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Endoxan
Synovia Pharma PLC.
Generic: Cyclophosphamide
Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Endoxan.
CONSULT YOUR DOCTOR
Endoxan is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
UNSAFE
Endoxan is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.
UNSAFE
Endoxan may cause side effects which could affect your ability to drive.
Endoxan may cause undesirable effects (e.g., dizziness, blurred vision, visual impairment) which could affect the ability to drive.
CAUTION
Endoxan should be used with caution in patients with severe kidney disease. Dose adjustment of Endoxan may be needed. Please consult your doctor.
CAUTION
Endoxan should be used with caution in patients with liver disease. Dose adjustment of Endoxan may be needed. Please consult your doctor.
Medicine Overview of Endoxan 200mg/vial Injection
Introduction
Endoxan is used in the treatment of different kinds of cancers. It is also used to treat kidney disease known as nephrotic syndrome in children after other treatments have not worked. It may be also used to treat other conditions, as determined by the doctor. Endoxan should be taken with food preferably in morning but at the same time every day to get the most benefit. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You...
... Show moreUses of Endoxan
- Cancer
- Nephrotic syndrome
Side effects of Endoxan
Common
- Vomiting
- Nausea
- Hair loss
- Fever
- Blood in urine
- Diarrhea
- Decreased white blood cell count (neutrophils)
How to use Endoxan
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Endoxan is to be taken with food.
How Endoxan works
Endoxan is an anti-cancer medication. It is an alkylating agent which works by damaging the genetic material (DNA and RNA) of the cancer cells, thereby stopping their growth and multiplication. This is how it works against cancer.
Quick Tips
- Endoxan helps in the treatment of cancer.
- Drink plenty of fluids or urinate frequently to prevent urinary problems while taking this medication.
- Take it with food if you experience irritation of the stomach, preferably in the morning.
- Your doctor may get regular blood tests to monitor your blood counts while on treatment with this medication.
- You are more likely to get sick or heal slower while taking this medication. Talk to your doctor before getting any vaccines.
- Contact your doctor immediately if you experience difficulty in urinating or blood in urine while on treatment with this medication.
- Do not take Endoxan if you are pregnant or breastfeeding.
- Use effective contraception method to prevent pregnancy while taking this medicine.
Brief Description
Indication
Bone marrow transplantation, malignancies, lymphomas, brain cancer, leukemia, systemic lupus erythematosus, minimal change disease, severe rheumatoid arthritis, wegener's granulomatosis, multiple sclerosis, multiple myeloma, carcinoma of the breast, ovarian carcinoma, neuroblastoma, retinoblastoma.
Administration
Should be taken on an empty stomach. Preferably taken on an empty stomach, but may be taken w/ meals to minimise GI irritation. Ensure adequate fluid intake. Swallow whole. IV Preparation Maximum concentration of cyclophosphamide is limited to 20 mg/mL because of solubility IV push: Reconstitute with NS (do not use SWI, because it is hypotonic) Infusion: Reconstitute with SWI to concentration of 20 mg/mL May dilute further with D5W, NS, lactated Ringer solution, or other compatible fluids IV Administration Infusions may be administered over 1-2 hours Doses >500 mg up to ~1 g may be administered over 20-30 minutes...
... Show moreAdult Dose
Malignant Diseases
IV (intermittent therapy): 40-50 mg/kg (400-1800 mg/m²) divided over 2-5 days; may be repeated at intervals of 2-4 weeks
IV (continuous daily therapy): 60-120 mg/m²/day (1-2.5 mg/kg/day)
PO (intermittent therapy): 400-1000 mg/m² divided over 4-5 days
PO (continuous daily therapy): 50-100 mg/m²/day or 1-5 mg/kg/day
Nephrotic Syndrome
2-3 mg/kg/day for up to 12 weeks when corticosteroids unsuccessful
Non-Hodgkin Lymphoma
600-1500 mg/m² IV with other antineoplastics (part of CHOP regimen); dose intensification possible
Breast Cancer
600 mg/m² IV with other antineoplastics; dose intensification possible
Child Dose
Malignant Diseases
IV (intermittent therapy): 40-50 mg/kg (400-1800 mg/m²) divided over 2-5 days; may be repeated at intervals of 2-4 weeks
IV (continuous daily therapy): 60-120 mg/m²/day (1-2.5 mg/kg/day)
PO (intermittent therapy): 400-1000 mg/m² divided over 4-5 days
PO (continuous daily therapy): 50-100 mg/m²/day
uvenile Idiopathic Arthritis/Vasculitis
10 mg/kg IV every 2 weeks
Nephrotic Syndrome
2-3 mg/kg/day for up to 12 weeks when corticosteroids unsuccessful
Systemic Lupus Erythematosus
500-750 mg/m² IV monthly; not to exceed 1 g/m²
Contraindication
Bladder haemorrhage. Patients with bone-marrow aplasia, acute infection, drug- or radiation-induced urothelial toxicity. Porphyria. Pregnancy and lactation.
Mode of Action
Cyclophosphamide is a prodrug which is converted in the body to the active metabolites. It acts at any stage of the cell cycle but its main action is blockage at the G2 stage. It arrests cell division by alkylating the DNA in a dose-dependent manner. It also exerts immunosuppressive effects possibly due to a cytotoxic effect on lymphocytes.
Precaution
Blood disorders. Elderly or debilitated patients. Diabetic patients. Renal or hepatic impairment or who have gone adrenaloctomy. Previous treatment with x-ray or cytotoxic agents. Monitor haematological profile and presence of RBCs in urine regularly. Maintain adequate hydration and frequent micturition to reduce the risk of cystitis.
Lactation: Drug excreted in breast milk; do not nurse
Side Effect
Alopecia, skin and nails hyperpigmentation, nausea and vomiting, mucositis, inappropriate antidiuretic hormone secretion, carbohydrate metabolism disturbances, gonadal suppression, interstitial pulmonary fibrosis.
Potentially Fatal: Anaphylactic reactions, bone marrow failure, severe immunosuppression, urotoxicity, cardiotoxicity, hyponatraemia, haemorrhagic cystitis.
Pregnancy Category Note
Pregnancy Based on mechanism of action and published reports of effects in pregnant patients or animals, drug can cause fetal harm when administered to pregnant woman; exposure to cyclophosphamide during pregnancy may cause fetal malformations, miscarriage, fetal growth retardation, and toxic effects in the newborn; drug is teratogenic and embryo-fetal toxic in mice, rats, rabbits and monkeys; advise pregnant women and females of reproductive potential of the potential risk to the fetus Verify the pregnancy status of females of reproductive potential prior to the initiation of therapy Contraception Therapy can cause fetal harm; advise females of reproductive potential to use...
... Show moreInteraction
Increased risk of cardiotoxicity w/ doxorubicin or other cardiotoxic drugs. May increase incidence of mucositis w/ protease inhibitors. May increase haematotoxicity and/or immunosuppression w/ ACE inhibitors, natalizumab, paclitaxel, thiazide diuretics, zidovudine. May increase pulmonary toxicity w/ amiodarone. May increase nephrotoxicity w/ amphotericin B. May result to acute water intoxication w/ indometacin. May increase risk of hepatotoxicity w/ azathioprine. May increase incidence of hepatic veno-occlusive disease and mucositis w/ busulfan. May increase risk of haemorrhagic cystitis w/ previous or concomitant radiotherapy. May result to acute encephalopathy w/ metronidazole. May increase risk of thromboembolic complications. May alter the effect of warfarin. May...
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