Comparative Pharmacology
Head-to-head clinical analysis: CYTOXAN versus LOMUSTINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CYTOXAN versus LOMUSTINE.
CYTOXAN vs LOMUSTINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Alkylating agent that crosslinks DNA, inhibits DNA synthesis, and produces interstrand crosslinks via chloroethyl carbonium ion formation. Also has carbamoylating activity.
500-1500 mg/m² IV every 2-4 weeks or 1-5 mg/kg/day PO for 10-14 days.
130 mg/m² orally as a single dose every 6 weeks; subsequent doses adjusted based on hematologic response.
None Documented
None Documented
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.
Clinical Note
moderateLomustine + Digoxin
"Lomustine may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateLomustine + Digitoxin
"Lomustine may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateLomustine + Deslanoside
"Lomustine may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateLomustine + Acetyldigitoxin
"Lomustine may decrease the cardiotoxic activities of Acetyldigitoxin."
Biphasic: initial half-life ~6 hours; terminal half-life ~16-48 hours (mean 24 hours). Metabolites have prolonged half-life up to 72 hours. Clinical context: accumulation with repeated dosing, requiring 6-week intervals.
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%).
Renal excretion approximately 50% (as metabolites), biliary/fecal excretion approximately 20%; remainder unaccounted, likely metabolized.
Category C
Category D/X
Alkylating Agent
Alkylating Agent