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Cyclophosphamide Protocol

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									                                Cyclophosphamide Protocol



1. Check blood for CBC, C3, C4, CC7, ANA, U/A, Urine protein/creatinine ratio
2. Cyclophosphamide dose depends on WBC
              if WBC 3000-6000 : Give 500 mg/m2
                      > 6000     : Give 1000 mg/m2
                      < 3000     : Please call Dr.John

First dose of cyclophosphamide: Always give 500 mg/m2

       0 hr: Start 5%D in 0.45NS 1.25 of maintenance until tomorrow
       1 hr: give lasix 0.5 mg/kg IV
       2 hr: give Zofran 0.15 mg/kg IV
              give Cyclophosphamide: drip in 1 hr
       6 hr: give Zofran 0.15 mg/kg IV
      10 hr : give Zofran 0.15 mg/kg IV

        NPO 6 hours after start Cyclophosphamide

3. Monitor urine sp gr. If > 1010, give 0.9% NS 5-10 cc/kg within 1 hour bolus and watch for
hypertension. Watch for hemorrhagic cystitis, SIADH

4. Tomorrow will D/C if no complication. RTC in … weeks with CBC, CC1, ANA, C3, C4

Note : Please do not give Hydralazine for hypertension in SLE patients
        If BP > 140/90: Give labetalol 10 mg IV prn q 3 hr (non asthmatic patients)
           BP 135/85 - 140/90: Give labetalol 5-10 mg IV prn q 3 hr (non asthmatic patients)

In asthmatic patients: consider nifedipine 5-7.5 mg PO prn q 3-4 hr.

								
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