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Oral cyclophosphamideHemorrhagic cystitisMetabolite acroleinIfosfamideMesnaHematuriaUrotoxicityUrotoxicCystitis1999ChemotherapyDiscontinueHematologicUrineCytotoxicUrinary bladderBreakdownLiverMyelosuppressionIntravenousVivoIrrigationDoseNephrotoxicityStableMalignanciesCommonlySevereTreatmentRiskSide effectsProfileAgentsCasesReduce

Oral cyclophosphamide3

• The IV mesna infusions would be given with IV ifosfamide, while oral mesna would be given with oral cyclophosphamide. (wikipedia.org)
• Single agent: oral cyclophosphamide is usually administered at dosages in the range of 1 to 5 mg/kg/day for both initial and maintenance dosing. (wikidoc.org)
• Many other regimens of intravenous and oral cyclophosphamide have been reported. (pillintrip.com)

Hemorrhagic cystitis9

• Patients who undergo hematopoietic stem cell transplantation frequently have hemorrhagic cystitis because most are exposed to cyclophosphamide, total-body irradiation, or both. (medscape.com)
• The bladder anatomy relevant to noninfectious hemorrhagic cystitis includes an appreciation of the layers from the lumen outward. (medscape.com)
• Cyclophosphamide is the most common cause of hemorrhagic cystitis in the oncologic population. (medscape.com)
• If hemorrhagic cystitis does not resolve despite clot evacuation and irrigation, a variety of agents may be instilled into the bladder to promote local hemostasis. (medscape.com)
• In patients undergoing chemotherapy with cyclophosphamide, which is known to cause hemorrhagic cystitis, use of antidotes may have prophylactic benefit. (medscape.com)
• Walker RD. Cyclophosphamide induced hemorrhagic cystitis. (medscape.com)
• Stillwell TJ, Benson RC Jr. Cyclophosphamide-induced hemorrhagic cystitis. (medscape.com)
• Very bad and sometimes deadly urinary tract problems like hemorrhagic cystitis have happened with this medicine (cyclophosphamide capsules). (edrugswiki.com)
• Discontinue cyclophosphamide therapy in case of severe hemorrhagic cystitis. (edrugswiki.com)

Metabolite acrolein2

• The urotoxicity observed with cyclophosphamide is due to its liver metabolite acrolein, which is excreted in the urine. (medscape.com)
• As previously discussed, mesna binds to the urotoxic cyclophosphamide metabolite acrolein, creating stable thioester compounds with no bladder toxicity. (medscape.com)

Ifosfamide5

• Mesna, sold under the brand name Mesnex among others, is a medication used in those taking cyclophosphamide or ifosfamide to decrease the risk of bleeding from the bladder. (wikipedia.org)
• It works by altering the breakdown products of cyclophosphamide and ifosfamide found in the urine making them less toxic. (wikipedia.org)
• Mesna is used therapeutically to reduce the incidence of haemorrhagic cystitis and haematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy. (wikipedia.org)
• Mesna is a water-soluble compound with antioxidant properties, and is given concomitantly with the chemotherapeutic agents cyclophosphamide and ifosfamide. (wikipedia.org)
• In the kidney, mesna disulfide is reduced to free mesna, which has thiol groups that react with acrolein, the metabolite of ifosfamide and cyclophosphamide considered responsible for urotoxicity. (medscape.com)

Mesna5

• Mesna assists to detoxify these metabolites by reaction of its sulfhydryl group with α,β-unsaturated carbonyl containing compounds such as acrolein. (wikipedia.org)
• Mesna reduces the toxicity of urotoxic compounds that may form after chemotherapy administration. (wikipedia.org)
• Mesna concentrates in the bladder where acrolein accumulates after administration of chemotherapy and through a Michael addition, forms a conjugate with acrolein and other urotoxic metabolites. (wikipedia.org)
• Two standard methods of preventing cyclophosphamide-related bladder toxicity are hyperhydration and mesna administration. (medscape.com)
• Mesna inactivates acrolein and prevents urothelial toxicity without affecting cytostatic activity. (medscape.com)

Hematuria1

• Persistent hematuria can be treated with bladder irrigation, using carboprost, 1-2% alum, or silver nitrate. (medscape.com)

Urotoxicity3

• Although the entire urothelium is at risk of urotoxicity, the bladder, which serves as a reservoir, is most frequently affected, because the contact time between acrolein and the urothelium is greatest at this site. (medscape.com)
• Urotoxicity and myelosuppression is known as the most prevailing dose-limiting toxicity associated with CP. (researchwap.com)
• The result of the present study revealed that aqueous leaf extract of V. amygdalina has the potential to prevent urotoxicity and myelosuppression induced by CP and thus can be used as therapeutic adjuvant in the management of CP and other oxazaphosphorine toxicities. (researchwap.com)

Urotoxic1

• These two anticancer agents, in vivo, may be converted to urotoxic metabolites, such as acrolein. (wikipedia.org)

Cystitis2

• Cystitis is generally defined as inflammation of the urinary bladder. (uic.edu)
• A simple cystitis that does not involve the rest of the urinary tract, for example confined to the urethra, is not as serious as the descending type in which various parts of the urinary system (eg, ureters, kidneys and bladder) may be involved. (uic.edu)

19991

• 1999. Acrolein-induced toxicity. (cdc.gov)

Chemotherapy1

• Metronomic chemotherapy is often administered in conjunction with an NSAID, such as piroxicam, therefore we can see toxicity associated with these medications. (ethosvet.com)

