Cyclophosphamide Injection

• Type: Chemotherapy medication

• Drug Class: Alkylating agent (nitrogen mustard derivative)

• Form: Sterile powder for reconstitution or solution, given intravenously (IV)

How It Works

• Cyclophosphamide is a prodrug (inactive form) that becomes active in the liver.

• The active form attaches alkyl groups to DNA, causing cross-linking and preventing DNA replication.

• This stops rapidly dividing cancer cells (and some normal cells) from growing, leading to cell death.

Common Uses

Cyclophosphamide injection is widely used in cancer treatment and some immune disorders:

Cancer Treatment

• Breast cancer

• Lymphomas (Hodgkin and non-Hodgkin)

• Leukemias

• Multiple myeloma

• Ovarian cancer

• Small cell lung cancer

• Sarcomas

Non-Cancer Uses (Immunosuppressive Therapy)

• Severe autoimmune diseases (e.g., lupus nephritis, vasculitis)

• Bone marrow transplant conditioning

Advantages

• Very effective and versatile drug used in many chemotherapy regimens

• Can be given alone or combined with other anticancer medicines

• Also helpful for immune system–related conditions where strong immunosuppression is needed

Possible Side Effects

Cyclophosphamide affects both cancer cells and healthy rapidly dividing cells, so side effects may occur:

Common

• Nausea, vomiting

• Hair loss (alopecia)

• Low blood cell counts (increased infection risk, anemia, bleeding tendency)

• Loss of appetite, fatigue

Serious/Specific

• Hemorrhagic cystitis (bladder irritation and bleeding — prevented with hydration and mesna)

• Infertility (may affect ovaries or testes)

• Heart toxicity (at very high doses)

• Secondary cancers (rare, with long-term use)

Precautions

• Patients must stay well-hydrated to prevent bladder damage

• Blood counts need regular monitoring

• Use with caution in patients with liver or kidney impairment

• Avoid live vaccines during treatment due to immunosuppression

• Should only be given under specialist supervision