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.
Sendoxan (cyclophosphamide) is a powerful immunosuppressant drug used in disease periods with severe rheumatic disease, for example, if the lungs or kidneys are attacked.
- The dose (depending on indication and disease) may be given after Lupus MAINATIN trial (kidney infection) 500mg iv every 14 day 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
- 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