Discontinue1

• Monitor for CNS toxicity and discontinue treatment for encephalopathy. (guidelinecentral.com)

Hematologic2

• Treatment is repeated every 3 weeks or after recovery from hematologic toxicity. (guidelinecentral.com)
• When used as the only oncolytic drug therapy, the initial course of cyclophosphamide for patients with no hematologic deficiency usually consists of 40 mg per kg to 50 mg per kg given intravenously in divided doses over a period of 2 to 5 days. (pillintrip.com)

Urine2

• Deep to this transitional epithelium, which is covered superficially by "umbrella" cells, the bladder submucosa with its microvasculature overlies the detrusor muscle, which is smooth muscle oriented in multiple directions to allow for uniform stretching and the storage of urine. (medscape.com)
• 1993. Determination of acrolein in urine by liquid chromatography and fluorescence detection of its quinoline derivative. (cdc.gov)

Cytotoxic3

• Evidence for the formation of the cytotoxic aldehyde acrolein from enzymatically oxidized spermine or spermidine. (cdc.gov)
• Cyclophosphamide, [2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxzaphosphorine-2- oxide] is one of the most effective and widely used cytotoxic antitumor agents. (researchwap.com)
• When cyclophosphamide is included in combined cytotoxic regimens, it may be necessary to reduce the dose of cyclophosphamide as well as that of the other drugs. (pillintrip.com)

Urinary bladder1

• The protective effects of V. amygdalina was further evident through decreased histopathological alteration of the urinary bladder, kidney and liver tissues unlike the CP and O. gratissimum treated groups. (researchwap.com)

Breakdown2

• It also directly reacts with 4-hydroxy metabolites, inhibiting breakdown and release of acrolein. (medscape.com)
• Acrolein, a breakdown product of cyclophosphamide, is known to irritate the bladder epithelium. (ethosvet.com)

Liver1

• CYP inducers - such as phenytoin and carbamazepine - increase rate of NAPQI production / liver toxicity, after acetaminophen overdose. (naplexstudyguide.com)

Myelosuppression1

• Cyclophosphamide can cause myelosuppression (leukopenia, neutropenia, thrombocytopenia and anemia), bone marrow failure, and severe immunosuppression which may lead to serious and sometimes fatal infections, including sepsis and septic shock. (edrugswiki.com)

Intravenous1

• In order to prevent bladder toxicity, IFEX should be given with extensive hydration consisting of at least 2 liters of oral or intravenous fluid per day. (guidelinecentral.com)

Vivo1

• 1976. Studies on the in vivo formation of acrolein. (cdc.gov)

Irrigation1

• [ 4 ] Controversial methods include prophylactic bladder irrigation and hourly voiding. (medscape.com)

Dose2

• Monitoring of complete blood counts is essential during cyclophosphamide treatment so that the dose can be adjusted, if needed. (edrugswiki.com)
• Cyclophosphamide treatment may not be indicated, or should be interrupted, or the dose reduced, in patients who have or who develop a serious infection. (edrugswiki.com)

Nephrotoxicity1

• Piroxicam alone has been reported to cause GI toxicity in 6-23% and nephrotoxicity in approximately 5% of cancer-bearing dogs. (ethosvet.com)

Stable1

• Metronomic chlorambucil has be trialed in dogs with transitional cell carcinoma of the bladder in dogs, with 70% having a response or sustained stable disease for median of 119 days. (ethosvet.com)

Malignancies1

• Cyclophosphamide, although effective alone in susceptible malignancies, is more frequently used concurrently or sequentially with other antineoplastic drugs. (pillintrip.com)

Commonly1

• This is commonly executed using a combination of cyclophosphamide (cytoxan) and piroxicam, however several other protocols have been published, including chlorambucil, etoposide and thalidomide. (ethosvet.com)

Severe1

• CNS toxicities can be severe and result in encephalopathy and death. (guidelinecentral.com)

Treatment2

• Cyclophosphamide is a antineoplastic , immunosuppressive agent that is FDA approved for the treatment of malignant diseases , minimal change nephrotic syndrome in pediatric patients. (wikidoc.org)
• Cyclophosphamide is indicated for the treatment of biopsy proven minimal change nephrotic syndrome in pediatrics patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy. (pillintrip.com)

Risk2

• By knowing these mechanistic facts, you can conclude that taking both allopurinol and one of those two drugs together will increase the risk of azathioprine / mercaptopurine toxicity. (naplexstudyguide.com)
• During or immediately after the administration, adequate amounts of fluid should be ingested or infused to force diuresis in order to reduce the risk of urinary tract toxicity. (pillintrip.com)

Side effects2

• Many natural products have been widely reported to ameliorate at varying degrees the side effects of oxazophosphorines e.g. cyclophosphamide and ifosphamide (Łukasz and Piotr, 2012). (researchwap.com)
• What are some other side effects of Cyclophosphamide Capsules? (edrugswiki.com)

Profile1

• It is often an attractive option for clients due to its relatively low toxicity profile, moderate cost, and less intensive recheck schedule. (ethosvet.com)

Agents1

• Cyclophosphamide (CP) is one of the most potent and widely used alkylating anticancer agents. (researchwap.com)

Cases1

• For this reason, it is used in cases of toxicity / overdose. (naplexstudyguide.com)

Reduce1

• G-CSF may be administered to reduce the risks of neutropenia complications associated with cyclophosphamide use. (edrugswiki.com)