Cyclophosphamide

Drug Levels and Effects:




Summary of Use during Lactation:


Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.


Drug Levels:


Maternal Levels.

Unmetabolized cyclophosphamide has been qualitatively detected in milk 1, 3, 5 and 6 hours after an intravenous injection of 500 mg of drug in one patient.[1][2] Quantitative determination has not been reported.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


In one 23-day-old infant, neutropenia, thrombocytopenia and a low hemoglobin were possibly caused by cyclophosphamide after 3 days of maternal treatment with cyclophosphamide 6 mg/kg intravenously daily (total dose 300 mg).[3]

In a 4-month-old, neutropenia was probably caused by cyclophosphamide in a mother 9 days after the last of 6 weekly doses of 800 mg cyclophosphamide intravenously, 2 mgvincristineintravenously and daily doses of 30 mg of prednisolone orally. Neutropenia persisted at least 12 days and was accompanied by a brief episode of diarrhea.[4]


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


Dependent on the condition being treated.


References:


1. Duncan JH, Colvin OM, Fenselau C. Mass spectrometric study of the distribution of cyclophosphamide in humans. Toxicol Appl Pharmacol. 1973;24:317-23. PMID:4741053
2. Wiernik PH, Duncan JH. Cyclophosphamide in human milk. Lancet. 1971;1(7705):912. PMID:4102054
3. Durodola JI. Administration of cyclophosphamide during late pregnancy and early lactation: a case report. J Nat Med Assoc. 1979;71:165-6. PMID:423292
4. Amato D, Niblett JS. Neutropenia from cyclophosphamide in breast milk. Med J Aust. 1977;1:383-4. PMID:859486



Substance Identification:




Substance Name:

Cyclophosphamide

CAS Registry Number:

6055-19-2

Drug Class:


  • Antineoplastic Agents


  • Administrative Information:




    LactMed Record Number:


    77


    Last Revision Date:


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