Buy Ciclofosfamida (Cyclophosphamide) tablets online in the USA

Product Name	Cyclophosphamide (Ciclofosfamida)
Dosage	Tablets: 25 mg, 50 mg; Injection (vials): 200 mg, 500 mg, 1 g, 2 g
Active Ingredient	Cyclophosphamide
Form	Oral Tablets; Powder for Injection (IV)
Description	Prescription antineoplastic and immunosuppressant used for cancers (e.g., lymphomas, leukemias, breast and ovarian cancer, multiple myeloma) and severe autoimmune conditions (e.g., vasculitis, lupus nephritis).
How to Order Without Prescription	Prescription required in the USA (Rx-only)

Cyclophosphamide (also known as Ciclofosfamida in Spanish) is a cornerstone chemotherapy and immunosuppressive medication that has been used for decades in the United States. It is available in oral and injectable formulations and is dispensed only with a valid prescription from a licensed clinician. In the USA, cyclophosphamide is most commonly prescribed as part of combination cancer regimens or as pulse therapy for severe autoimmune diseases under the supervision of oncologists, hematologists, rheumatologists, or transplant specialists.

As a prodrug alkylating agent in the nitrogen mustard class, cyclophosphamide is activated in the liver to form metabolites that damage rapidly dividing cells. That mechanism underlies its efficacy in treating a wide range of malignancies, including non-Hodgkin lymphoma, Hodgkin lymphoma, chronic lymphocytic leukemia (CLL), acute leukemias, multiple myeloma, breast cancer, ovarian cancer, and sarcomas. It is also widely used in non-oncology settings for severe autoimmune and inflammatory diseases, such as ANCA-associated vasculitis, lupus nephritis, dermatomyositis, polymyositis, and certain glomerular diseases like minimal change disease or membranous nephropathy in steroid-refractory cases.

In the American healthcare system, cyclophosphamide is categorized as Rx-only and must be obtained through licensed pharmacies or administered in infusion centers. Therapy is tailored to the individual, taking into account organ function, prior treatments, concurrent medicines, and the intended therapeutic goal. Because it can suppress the immune system and cause dose-dependent adverse effects, cyclophosphamide requires careful monitoring with laboratory tests, hydration protocols, and sometimes uroprotection with mesna to guard against hemorrhagic cystitis.

Cyclophosphamide cost in the USA

The cost of cyclophosphamide in the United States varies based on dosage strength, formulation (tablets versus IV vials), care setting (outpatient pharmacy versus hospital infusion center), insurance coverage, and negotiated pharmacy benefit rates. Generic tablets (25 mg and 50 mg) are typically more affordable than brand-name versions, and prices can differ across states and pharmacy networks. Injectable cyclophosphamide vials (commonly 200 mg, 500 mg, 1 g, 2 g) are often billed through medical benefits and may include facility and administration fees when given in clinics or hospitals.

Private insurance plans and Medicare Part D can significantly reduce out-of-pocket expenses for the oral formulation. For IV cyclophosphamide, coverage often falls under Medicare Part B or commercial medical plans when administered in a physician’s office or hospital outpatient department. Copay amounts depend on the individual plan, deductibles, and whether the provider is in-network.

Patients without insurance or with high deductibles may benefit from pharmacy discount programs, manufacturer assistance (when available), nonprofit foundations, or state-specific programs. Your oncology or rheumatology care team can usually help navigate financial counseling resources. When comparing options, consider total treatment costs, including antiemetics, mesna, IV supplies, and supportive care medications like growth factors or prophylactic antibiotics.

Where can I get Cyclophosphamide in the USA?

If your clinician has prescribed cyclophosphamide, you will obtain it through a licensed US pharmacy or have it administered at a certified infusion center. Oral tablets are typically dispensed by community, hospital, or specialty pharmacies. Injectable cyclophosphamide is usually prepared by hospital or infusion center pharmacies and administered by trained healthcare professionals.

In the United States, cyclophosphamide cannot be purchased over the counter. A valid prescription is required. Depending on your location and insurance, mail-order delivery may be available for the oral form, offering convenient home shipment. Many oncology practices coordinate delivery directly to the clinic for infusion appointments, ensuring drug availability on treatment days.

Pharmacies must adhere to strict handling and safety standards for hazardous medications. Pharmacists provide counseling on administration, side effect management, and drug interactions. If you need help finding a participating pharmacy or verifying coverage, your care team or insurer’s member services can offer guidance and network directories.

