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CYCLOPHOSHPAMIDE: It is an alkylating agent
which produces highly reactive carbonium ion intermediates which transfer alkyl groups to cellular macro-molecules by forming covalent bonds. This results in cross linking/abnormal base pairing/ scission of DNA strand. Cross linking f nucleic acids with proteins can also take place. Transfor-mtion into active metabolites occurs in the liver and a wide range of antitumour action is exerted. It has a prominent immunosuppressant property. It is less damaging to platelets
Indications: Leukaemias, lymphogranulomatosis, lymphosatcoma, reticulum cell sarcoma, Hodgkin's disease, multiple myeloma. Inoperable solid malignancies. Combination with surgery, radiation & other hemotherapeutics drugs.
Dosage: 2-3 mg/kg/day oral; 12-15 mg/kg body wt i.v evey 7-10 days.
Contra-indications: Acute Urinary tract infection. Pregnancy. Bladder haemorrhage. Myelosup-pression. Lactation.
Special Precautions: Chloramphenicol retards the metabolism of cyclophosphamide. Elderly, debilitated, diabetes. Discontinue if W.B.C. Count is less than 3000, Cardiac, hepatic or renal disease.
Side-effects: Alopecia, gonadal suppression, cardiotoxicity. ulmonary fibrosis.
Drug Interaction: Serioustoxicity in combination with other myelotoxic drugs of radiotherapy. Phenobarbital increase metabolism and leukopenic activity. Doxorubicin and daunorubicin increase risk of cardiotoxicity. Allopurinol and Chloramphenicol increase risk of bone marrow toxicity.