Uniphos 200 Injection

Description of Uniphos 200 (Cyclophosphamide 200 mg) injection

Cyclophosphamide, an antineoplastic drug and one of the ingredients of Uniphos 200 injection is a type of alkylating agent. It has extensive applications in the management of different types of cancer and the treatment of some autoimmune diseases. Cyclophosphamide is a prodrug activated to active metabolites in the liver and affects the structure and functioning of DNA. It prevents division of cancer cells and causes cell death by using cross links in DNA strands. It is highly cytotoxic and hence it targets cancer and rapidly dividing normal cells.

Indications of Uniphos 200 (Cyclophosphamide 200 mg) injection

Other typical applications of Cyclophosphamide include the treatment of Breast cancer, Lymphoma (Hodgkin and Non-Hodgkin), Leukemia and Multiple myeloma and in the treatment of autoimmune diseases (including lupus and nephrotic syndrome).

Mechanism of action of Uniphos 200 (Cyclophosphamide 200 mg) injection

Phosphoramide mustard is a mustard which is a cyclophosphamide metabolite generated in the liver. These metabolites crosslink DNA strands and this interferes with DNA replication and transcription. This avoids the division of cancer cells, and ends up causing cell death. The drug is suitable in tumours as it targets fast-proliferating cells.

How to consume Uniphos 200 (Cyclophosphamide 200 mg) injection

Cyclophosphamide comes in the form of oral dosage or intravenous injection that a medical practitioner. The drug is administered in cycles and in doses depending on body surface area. The treatment is also associated with adequate hydration.

Side Effects of Uniphos 200 (Cyclophosphamide 200 mg) injection

1. Common side effects

• Nausea
• Vomiting
• Hair loss
• Fatigue
• Loss of appetite

2. Serious side effects

• Bone marrow suppression
• Hemorrhagic cystitis
• Severe infections
• Cardiotoxicity

3. Rare side effects

• Secondary malignancies
• Infertility

Safety Advice for Uniphos 200 (Cyclophosphamide 200 mg) injection

Close monitoring and regular blood analysis and urine culture should be done on the patients who are on a course of Cyclophosphamide because such a drug may compromise both the bone marrow and the urinary system.

Breastfeeding: Breastfeeding should not be exposed to cyclophosphamide that may get to the breast milk and cause damage to the infant.

Pregnancy: It should not be used in pregnancy because it has high teratogenic and cytotoxic effects.

Alcohol: Alcohol consumption must be avoided since it can cause liver stress and aggravate such side-effects like nausea.

Liver: As the drug is metabolised in the liver, liver-diseased patients are to be watched.

Lungs: Cough or breathlessness: Any of these should be reported as occasional pulmonary toxicity is possible.

Kidney: The renal functioning must be observed and sufficient hydration is needed to avoid build up and toxicity.

Driving: The patient might become dizzy or sleepy; therefore, patients are not supposed to drive at the onset of the symptoms.

Interaction of Uniphos 200 (Cyclophosphamide 200 mg) injection

• Drug–Drug Interaction

Allopurinol x Cyclophosphamide

Allopurinol has the ability to increase the toxicity of Cyclophosphamide on the bone marrow. Such a combination can result in the development of severe leukopenia and risk of increased infection rates, thus close attention to blood counts is needed.

Warfarin × Cyclophosphamide

The use of cyclophosphamide can also change the metabolism of Warfarin causing either the increase or a decrease in anticoagulant effect. It may lead to bleeding complications or decrease the therapeutic effect and close attention should be paid to the INR levels.

Cisplatin/ Cyclophosphamide

This possibility can augment the danger of nephrotoxicity and general systemic toxicity. The two drugs can affect the functioning of the kidneys and therefore, there is a need to carefully monitor patients in regard to their renal parameters.

Doxorubicin × Cyclophosphamide

These drugs may exhibit serious bone marrow suppression when combined that causes severe anaemia, neutropenia and predisposition to infections. Monitoring and dose adjustment is necessary.

