環磷醯胺

用途

• Immunosuppressant (ITP or IMHA)
• To slow progression of FIP
• Chemical shearing agent
• Neoplastic diseases
• Antineoplastic (lymphoma) in rabbits
• To inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas
• Antineoplastic
• Immunosuppressant (IMHA/ITP)
• Immunosuppressant (IMHA pulse therapy)
• Polyarthritis
• Glomerulonephritis
• Lymphoma (COP low dose protocol - Induction)
• Lymphoma (COP low dose protocol - Maintenance after 2 months)

給藥方式

可能的副作用

• Myelosuppression (leukopenia, thrombocytopenia, anemia)
• Gastroenterocolitis (anorexia, nausea, vomiting, diarrhea)
• Sterile hemorrhagic cystitis (induced by acrolein metabolite)
• Alopecia (especially in continuously growing coats like Poodles and Old English Sheepdogs)
• Pulmonary infiltrates and fibrosis
• Hyponatremia
• Secondary leukemia
• Myelosuppression (nadir usually 5-14 days post-therapy)
• Sterile haemorrhagic cystitis (caused by acrolein metabolite)
• Bladder fibrosis
• Transitional cell carcinoma (secondary to chronic cystitis)
• Vomiting
• Diarrhoea

注意事項與禁忌

• Prior anaphylactic reactions to the drug
• Severe pre-existing myelosuppression (leukopenia, thrombocytopenia)
• Active infections where immunosuppression may be dangerous
• No specific contraindications available in the monograph, but clinically contraindicated in patients with severe pre-existing myelosuppression or active haemorrhagic cystitis.
• Pre-existing severe myelosuppression
• Active haemorrhagic cystitis
• **WARNING**: Cyclophosphamide is potentially teratogenic and embryotoxic. Safe use in pregnancy is not established. * **Hemorrhagic Cystitis**: Up to 30% of dogs on long-term therapy may develop sterile hemorrhagic cystitis. Encourage frequent urination and water intake. Co-administration of furosemide may reduce risk. * **Myelosuppression**: Monitor CBC closely. Delay doses if severe leukopenia or thrombocytopenia occurs. * **Handling**: Cytotoxic precautions must be taken. Do not split or crush tablets. Avoid direct contact with urine or feces of treated animals.

藥物相互作用

• Allopurinol: May increase the myelosuppression caused by cyclophosphamide
• Doxorubicin: Potentiation of cardiotoxicity may occur
• Chloramphenicol: May inhibit cyclophosphamide metabolism
• Phenobarbital: May increase the rate of metabolism to active metabolites, increasing toxicity risk
• Thiazide Diuretics: May increase the myelosuppression caused by cyclophosphamide
• Succinylcholine: Metabolism may be slowed, prolonging effects due to decreased pseudocholinesterases
• Digoxin: Absorption of orally administered digoxin may be decreased (may occur several days after dosing)
• Barbiturates: Increase cyclophosphamide toxicity due to increased rate of conversion to metabolites
• Phenothiazines: Reduce cyclophosphamide efficacy
• Ondansetron: Reduce cyclophosphamide efficacy
• Insulin: Insulin requirements are altered by concurrent cyclophosphamide

常見問題