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Introduction About NUPHOS 500MG INJECTION

NUPHOS 500MG INJECTION contains Cyclophosphamide, which belongs to a group of medicines called Cytotoxic agents or Anti-cancer agents. It is indicated for malignant diseases in adults and children (such as malignant lymphomas, Hodgkin’s disease, Non-Hodgkin’s lymphoma, lymphocytic lymphoma mixed-cell type lymphoma, histiocytic lymphoma, Burkitt’s lymphoma, multiple myeloma, chronic lymphocytic leukemia, chronic granulocytic leukemia, acute myelogenous and monocytic leukemia, acute lymphoblastic leukemia, mycosis fungoides, neuroblastoma, adenocarcinoma of the ovary, retinoblastoma, Ewing’s sarcoma, breast cancer. It is also used for minimal change nephrotic syndrome in children.

NUPHOS 500MG INJECTION is not recommended for use in patients with acute infections, bone-marrow aplasia, urinary tract infections like cystitis, acute urothelial toxicity from cytotoxic chemotherapy or radiation therapy, urinary outflow obstruction, or unmanageed infections. Before receiving NUPHOS 500MG INJECTION inform your doctor if you are allergic or have anaphylactic reactions, bone marrow suppression, neutropenic fever, serious infections, severe immune suppression, concomitant chemotherapy and/or radiation therapy, urinary tract and renal diseases, heart diseases, pneumonitis, pulmonary fibrosis, pulmonary veno-occlusive disease, respiratory failure, pneumonitis and secondary malignancies, veno-occlusive liver disease, SIADH (syndrome of inappropriate secretion of antidiuretic hormone), rare hereditary problems of fructose intolerance, galactose intolerance, glucose-galactose malabsorption, Lapp lactase deficiency, sucrase-isomaltase insufficiency, adrenal insufficiency, diabetes and poor general health.

NUPHOS 500MG INJECTION is not recommended for use by pregnant women. It is generally not recommended for use in breastfeeding women as it may pass through the breast milk. NUPHOS 500MG INJECTION should be used with caution in children and adolescents. It should be used with caution in elderly patients. The most common side effects of receiving NUPHOS 500MG INJECTION are nausea, vomiting, weight loss, alopecia, hematuria and leukopenia. Contact your doctor if any of your symptoms gets worse or persists for a long duration.

Uses Of NUPHOS 500MG INJECTION

It is used for:

malignant diseases in adults and children
minimal change nephrotic syndrome in children

How NUPHOS 500MG INJECTION Works

NUPHOS 500MG INJECTION works by interfering with the malignant cell growth by cross-linking of cancer cells DNA. NUPHOS 500MG INJECTION also transfers alkyl groups to DNA during the process of cell division, thus managing the normal synthesis of DNA. Therefore it works against the growth and multiplication of cancer cells.

How to use NUPHOS 500MG INJECTION

NUPHOS 500MG INJECTION will be administered only by a doctor or a nurse into a vein as an intravenous injection or infusion. Your doctor will decide the correct dose and duration for you depending on your age, body weight and disease condition.

Side Effects Of NUPHOS 500MG INJECTION

Common

nausea, vomiting
weight loss
alopecia (hair loss)
hematuria
leukopenia (decrease in white blood cells)

Uncommon

diarrhea
darkening of skin/fingernails
stomatitis
anorexia
headache
diaphoresis
gonadal suppression
hyperuricemia
impaired wound healing
amenorrhea, premature menopause

Rare

Pain and redness at the injection site

Stop receiving NUPHOS 500MG INJECTION and contact your doctor immediately if you experience any of the following side effects:

Allergic reactions such as anaphylaxis, swelling of the face, lips, ankles/legs causing shortness of breath
Palpitations
Weight gain, dizziness or loss of consciousness
Signs of infection include fever, sore throat, cold and cough
Signs of bleeding from gums, bruising and petechiae due to a decrease in platelet count
Haematuria (blood in urine)

How To Manage Side Effects

Diarrhea

Drink lots of fluids, such as water or fruit juices to keep you hydrated. Do not take any medicine on your own for managing diarrhea. Contact your doctor if the symptom did not improve.

Headache

Rest and relax. Drink plenty of fluids such as water and electrolytes. Apply a pain-relieving balm on the head if necessary. Do not consume alcohol. Contact your doctor if the symptom did not improve.

