Cyclophosphamide

Cyclophosphamide is a nitrogen mustard containing alkylating agent that is used for antineoplastic and immunosuppressive therapy. Cyclophosphamide is metabolized by hepatic cytochrome P450 to produce three toxic metabolites: phosphoramide mustard, acrolein, and nor-nitrogen mustard. The most common side effects seen after exposure to cyclophosphamide include bone marrow suppression, opportunistic infections, hemorrhagic cystitis, nausea, vomiting, infertility, and hair loss. Chronic exposure to cyclophosphamide is associated with neoplasms, bone marrow suppression, and gonadal toxicity. Management is largely supportive and may require a prolonged observation time due to the delay in the development of adverse effects.