Description

Endoxan (cyclophosphamide) 50mg is a chemotherapy medication used to treat various types of cancer, as well as certain kidney disorders.

Mechanism of Action

• 

  Cyclophosphamide

  Chemotherapy medication and immune system suppressor

  More

  Use Cases

  Treats lymphoma, multiple myeloma, leukemia, ovarian cancer, breast cancer, small cell lung cancer, neuroblastoma, sarcoma; suppresses immune system in conditions like nephrotic syndrome, granulomatosis with polyangiitis, and post organ transplant

  Administration

  Orally or by injection into a vein

  Common Side Effects

  Low white blood cell counts, loss of appetite, vomiting, hair loss, bleeding from the bladder

  Endoxan (cyclophosphamide) is an alkylating agent that interferes with DNA replication, leading to cell death, particularly in rapidly dividing cancer cells.The main mechanism of action is:

  • Cyclophosphamide is a prodrug that requires metabolic activation in the liver to become cytotoxic.
  • The active metabolite phosphoramide mustard forms DNA crosslinks both between and within DNA strands at guanine N-7 positions, leading to irreversible cell apoptosis.
  • Cyclophosphamide has relatively little typical chemotherapy toxicity in bone marrow stem cells, liver and intestinal epithelium due to high levels of aldehyde dehydrogenases (ALDHs) that convert it to an inactive metabolite.

  In addition, cyclophosphamide has immunomodulatory effects in adaptive immunotherapy, including:

  • Elimination of T regulatory cells (CD4+CD25+ T cells) in naive and tumor-bearing hosts
  • Induction of T cell growth factors, such as type I IFNs
  • Enhanced grafting of adoptively transferred, tumor-reactive effector T cells

  .

Indications

• In addition to cancer treatments, Endoxan is uniquely used to treat nephrotic syndrome, a kidney disorder.
• It is one of the few chemotherapy drugs approved for this non-oncological indication.

Dosing and Administration

• Endoxan has a relatively wide dosing range, from 100-300mg daily, allowing for individualized titration.
• It can be taken as a single daily dose or divided into multiple doses per day.

Safety Considerations

• Endoxan has a black box warning for potential development of secondary cancers with long-term use.
• It requires close monitoring of blood counts and other parameters to manage potential toxicities.

Formulations

• The 50mg tablet formulation is unique, as many chemotherapy drugs are available in higher strengths or injectable forms.                                                                                                                                    The active ingredient is:
  • Cyclophosphamide monohydrate (53.5mg per 50mg tablet)

  The inactive ingredients (excipients) include:

  • Calcium carbonate, calcium hydrogen phosphate, carmellose sodium, gelatin, glycerol, lactose, maize starch, magnesium stearate, macrogol, montan glycol wax, polysorbate, povidone, saccharose, silicon dioxide, talc, and titanium dioxide.

  key storage requirements for Endoxan (cyclophosphamide) 50mg tablets:

  • Store at 20°C to 25°C (68°F to 77°F) in a cool, dry place
  • Keep out of reach of children and pets
  • Reconstituted injectable solution should be used within 24 hours and stored below 8°C (46°F)