Endoxan Baxter - Pharmacology: Endoxan Baxter is first hydroxylated by hepatic microsomal enzymes to the intermediate metabolites 4-hydroxycyclophosphamide and aldophosphamide. These are oxidized to the active antineoplastic alkylating compounds acrolein and phosphoramide mustard. The mechanism of action of the active metabolites is thought to involve cross-linking of DNA, which interferes with growth of susceptible neoplasms and normal tissues.
Indication: Malignant diseases
Malignant lymphomas (stages III and IV of the Ann Arbor staging system); Hodgkin disease; lymphocytic lymphoma (nodular or diffuse); mixed-cell type lymphoma; histocytic lymphoma; Burkitt lymphoma; multiple myeloma; chronic lymphocytic leukemia; chronic granulocytic leukemia; acute myelogenous and monocytic leukemia; acute lymphoblastic (stem cell) leukemia in children; mycosis fungoides (advanced disease); neuroblastoma (disseminated disease); adenocarcinoma of the ovary; retinoblastoma; carcinoma of the breast.
Biopsy-proven minimal change nephrotic syndrome in children, but not as primary therapy.
Multiple sclerosis; Wegener granulomatosis; other steroid-resistant vasculitis; severe progressive rheumatoid arthritis; SLE; polyarteritis nodosa; bronchogenic, small cell lung, endometrial, prostate, and testicular carcinomas; sarcomas; hematopoietic stem cell transplantation (HSCT).
Endoxan Baxter is an antineoplastic in the class of alkylating agents and is used to treat various forms of cancer. Alkylating agents are so named because of their ability to add alkyl groups to many electronegative groups under conditions present in cells. They stop tumor growth by cross-linking guanine bases in DNA double-helix strands - directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. In addition, these drugs add methyl or other alkyl groups onto molecules where they do not belong which in turn inhibits their correct utilization by base pairing and causes a miscoding of DNA. Alkylating agents are cell cycle-nonspecific. Alkylating agents work by three different mechanisms all of which achieve the same end result - disruption of DNA function and cell death.
Oral As part of the conditioning regimen in patients undergoing bone marrow transplantation
Adult: 60 mg/kg daily for 2 days. Oral Malignancies
Adult: Low-dose regimen: 2-6 mg/kg wkly in divided dose. May also be given as a single IV dose. Intravenous Malignancies
Adult: Moderate dose regimen: 10-15 mg/kg wkly; high dose regimen: 20-40 mg/kg every 10-20 days. Dosage may vary depending on the disease state, patient's condition, state of the bone marrow and whether it is used as a single agent or in combination regimens.
Endoxan Baxter (the generic name for Endoxan, Cytoxan, Neosar, Procytox, Revimmune), also known as cytophosphane, is a nitrogen mustard alkylating agent, from the oxazophorines group.
An alkylating agent adds an alkyl group (CnH2n+1) to DNA. It attaches the alkyl group to the guanine base of DNA, at the number 7 nitrogen atom of the imidozole ring.
It is used to treat various types of cancer and some autoimmune disorders. It is a "prodrug"; it is converted in the liver to active forms that have chemotherapeutic activity.
Adult: PO Part of the conditioning regimen in patients undergoing bone marrow transplantation 60 mg/kg/day for 2 days. Malignancies Low dose regimen: 2-6 mg/kg/wk in divided doses. IV Malignancies Moderate dose regimen: 10-15 mg/kg/wk; high dose regimen: 20-40 mg/kg given every 10-20 days.
Indications: Leukaemias, Lymphogranulomatosis, Lymphosarcoma, Reticulum cell sarcoma.
Hodgkins disease, multiple Myeloma.
Inoperable solid malignancies.
Combination with surgery, radiation and other cytotroxic drugs.