This page contains a brief description that does not cover the medication. For more information read the review in Felleskatalogen.no for the respective drug.

Definition

Sendoxan (cyclophosphamide) is a powerful immunosuppressant drug used in disease periods with severe rheumatic disease, for example, if the lungs or kidneys are attacked.

Dosage

• The dose can (depending on indication and disease) be given after Lupus MAINATIN trial (kidney affection) 500mg iv every 14 days a total of 6 times (3 months treatment = cumulative dose of 3g)
• Leukocytes (white blood cells, especially neutrophilic granulocytes) fall in numbers with the expected lowest value on day 10 after treatment. Weekly blood sample testing is recommended
• Urometexan prophylaxis against hemorrhagic cystitis (bloody bladder inflammation)
• Navoban or similar to nausea before and after infusion
• Sendoxan doses of up to 1250mg can be given, for example, every 2-X NUMBER weeks.
  • Lower dose in the elderly and by reduced kidney or heart function.
  • The drug is excreted by dialysis, so treatment intervals must then be considered specifically
• Cyclophosphamide is activated and metabolized via CYP-450 (note interactions)
• After induction treatment, the transition (maintenance treatment) is done
  • Azathioprine
  • Methotrexate or
  • CellCept tablets
• Sendoxan is combined with Prednisone in decreasing dose
• Protection against strong sun is recommended because the medication can contribute to increased risk of skin cancer

Pneumocystis jiroveci prevention

• Prophylactic (preventive) treatment by immunomodulatory treatment with, for example, Sendoxan or MabThera
• Bactrim / Trimethoprim Sulfa (either 2 tablets two days a week or 1 tablets daily)
  • NB Interaction with Methorexate
• In case of sulpha allergy, Dapson 50mg x 1 may be an alternative

Patient information

• The Norwegian Medical Association
• UpToDate (Amrish page)

Medications, BINDEVEVSSYKDOMMER.no

• Bindevevssykdommer.no
• Vaskulitt.no