Cyclophosphamide across the United States

Access to cyclophosphamide is widespread across the USA through multidisciplinary cancer centers, regional infusion clinics, and specialty pharmacies. Patients in rural areas can often receive therapy via coordinated networks that link local physicians with larger centers. Telehealth follow-up for lab reviews and toxicity assessments has become more common, allowing patients to manage complex regimens with reduced travel when clinically appropriate.

What is Cyclophosphamide (Ciclofosfamida)?

Cyclophosphamide is a prodrug alkylating agent that, after hepatic activation, forms cytotoxic metabolites (including phosphoramide mustard and acrolein). These metabolites crosslink DNA, interfering with replication and transcription, and ultimately cause apoptosis of rapidly proliferating cells. This property makes cyclophosphamide effective in cancer therapy and as a potent immunosuppressant by depleting pathogenic immune cells.

The medication is available in two primary forms in the USA: oral tablets (commonly 25 mg and 50 mg) and vials of powder for reconstitution and IV infusion (e.g., 200 mg, 500 mg, 1 g, 2 g). Dosing schedules differ substantially across indications and regimens, and careful planning is required to balance efficacy with safety.

Beyond oncology, cyclophosphamide’s immunomodulatory effects are harnessed in severe autoimmune diseases when conventional therapies fail or when rapid disease control is essential. Given its toxicity profile, such use is restricted to specialist care with close monitoring.

Cyclophosphamide in Cancer Treatment

In oncology, cyclophosphamide is rarely used alone; instead, it is a component of many well-established combination regimens. Examples include:

• Breast cancer regimens such as AC (doxorubicin + cyclophosphamide), FAC (5‑fluorouracil + doxorubicin + cyclophosphamide), and TC (docetaxel + cyclophosphamide)
• Non-Hodgkin lymphoma protocols like CHOP (cyclophosphamide + doxorubicin + vincristine + prednisone) and variations for diffuse large B‑cell lymphoma or other subtypes
• Hodgkin lymphoma regimens that incorporate cyclophosphamide in salvage settings
• Multiple myeloma, sarcomas, and certain pediatric malignancies, where dosing is tailored to disease and patient characteristics

Use in these settings is guided by authoritative US guidelines and clinical trial evidence. Doses are typically calculated using body surface area (mg/m²) or by fixed dosing in combination cycles. Pre-medications to prevent nausea, growth factor support to manage neutropenia risk, and antimicrobial prophylaxis may be part of the treatment plan depending on intensity and patient-specific risk factors.

Why cyclophosphamide remains important in modern regimens

Despite the advent of targeted therapies and immuno-oncology agents, cyclophosphamide continues to play a central role due to its proven efficacy, broad applicability, and compatibility with other drugs. Its inclusion in foundational regimens provides a reliable cytotoxic backbone that complements newer agents and can achieve deep and durable responses in several cancers when used appropriately.

Cyclophosphamide in autoimmune and inflammatory diseases

In rheumatology and nephrology, cyclophosphamide is reserved for severe, organ- or life-threatening disease manifestations. Common scenarios include ANCA-associated vasculitis (e.g., granulomatosis with polyangiitis), lupus nephritis, severe systemic lupus erythematosus flares, and rapidly progressive glomerulonephritis. Regimens may involve pulsed IV dosing every few weeks or daily oral dosing for a defined period, followed by transition to maintenance immunosuppression.

Because cyclophosphamide can affect fertility and carries a risk of infections, hemorrhagic cystitis, and secondary malignancies, its use requires careful risk–benefit consideration, vaccination review (avoid live vaccines during and shortly after treatment), and proactive prophylaxis strategies (e.g., PJP prophylaxis in select patients).

How cyclophosphamide works (mechanism of action)

Cyclophosphamide is metabolized primarily via hepatic CYP450 enzymes (CYP2B6, CYP2C9, CYP2C19, and CYP3A4) into active alkylating species. Phosphoramide mustard crosslinks DNA, inhibiting cell division. Acrolein, another metabolite, is urotoxic and associated with hemorrhagic cystitis—an adverse effect mitigated by vigorous hydration and, when indicated, mesna co‑administration to bind and detoxify acrolein in the urinary tract.