Live vaccines x Cyclophosphamide

Cyclophosphamide has the effect of reducing the immune system and therefore, giving live vaccines may cause severe infections. Treatment should be done without or delayed vaccination.

Phenobarbital / Phenytoin × Cyclophosphamide

These drugs lead to increase in liver enzymes and may increase metabolism rate of Cyclophosphamide and alter its activity or alter its toxicity pattern.

Corticosteroids × Cyclophosphamide

This mixture can increase the immunosuppression, contributing to the threat of infections and slow healing of the wound.

Mesna × Cyclophosphamide

Mesna is commonly used in combination with increasing chances of hemorrhagic cystitis by counteracting toxic metabolites in the urine. This is a protective interaction and is widely used in clinical practice.

• Drug–Food Interaction

None of the food interaction is important; however, it is important to stay hydrated and not to drink alcohol during therapy.

• Drug–Disease Interaction of Uniphos 200 (Cyclophosphamide 200 mg) injection

Bone marrow suppression:
Cyclophosphamide reduces blood cells formation thus making one prone to anaemia, infections and bleeding.

Urinary bladder disorders:
Hemorrhagic cystitis may occur because of toxic metabolites of the drug which particularly occurs in patients with a pre-existing bladder condition.

Liver disease:
The liver dysfunction can influence activation of the drug and influence its effect and toxicity.

Renal impairment:         
The poor functioning of the kidney can result in build-up of toxic wastes.

Contraindication of Uniphos 200 (Cyclophosphamide 200 mg) injection

Should not be administered with hypersensitivity, severe bone marrow incompetence, and pregnancy, and active infections.

Dosage of Uniphos 200 (Cyclophosphamide 200 mg) injection

Its dosage varies with the body surface area of the body and has cycles depending on the oncologist. The dose might need to be adjusted according to toxicity and response of the patient.

Storage of Uniphos 200 (Cyclophosphamide 200 mg) injection

It is administered in cycles according to its dosage which is dependent on the surface area of the body according to the oncologist. The dose might need to be adjusted according to toxicity and response of the patient.

Missed Dose of Uniphos 200 (Cyclophosphamide 200 mg) injection

Medical care must be done in case of a dose omission, the dose is to be taken as soon as possible.

Other General Information of Uniphos 200 (Cyclophosphamide 200 mg) injection

To ensure less bladder toxicity, patients are to be hydrated and frequently urinate. Frequent follow up must be done to cheque response to treatment and adverse effects. Any symptoms like blood in the urine, fever or extreme fatigue need to be reported as soon as possible.

FAQs of Uniphos 200 (Cyclophosphamide 200 mg) injection

1. What is the significance of hydration in Cyclophosphamide treatment?

Hydration assists in the dilution of toxic metabolites in the urine and minimising the chance of hemorrhagic cystitis.

2. Is Cyclophosphamide capable of influence on fertility?

Well, it could make both men and women infertile because of its impact on rapidly-dividing cells.

3. And what is hemorrhagic cystitis?

It is a bladder inflammation and bleeding, which occurs due to toxic metabolites of the drug.

4. Why are blood tests required?

To help keep a track of bone marrow suppression and identify complications at an early stage.

5. Does Cyclophosphamide make people prone to infection?

Yes, because of the inhibition of white blood cells, patients are susceptible to infections.

Fact Box of Uniphos 200 (Cyclophosphamide 200 mg) injection

Field	Details
Generic Name	Cyclophosphamide
Therapeutic Class	Anti-neoplastic agent
Pharmacological Class	Alkylating agent
Dosage form	Injection
Habit forming	No
Indication	Breast cancer, lymphoma

 

References

• FDA Prescribing Information – Cyclophosphamide
  https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/012141s092lbl.pdf
• European Medicines Agency (EMA) – Cyclophosphamide Product Information
  https://www.ema.europa.eu/en/documents/product-information/endoxan-epar-product-information_en.pdf
• DrugBank – Cyclophosphamide
  https://go.drugbank.com/drugs/DB00531
• National Cancer Institute (NCI) – Cyclophosphamide
  https://www.cancer.gov/about-cancer/treatment/drugs/cyclophosphamide