• Mechanism of Action
• A prodrug that is metabolized by the liver into phosphoramide mustard. This active metabolite shares nitrogen atoms between guanine residues in DNA, creating intrastrand and interstrand DNA crosslinks. Disruption of DNA results in cytotoxicity.

Clinical Use

• • Indications
  • Autoimmune diseases refractory to first and second line therapy, in weighing up the risks and benefits of treatment with cyclophosphamide
  • Certain solid organ and haematologic malignancies, as guided by specialists and local guidelines
• • Adverse Effects
  • Haemorrhagic cystitis
  • Bone marrow suppression – leucopaenia, thrombocytopaenia, anaemia
  • Renal dysfunction
  • Nausea / vomiting
  • Alopecia
• • Monitoring
  • Regular monitoring of FBC and renal function.