Medicine "Cyclophosphan": instructions for use, price, analogues, manufacturer and reviews

"Cyclophosphane" is an alkylating compound. It is a medicinal antitumour agent. Produced in the form of a white or almost such crystalline powder. Further about this preparation more.

"Cyclophosphane" - manufacturer

This drug is produced in the Russian company Biochemistry. It is located in Saransk on Vasenko street, 15A.

Cost

In any pharmacy you can buy powder number 1 "Cyclophosphane". Its price fluctuates around 90-98 rubles.

Description of dosage form

A solution is prepared from this powder. It is intended for intramuscular and intravenous administration

Features of composition

Each powder contains an active substance called cyclophosphamide. A certain number is its number. Namely contains "Cyclophosphane" 200 mg of this substance in one bottle. There are no excipients in this medication.

Description of pharmacological action

Based on the instructions for use, "Cyclophosphane" is an alkylating cytotoxic drug. Its chemical composition is similar to such substances as nitrogen analogues of mustard gas. The pharmacological action of "cyclophosphamide" is to produce cross-linking between the strands of DNA and RNA. Also, this drug helps to inhibit protein synthesis.

"Cyclophosphane" - analogues

In this case, select those funds that match the ATC code of the fourth category. Quite peculiar is "Cyclophosphane". Analogues to this drug exist in considerable quantity. The most common are:

1. "Endoxane".
2. "Ifosfamide."
3. "Alkeran".
4. Holoksan
5. Ribomustine.
6. "The Leukeran."

Selection of each of these drugs is carried out by a doctor individually. In this case, the health status and the portability of the components are taken into account.

In which cases is it used?

Let us consider this point in more detail. Quite peculiar is the use of such a drug as "Cyclophosphamide". The instruction for use in this plan will be an indispensable assistant. It states that the drug is indicated in the following cases:

1. When there is a chronic and acute lymphocytic leukemia.
2. With multiple myeloma.
3. When manifesting the symptoms of non-Hodgkin's lymphoma.
4. When there is mushroom mycosis and retinoblastoma.
5. In the presence of lymphogranulomatosis, as well as cancer of the ovaries and breast.
6. With the manifestation of neuroblastoma symptoms.

In addition, this drug is used in combination with other medicinal antitumour agents for treatment in the following cases:

1. With germinogenous tumors.
2. With cancer of the bladder and lung.
3. With sarcoma of soft tissue.
4. When prostate cancer and cervical cancer occur.
5. With Ewing's sarcoma.
6. In case of Wilms' tumors.
7. With reticulosarcoma.

Also, a drug such as "Cyclophosphane", whose reviews are positive, is effective as an immunosuppressive agent in the manifestation of progressive autoimmune diseases. In this case, there is the emergence of psoriatic and rheumatoid arthritis, autoimmune hemolytic anemia, collagenosis, nephrotic syndrome. Also, this agent suppresses the rejection reaction of the graft.

Contraindications

"Cyclophosphane" has certain contraindications. It can not be used:

1. During the period of breastfeeding and pregnancy.
2. With pronounced impairment of bone marrow function.
3. In case of hypersensitivity.
4. With a delay in urination.
5. In the presence of active infections.
6. During the manifestation of cystitis.

With care, "Cyclophosphane", the analogues of which are indicated above, should be prescribed in certain cases. Namely, in the presence of the following ailments:

1. Nephrourolithiasis.
2. Severe degree of heart disease, liver and kidney.
3. Gout.
4. Infiltration of bone marrow tumor cells.
5. Adrenalectomy.
6. Oppression of bone marrow functionality.

Description of side effects

"Cyclophosphamide", the synonyms (analogs) of which are indicated above, can contribute to the occurrence of the following side effects:

1. In the digestive system, symptoms such as vomiting, nausea, anorexia, discomfort, stomatitis, abdominal pain, diarrhea, or constipation may manifest. Individual cases of jaundice and hemorrhagic colitis are also known.
2. In the hematopoiesis system there were manifestations of neutropenia, anemia, thrombocytopenia, and leukopenia. At 7-14 days of admission, the number of platelets and white blood cells may decrease slightly.
3. The appearance of alopecia was observed on the skin. Grow the hair again after the drug is finished. In addition, during the treatment period, a rash may appear on the skin. There may also be a presence of skin pigmentation and nail changes.
4. In the cardiovascular system, with the introduction of increased dosages of this drug for a long time period, cardiotoxicity may occur. This is important to remember. In addition, there have been emergencies of complicated, and sometimes fatal, cases of heart failure. This is due to the occurrence of myocarditis of the hemorrhagic type.
5. In the urinary system, there may be necrosis of the renal canals (up to a lethal outcome), hemorrhagic cystitis or urethritis, and urinary bladder fibrosis. In rare cases, with the application of high dosages of this drug, nephropathy, hyperuricemia and impaired renal function may occur. In this case, the presence of epithelial cells can be observed in the urine.
6. In the respiratory system may manifest interstitial pulmonary fibrosis.
7. In the reproductive system, there may be violations of oogenesis and spermatogenesis, as well as sterility. The latter symptom may in some cases be irreversible. Most women use amenorrhea with this remedy. After the termination of treatment the regularity of menstruation, as a rule, is restored. In men, taking this medication can lead to the appearance of oligospermia or azoospermia, as well as to a different degree of testicular atrophy.
8. In this case, there may be an allergic reaction. Namely, the manifestation of skin rash, itching, hives, anaphylactic reactions.
9. Also, there may be side effects. That is, the flow of blood to the facial skin, hyperemia, the development of malignant secondary tumors, increased sweating, headaches.

Forms of interactions

When taking this drug, some elements that contribute to microsomal oxidation in the liver can effect an induction of the process of microsomal metabolism of cyclophosphamide. This leads to certain factors. Namely, to the large formation of metabolites of the aliphatic type. At the same time, the period during which half-elimination of cyclophosphamide is carried out decreases, and its activity also increases. The administration of cyclophosphamide, which significantly and continuously suppresses cholinesterase activity, enhances the action of suxamethonium. It also helps to reduce or slow the metabolism of cocaine. As a result, the duration of its effect is increased or increased and the risk of its toxic effect increases. This has a negative effect on the body as a whole. In addition, simultaneous use with allopurinol can enhance the toxic effect on the bone marrow.

When co-administration of cyclophosphamide with allopurinol, colchicine, probenecid, sulfinpyrazone, there may be a need for correction of doses of antidotal drugs in the treatment of gout and hyperuricemia. Also, there may be an increased risk of nephropathy, which is associated with increased production of uric acid by using cyclophosphamide.

The latter substance can cause an increase in anticoagulant activity. Since in this case, the synthesis of factors contributing to blood clotting and disruption of platelet formation is reduced in the liver. However, anticoagulant activity may also decrease through an unknown mechanism.

Cyclophosphamide increases the cardiotoxic effect of daunorubicin and doxorubicin. Other immunosuppressants (chlorambucil, azathioprine, cyclosporine, glucocorticosteroids, mercaptopurine, etc.) may increase the possibility of developing secondary tumors and infections.

The simultaneous use of lovastatin in patients with cardiac transplantation may increase the risk of diseases such as acute skeletal muscle necrosis and renal acute failure.

If in combination with this drug is used myelosuppressive drugs or radiation therapy, then the manifestation of additive inhibition of bone marrow functions is possible.

Simultaneous reception of cytarabine in large doses with a substance such as cyclophosphamide, at the preparatory stage for the bone marrow transplantation process leads to a frequency increase in cardiomyopathy with the onset of a fatal outcome.

Main criteria

In the process of application the following is taken into account:

1. During the treatment with this drug, a blood test should be performed regularly in order to assess the degree of myelosuppression. It is especially necessary to pay attention to the amount of platelets and neutrophils.
2. Also, a urine test should be performed regularly for the presence of red blood cells. Their appearance can contribute to the development of a disease such as hemorrhagic cystitis. If such signs are found, treatment with Cyclophosphan, the price of which is indicated above, should be discontinued.
3. With a decrease in the number of platelets (below 100,000 / μl) and / or white blood cells (<2500 / μl), this medication should be discontinued.
4. If there are infections during the period of therapy with this drug, the course of treatment should be discontinued or interrupted. Or in this case, the dosage should be reduced. Men and women during the treatment process "Cyclophosphamide" should use reliable methods of contraception.
5. During the period of therapy with this drug, you should refrain from drinking alcohol.
6. In the event that the first ten days after the operation that was performed under general anesthesia and the patient is prescribed "Cyclophosphamide", the price of which is indicated above, the anesthesiologist should be informed about this.
7. Patient after he underwent adrenalectomy, it is necessary to carry out adjustments of the dosage as glucocorticosteroids, which are used for the substitution therapy process, and such a drug as the drug "Cyclophosphane".

