitor therapyAnthracyclines: Cyclophosphamide may enhance the cardiotoxic effect of Anthracyclines. Monitor therapyAzaTHIOprine: May enhance the hepatotoxic effect of Cyclophosphamide. Monitor therapyBaricitinib: Immunosuppressants may enhance the immunosuppressive effect of Baricitinib. Management: Use of baricitinib in combination with potent immunosuppressants such as azathioprine or cyclosporine is not recommended. Concurrent use with antirheumatic doses
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