Comparative Pharmacology
Head-to-head clinical analysis: CISPLATIN versus CYTOXAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CISPLATIN versus CYTOXAN.
CISPLATIN vs CYTOXAN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Platinum-based alkylating-like agent that forms intrastrand and interstrand DNA crosslinks, inhibiting DNA replication and transcription, leading to cell cycle arrest and apoptosis.
Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to cell cycle nonspecific cytotoxicity. It requires hepatic activation by cytochrome P450 enzymes to form active metabolites, primarily phosphoramide mustard.
50-100 mg/m² IV every 3-4 weeks; or 20 mg/m² IV daily for 5 days every 3-4 weeks.
500-1500 mg/m² IV every 2-4 weeks or 1-5 mg/kg/day PO for 10-14 days.
None Documented
None Documented
The terminal elimination half-life is 20-30 hours (range 10-40 hours) in patients with normal renal function. This prolonged half-life is due to slow release of platinum from tissue binding and is clinically relevant for cumulative nephrotoxicity and ototoxicity.
Clinical Note
moderateCisplatin + Digoxin
"Cisplatin may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateCisplatin + Digitoxin
"Cisplatin may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateCisplatin + Deslanoside
"Cisplatin may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateCisplatin + Acetyldigitoxin
"Cisplatin may decrease the cardiotoxic activities of Acetyldigitoxin."
Terminal elimination half-life of cyclophosphamide is 3-12 hours (range 2-19 h) in adults; the half-life of active metabolites (e.g., 4-hydroxycyclophosphamide) is approximately 8-10 hours. Half-life is prolonged in hepatic impairment (up to 20 h) and reduced in dose adjustments.
Renal excretion accounts for 70-90% of cisplatin elimination, with approximately 20-50% excreted unchanged in the urine within 24 hours. Biliary/fecal excretion is minimal (<5%).
Renal elimination of unchanged cyclophosphamide (5-30%) and metabolites (primarily 4-ketocyclophosphamide and carboxyphosphamide) accounts for approximately 80% of total clearance; fecal excretion is minimal (<5%).
Category D/X
Category C
Alkylating Agent
Alkylating Agent