Precautions to be taken

Admission of this drug is possible only under the supervision of a doctor who has experience in chemotherapy. It is also necessary to strictly adhere to the dosage regimen. This should especially be done with combination therapy. Also, do not double the dose if the previous dose was missed. In the preparation of this drug for use in newborns, it is strongly advised not to use diluents that contain benzyl alcohol. Since this can lead to the development of toxic lethal syndrome. Namely, the emergence of metabolic acidosis, CNS depression, respiratory failure, renal failure, hypotension, seizures, intracranial hemorrhage.

During the whole treatment course, it is recommended to perform blood transfusion (for a week 1 time 100-125 ml). It is necessary to do this in order to prevent diseases such as hyperuricemia and nephropathy, which is caused by the formation of an increased amount of uric acid. Such symptoms are often manifested at the beginning of the treatment period. Also, before the therapy with this drug and during 72 hours after its administration, it is recommended to exercise certain fluid intake (about 3 liters per day), the use of allopurinol (in special cases) and the means that make alkalinize urine. To prevent manifestations of hemorrhagic cystitis, it is often necessary to empty the bladder and take "Uromiteksan". If the initial signs of the disease appeared, then the treatment course with this drug should be discontinued until the symptoms are completely eliminated.

To reduce the phenomena of the dyspeptic type, cyclophosphamide can be taken during the first day in small doses. Full or partial alopecia, which can be observed during the treatment period, is reversible and after the end of the course, the normal hair growth function is restored. However, their color and structure may be subject to change.

If there is chills, fever, cough or hoarseness, pain in the lower back or in the side, painful or difficult urination, bleeding or bleeding, black stool, blood in the feces or urine, you should immediately consult a doctor.

The possibility of thrombocytopenia leads to the need for special caution in carrying out such actions as invasive procedures and dental interventions. In this case, the skin and mucous membranes and places of intravenous injections should be inspected regularly. This is to identify signs of bleeding. It is also necessary to limit the frequency of venipunctures and to refuse intramuscular injections. It is necessary to control the blood content of feces, vomit, urine. It is extremely necessary for these patients to perform the process of shaving, manicure, dental cleaning, using toothpicks, etc. At the same time, categorically avoid falling and other damage. It is also forbidden to take acetylsalicylic acid and alcohol, which increases the risk of gastrointestinal bleeding. In this case, it is necessary to postpone the schedule of vaccination (after 3-12 months from the end of the last chemotherapy course). It is desirable to exclude contact with infectious patients. During the treatment period, adequate contraceptive measures should be used.

If this product comes into contact with the mucous membrane or skin, rinse it thoroughly with plain water or with soap, respectively.

When breastfeeding and pregnancy

In this respect, there are certain limitations that Cyclophosphane has. The instruction indicates that the use of this drug in pregnancy is contraindicated. In this case, the impact category on the fetus is designated "D" by the FDA. For the period of treatment it is necessary to stop breastfeeding.

Overdose

In this case, there are certain nuances. The presence of a specific antidote in an overdose of this drug is unknown. This is a reliable fact. In case of overdose, it is necessary to apply supportive measures, including appropriate treatment of infectious diseases, as well as the occurrence of cardiotoxicity and / or myelosuppression.

Storage conditions

In this plan, a certain preparation, such as Cyclophosphan, requires certain conditions. The instruction for use states that it must be stored at a temperature of no more than 10 ° C in a place that is dry and protected from light. At the same time, children's access to it should be limited.

Shelf life

There is a certain period of time during which a drug such as Cyclophosphan can be used. Instruction for use indicates that the period of its suitability is 3 years. In this case, you must adhere to a certain condition. It consists in the fact that the use of this medication is strictly forbidden after the expiration of the specified period.

Implementation

In this direction, there is also a condition that "Cyclophosphane" has. Instructions for use indicate that this drug is dispensed in pharmacies only on prescription.

Conclusion

In this text there is a lot of useful information. Namely, what is represented by "Cyclophosphane", instructions for use, the price of this drug. However, it should be borne in mind that before using this medication it is necessary to consult a qualified doctor.