Description of the medicine: Cyclophosphamide (Cyclophosphanum)
Phosphoric acid diamide N-bis- (b-Chloroethyl) -N-O-trimethylene ester.
Synonyms: Cyclophosphamide, Cyclophosphamide, Endoxan, Cyclophosphamide, Cyclophosphamidum, Cytofosfan, Cytophosphan, Cytoxan, Endoxan, Enduxan, Genoxal, Mitoxan, Procytox, Sendoxan, etc.
White crystalline powder. Soluble in water (1:50), easily soluble in alcohol, difficult - in isotonic sodium chloride solution.
It is an alkylating cytostatic drug with a characteristic chemical structure: its molecule has two phosphamide bonds and one phosphate ester bond; the synthesis was carried out in such a way that the drug had selective antitumor activity, i.e., that it was inactive while in the blood, but when it penetrated into the tumor cells, it quickly decomposed under the influence of phosphatases (phosphamidases) contained in them with release bis (b-chloroethyl) -amine.
Thus, the drug can be considered as a prodrug with a “transport” function, delivering the active cytostatic substance to the tumor cells. Recently, it has been established that phosphorus-containing active metabolites of cyclophosphamide are formed in the body, which play an important role in the antitumor effect. The drug has a relatively broad antitumor spectrum of action and has a milder effect on thrombocytopoiesis than other similar drugs.
Cyclophosphamide is used for small cell lung cancer, ovarian cancer, breast cancer, reticulosarcoma, lymphosarcoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, multiple myeloma, Williams tumor, bone reticulosarcoma, Ewing's tumor, angiosarcoma.
Enter intravenously, intramuscularly inside, as well as in the cavity.
Different treatment regimens are used: a) 200 mg (3 mg / kg) daily or 400 mg (6 mg / kg) every other day (by mouth, intravenously or intramuscularly); b) 1 g (15 mg / kg) once every 5 days intravenously; c) 2–3 g (30–45 mg / kg) once every 2–3 weeks intravenously. The course dose for all treatment regimens is 6-14 g. Other treatment regimens are also used.
When fluid accumulates as a result of the cancer process in the abdominal and pleural cavities, in addition to intravenous infections, 0.4 - 1.0 g of cyclophosphamide (with each puncture) is injected into the cavities. The amount of drug injected into a vein is reduced accordingly. After completion of the main course of treatment with cyclophosphamide, maintenance therapy can be used: 2 times a week, 0.1 0.2 g of the drug is administered intravenously (or intramuscularly) or it is prescribed orally in the form of tablets at 0.05 - 0.1 g 2 times day. Ingestion is convenient for long-term therapy.
Cyclophosphamide is also used as an immunosuppressive agent. It inhibits (like other cytostatics) the proliferation of lymphocytic clones involved in the immune response. At the same time, it acts mainly on vlymphocytes. There is evidence of the use of cyclophosphamide for glomerulonephritis, lupus erythematosus, rheumatoid arthritis, nonspecific aortoarteritis.