Name
- Cyclophosphamide.
Class of drug
- Nitrogen mustard group.
Uses
Action
- Antineoplastic cytotoxic immunosuppressive alkylating agent
.
Indications
- Lymphoproliferative disease .
- Myeloproliferative disease.
- Sarcoma , carcinoma .
- Immune-mediated diseases .
Adverse reactions
Other reported reactions
- Myelosuppression, with the nadir usually occurring 7-14 days after the start of therapy.
- Sterile hemorrhagic cystitis (the risk may be reduced by increasing water consumption and ensuring adequate urine flow) - rare complication in cats.
- Vomiting.
- Diarrhea.
- Reduction in hair growth rate.
Treatment
Myelosuppression- Regular monitoring of neutrophil is recommended. Adjust dose as necessary.
- Prophylactic antibiotics when neutrophil count <1000.
Sterile hemorrhagic cystitis
- The risk may be reduced by increasing water consumption and inducing polyuria.
- Administer in morning to allow animal to urinate out of bladder, evening dosing increases dwell time of toxic metabolite (acrolein) in bladder as animal sleeps.
- Administer furosemide concurrently to increase urine production and therefore dilution and excretion of the toxic metabolite.
Treatment
- Discontinue cyclophosphamide.
- Treat concurrent UTI.
- Increase fluid intake possibly with use of furosemide.
- Possible use of anti-inflammatory doses of corticosteroids.
- Intracavitary instillation of formalin or DMSO in cases that do not respond to above therapies after 2-3 months.