Nausea And Vomiting

Take the medicine, with or just after a meal. Stick to simple meals. Avoid eating oily or spicy food.

Warning & Precautions

Pregnancy

Contraindicated

NUPHOS 500MG INJECTION is generally not recommended for use in pregnant women. Consult your doctor before receiving NUPHOS 500MG INJECTION.

Breastfeeding

Contraindicated

NUPHOS 500MG INJECTION is generally not recommended for use in breastfeeding women as it may pass through the breast milk. Consult your doctor before receiving NUPHOS 500MG INJECTION.

Driving and Using Machines

Use with Caution

Do not drive or operate any machinery if you feel dizziness, blurred vision, and visual impairment after receiving NUPHOS 500MG INJECTION.

Alcohol

Consult your doctor

Avoid consumption of alcohol while receiving NUPHOS 500MG INJECTION as it increases nausea and vomiting caused by NUPHOS 500MG INJECTION.

Kidney

Consult your doctor

NUPHOS 500MG INJECTION is not recommended if you have kidney or bladder problems as a result of previous chemotherapy or radiotherapy. It should be used with caution in patients with kidney diseases. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Liver

Use with Caution

NUPHOS 500MG INJECTION should be used with caution in patients with liver diseases. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Allergy

Use with Caution

Do not receive NUPHOS 500MG INJECTION if you are allergic to Cyclophosphamide or any other ingredients of this medicine.

Lungs

Use with Caution

[GBNEYWORD] should be used with caution in patients with lung diseases such as pneumonia, pulmonary fibrosis, pulmonary venous-occlusive disease, respiratory failure, and pneumonitis. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Heart Disease

Use with Caution

NUPHOS 500MG INJECTION should be used with caution in patients with heart disease such as myocarditis, myopericarditis, and pericardial effusion including cardiac tamponade, congestive heart failure, ventricular arrhythmias. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Use In Pediatrics

Use with Caution

NUPHOS 500MG INJECTION should be used with caution in children. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Use In Geriatrics

Use with Caution

NUPHOS 500MG INJECTION should be used with caution in elderly patients aged 65 years or above. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Others

NUPHOS 500MG INJECTION is not recommended for use if you have:

acute infections
bone-marrow aplasia
urinary tract infection like cystitis
acute urothelial toxicity from cytotoxic chemotherapy and radiation
urinary outflow obstruction
unmanageed infections

Before receiving NUPHOS 500MG INJECTION, inform your doctor if you have:

bone marrow suppression
serious infections include pneumonia, bacterial, fungal, viral, protozoal, and parasitic infections
severe immune suppression
concomitant chemotherapy and/or radiation therapy
urinary tract and renal diseases like haemorrhagic cystitis, pyelitis, urethritis, and hematuria
urotoxicity such as bladder ulceration, necrosis, fibrosis, contracture
urinary tract obstructions or active urinary tract infections
secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, sarcomas, and bladder cancer)
veno-occlusive liver disease
poor wound healing
hyponatremia
SIADH (syndrome of inappropriate secretion of antidiuretic hormone)
rare hereditary problems of fructose intolerance, galactose intolerance, glucose-galactose malabsorption
diabetes

Interactions

A. Drug-Drug interactions:

Before receiving NUPHOS 500MG INJECTION, inform your doctor if you are taking any of the following medicine:

Medicines used for cancer (Ex. paclitaxel, Busulfan, thiotepa)
Depolarizing muscle relaxants Ex. succinylcholine (a medicine used in anaesthesia)
Aprepitant
Ciprofloxacin, chloramphenicol, sulfadiazine, sulfasalazine, sulfamethoxazole, Rifampin (medicines used to manage bacterial infections)
Fluconazole, itraconazole, Amphotericin-B (medicines used for fungal infections)
Prasugrel (medicines used to thin the blood)
Allopurinol (medicines used for gout)
Azathioprine (medicines used to reduce the activity of the immune system)
Chloral hydrate (medicines used for insomnia)
Medicines used to manage stomach ulcers (Ex. cimetidine)
Disulfiram (medicines used for alcoholism)
Glyceraldehyde (medicines used for warts)
Protease inhibitors Ex. atazanavir, darunavir, Zidovudine (medicines used to manage viral infection)
Ondansetron
Medicines used to manage epilepsy or seizures (Ex. carbamazepine, phenobarbital, phenytoin)
St. John’s wort (used for depression)
Corticosteroids (medicines used for inflammation)
Carbimazole (medicines used for an overactive thyroid)
Medicines used for multiple sclerosis Ex. natalizumab
Medicines used to manage high blood pressure (enalapril, thiazide diuretics such as hydrochlorothiazide or chlorthalidone)
Amiodarone (medicines used to manage irregular heartbeat)
Medicine used to increase white blood cell numbers after chemotherapy (Ex. GM-CSF, G-CSF)
Indomethacin (medicines used to manage pain and inflammation)
Etanercept (medicines used for rheumatoid arthritis)
Metronidazole (medicines used for bacterial or protozoal infections)
Bupropion (medicines used to manage depression)
Digoxin, β-acetyl digoxin (medicines used for heart conditions)
Vaccines Ex. BCG vaccine, anthrax vaccine (used to manage infections)
Verapamil (medicines used to manage high blood pressure, angina or irregular heartbeat)
Clozapine (medicines used to manage psychotic disorders)

Overdosage:

NUPHOS 500MG INJECTION will be administered by your doctor or nurse, so it is unlikely to cause an overdose, if you experience any unusual reactions, consult your doctor immediately or visit the nearby hospital.

Synopsis

Drug	:	Cyclophosphamide
Pharmacological Category	:	Alkylating agents
Therapeutic Indication	:	Malignant diseases, Minimal change nephrotic syndrome in children
Dosage Forms	:	Tablet, Injection, Infusion

More Information

Keep NUPHOS 500MG INJECTION out of the sight and reach from children
Store NUPHOS 500MG INJECTION at 2°C to 8°C

FAQs About NUPHOS 500MG INJECTION

Q: How NUPHOS 500MG INJECTION is given?

A: NUPHOS 500MG INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous injection or infusion. Your doctor will determine the correct dose and duration for you depending on your age, body weight and disease condition.

Q: Does NUPHOS 500MG INJECTION cause hair loss?

A: Yes. NUPHOS 500MG INJECTION may cause hair loss. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Q: Can I receive NUPHOS 500MG INJECTION during pregnancy?

A: No. NUPHOS 500MG INJECTION is not recommended for use by pregnant women. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Q: Does NUPHOS 500MG INJECTION cause mouth ulcers?

A: Yes. NUPHOS 500MG INJECTION causes mouth ulcers. Contact your doctor before receiving NUPHOS 500MG INJECTION.

Q: Can I receive vaccines while using NUPHOS 500MG INJECTION?

A: No. Do not receive vaccines while using NUPHOS 500MG INJECTION. Contact your doctor before receiving NUPHOS 500MG INJECTION.

References

1. Skidmore. Cyclophosphamide. Mosby’s 2021 Nursing Drug Reference. 34th edition. 2021. Page - 330-332.

2. Robert j. Kizior, Keith j. Hodgson. Cyclophosphamide. Saunder’s Nursing Drug Handbook 2021. 29th edition. 2021. Page -283-285.

3. Baxter Healthcare Corporation. U.S. Food & Drug Administration. [Revised on May 2013] [Accessed on 28th May 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/012141s090,012142s112lbl.pdf

4. Baxter Healthcare Ltd. Electronic Medicines Compendium (EMC). [Revised on June 2016] [Accessed on 28th May 2022] https://www.medicines.org.uk/emc/product/1815/smpc#PRODUCTINFO

5. AuroMedics Pharma LLC. Cyclophosphamide. [Revised on September 2021] [Accessed on 2th May 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3c1eb470-0bba-457d-94e3-b9508f0d398a

6. Ingenus Pharmaceuticals, LLC. Cyclophosphamide. [Revised on November 2021] [Accessed on 2th May 2022] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=783d7523-8505-4b3e-837c-cefbcec61da6

Useful Diagnostic Tests

Complete blood count
Peripheral smear count
Renal function test
Liver function test
Prothrombin time
Triglycerides
Urine albumin

Author Details

Written By Dr. Janet.C - Pharm.D

Reviewed For Accuracy By Dr. Rajnikant - MBBS, MD (Physiology)

Last updated on 27 Nov 2023 | 09:48 AM(IST)