Endoxan (50mg) 100 Tablets

Cyclophosphamide primarily exerts its therapeutic effects through its active metabolites, which are formed by enzymatic conversion in the liver. The drug is a prodrug that undergoes metabolism to produce two major active metabolites, phosphoramide mustard and acrolein. Phosphoramide mustard is responsible for the cytotoxic and immunosuppressive actions of cyclophosphamide. It acts by forming DNA cross-links, primarily between adjacent guanine bases, which leads to DNA damage and interference with DNA replication and transcription. This results in cell cycle arrest and cell death, particularly in rapidly dividing cells, such as those in the immune system and certain cancer cells. Acrolein, another metabolite, contributes to the overall cytotoxicity and may also play a role in the immunosuppressive effects by causing oxidative stress and damaging cellular components. The mechanism of action of cyclophosphamide involves the disruption of DNA synthesis and function, leading to cell growth inhibition and apoptosis, making it effective in treating various types of cancers and autoimmune diseases.

Cyclophosphamide

Alkylating agent.

Tablet

The following are the uses of Cyclophosphamide Tablet:

• Used for treating certain types of cancers, such as lymphoma, leukemia, and multiple myeloma.
• Used for managing severe rheumatoid arthritis and lupus.
• Used for suppressing the immune system to prevent organ rejection after transplants.
• Used for controlling inflammatory conditions like vasculitis.
• Used for treating certain autoimmune disorders.
• Used for managing some rare kidney diseases.
• Used for specific cases of severe asthma.

In the case of an overdose of Cyclophosphamide Tablets, immediate medical intervention is necessary. The severity of symptoms can vary depending on the amount ingested. Common signs of overdose may include nausea, vomiting, and severe bone marrow suppression, leading to a decrease in white blood cell count. Prompt medical treatment should be sought, and healthcare professionals should be informed to provide appropriate supportive care and manage any potential complications effectively.

In the case of a missed dose of Cyclophosphamide Tablet, it is important to take the medication as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of side effects. If you miss multiple doses, contact your healthcare provider for guidance on how to adjust your dosing schedule to ensure the best treatment outcome. It is advisable to set reminders or use a pill organizer to help you remember to take your medication on time.

To take Cyclophosphamide Tablets, swallow the prescribed number of tablets whole with a full glass of water as directed by your doctor, typically once or twice a day. It is important to take the medication at the same time each day to maintain consistent blood levels and ensure its effectiveness.

Following are the conditions or situations when Cyclophosphamide Tablet should not be used:

• Avoid using if you have a known allergy to Cyclophosphamide or any of its ingredients.
• Not suitable for individuals with severe bone marrow depression or low white blood cell counts.
• Contraindicated in patients with severe kidney or liver disease.
• Should not be used during pregnancy as it may cause harm to the fetus.
• Avoid using if you have active infections or recent vaccination with live vaccines.
• Not recommended for individuals with severe urinary tract infections or a history of urinary bleeding.
• Do not use if you have a history of severe heart disease or recent heart attack.
• Contraindicated in patients with certain types of cancers that are sensitive to Cyclophosphamide.
• Should not be used in individuals with a history of severe allergic reactions to other medications.
• Avoid using if you have a history of bowel or bladder surgery, as it may increase the risk of complications.

The side effects of Cyclophosphamide Tablet may include:

• Nausea and vomiting
• Hair loss (alopecia)
• Fatigue and weakness
• Increased risk of infections
• Mouth sores or ulcers
• Diarrhea
• Skin rashes or itching
• Reduced white blood cell count (increasing infection risk)

Following are the precautions and warnings for Cyclophosphamide Tablet:

• This medication is potentially toxic and should be handled with extreme care by healthcare professionals.
• Regular blood tests are required to monitor blood cell counts and liver/kidney function during treatment.
• Patients should be well-hydrated before and during treatment to reduce the risk of bladder toxicity.
• Urine output should be monitored, and patients should be encouraged to drink plenty of fluids to prevent bladder complications.
• Cyclophosphamide may cause infertility in both men and women. Discuss fertility preservation options with your doctor.
• It can increase the risk of developing certain types of cancer, especially bladder cancer. Regular monitoring is essential.
• Patients may experience hair loss, nausea, vomiting, and skin rashes. Inform your doctor if these symptoms become severe.
• Keep this medication out of the reach of children and pets, and store it in a secure location.

Following are the drug interactions for Clindamycin, Pycnogenol Gel:

• Concomitant use with other topical antibiotics may increase the risk of skin irritation or allergic reactions.
• Benzoyl peroxide or other harsh topical acne treatments may increase irritation or dryness when used with clindamycin and pycnogenol gel.
• Oral contraceptives may have reduced effectiveness when combined with clindamycin, especially in combination with other acne treatments.
• Topical corticosteroids may exacerbate skin thinning when used in combination with clindamycin.
• Alcohol-based products may increase skin dryness or irritation when used with the gel, leading to increased discomfort.
• Vitamin A derivatives like tretinoin or isotretinoin may increase the risk of skin dryness or irritation when used with clindamycin and pycnogenol gel.

Following are the food interactions to be aware of when taking Cyclophosphamide Tablets:

• Grapefruit and grapefruit juice consumption should be avoided as they can decrease the elimination of Cyclophosphamide, leading to increased drug levels and potential toxicity.
• Alcohol is not recommended during treatment as it can cause further suppression of the immune system and increase the risk of infections.
• Avoid cranberry juice as it may decrease the effectiveness of Cyclophosphamide by altering its metabolism.
• High-fat meals can delay the absorption of Cyclophosphamide, potentially affecting its optimal timing in the body.
• Foods rich in Vitamin C, like citrus fruits and broccoli, might interfere with Cyclophosphamide's action, so moderation is advised.
• Live or undercooked foods should be avoided to reduce the risk of foodborne illnesses, as Cyclophosphamide can weaken the immune system.
• Ensure adequate hydration by drinking plenty of fluids, especially water, to reduce the risk of bladder irritation and other kidney-related side effects.
• Follow any dietary recommendations provided by your healthcare team, as nutrition plays a crucial role in managing side effects during Cyclophosphamide therapy.

Cyclophosphamide Tablets should be stored in a secure and dry location, preferably in a medicine cabinet or designated storage area, away from direct sunlight, moisture, and heat. The tablets should be kept in their original container, tightly sealed, to maintain their integrity and protect them from exposure to air and humidity. It is crucial not to store them in the bathroom or near any heat-emitting appliances to prevent degradation. Always check the expiration date before using the medication, and if expired, dispose of it properly. Do not dispose of Cyclophosphamide Tablets by flushing or pouring them down the drain; instead, consult your pharmacist or local waste management guidelines for safe disposal methods. Keep the medication out of children's reach to prevent accidental ingestion.

Following are the quick tips for Cyclophosphamide Tablet:

• Consult your doctor to determine the appropriate dosage and duration of treatment.
• Take the tablet as directed, usually once or twice daily.
• Swallow the tablet whole with a full glass of water; do not crush, chew, or break it.
• Ensure regular blood tests to monitor your body's response and adjust the dosage if needed.
• Avoid contact with people who have recently received live vaccines, especially chickenpox or measles.
• Inform your doctor about all medications and supplements you are taking to prevent potential interactions.
• Store the tablets in a secure location, away from children and pets.
• If you experience any severe side effects, seek medical attention immediately.