Formulations and administration (oral vs IV)

Oral cyclophosphamide tablets (25 mg, 50 mg) are generally swallowed whole with water. Dosing may be once daily or part of a cycle, depending on the protocol. Many clinicians recommend taking oral doses in the morning and maintaining high fluid intake throughout the day to reduce bladder exposure time. Intravenous cyclophosphamide is administered as an infusion over minutes to hours, with pre- and post-hydration protocols and antiemetics. In higher-dose settings or for patients at elevated risk, mesna is used to protect the bladder.

Handling precautions apply because cyclophosphamide is a hazardous drug. Patients and caregivers should follow pharmacy instructions for safe handling of tablets at home (e.g., avoid crushing or splitting unless directed, wash hands after handling). Infusion centers use closed-system devices and protective equipment per US standards.

Cyclophosphamide and reproductive health

Fertility considerations are essential before starting therapy. Cyclophosphamide can cause ovarian insufficiency, reduced ovarian reserve, and amenorrhea in females, and oligospermia or azoospermia in males. Discussions about sperm banking, embryo or oocyte cryopreservation, and ovarian protection strategies should occur prior to treatment initiation whenever feasible. Effective contraception is required during treatment and for a period after the last dose (commonly at least 6 months for females and 3 months for males, though recommendations vary by guideline). Cyclophosphamide is teratogenic and should not be used during pregnancy unless the potential benefit justifies the potential risk and it is deemed strictly necessary under specialist care.

How it works in the body (Action)

As an alkylating agent, cyclophosphamide forms covalent bonds with DNA, leading to crosslinks and strand breaks. This prevents the replication of rapidly dividing malignant cells and also suppresses certain immune cell populations, contributing to its effect in autoimmune diseases. Its pharmacodynamics are influenced by hepatic activation and by concurrent therapies that induce or inhibit CYP enzymes.

Safety

Cyclophosphamide carries US boxed warnings for myelosuppression, hemorrhagic cystitis, cardiotoxicity (particularly at high doses), and secondary malignancies. Close monitoring is mandatory. Typical safety measures include baseline and periodic complete blood counts with differential, renal and hepatic panels, urinalysis to detect hematuria, and assessment for signs of infection. Many clinicians implement antimicrobial prophylaxis in higher-risk scenarios. Adequate hydration and, when indicated, mesna reduce urotoxicity. Cardiac monitoring is recommended for high-dose regimens or in patients with pre-existing heart disease.

Cyclophosphamide dosing (adults and pediatrics)

There is no single standard dose because dosing depends on the specific disease, regimen, and patient characteristics. Examples include:

• Oncology combination regimens: Doses commonly range from 500 to 1,200 mg/m² per cycle in adult patients, administered every 2–3 weeks alongside other agents, or lower doses more frequently as part of metronomic schedules
• Autoimmune diseases (e.g., ANCA-associated vasculitis): Pulsed IV dosing such as 500–1,000 mg every 2–4 weeks for several doses, or oral dosing around 1–2 mg/kg/day for a limited period, with careful monitoring
• Pediatric dosing: Typically based on body surface area or weight, with disease-specific protocols in specialized centers

All dosing must be individualized by the treating specialist, accounting for organ function, concomitant medications, and prior therapies. Do not adjust doses without direct medical guidance.

Example dosing in autoimmune protocols

For ANCA-associated vasculitis or severe lupus nephritis, US specialists may use pulsed IV cyclophosphamide (e.g., 500–1,000 mg IV every 2–4 weeks for several doses) or daily oral dosing (e.g., 1–2 mg/kg/day) for a specified induction period before switching to maintenance therapy (e.g., azathioprine, mycophenolate, rituximab) once remission is achieved. Supportive measures—such as infection prophylaxis, bladder protection, and fertility counseling—are integral to these protocols.

Always follow your specialist’s instructions. Take oral doses exactly as directed, maintain hydration, and complete all scheduled laboratory checks to ensure safe and effective therapy.

Non-Hodgkin lymphoma (NHL) and related protocols

In the USA, cyclophosphamide features prominently in CHOP-based regimens for NHL. Depending on the lymphoma subtype, it may be combined with monoclonal antibodies (e.g., rituximab) and other cytotoxic drugs. Treatment goals range from curative intent in aggressive lymphomas to disease control in indolent forms. Prephase steroids, growth factor support, and antiemetics are common. Your oncology team will tailor the number of cycles and restaging scans to your specific case.

For Hodgkin lymphoma, cyclophosphamide may be used in select salvage regimens or within clinical trials. Multidisciplinary evaluation ensures that subsequent therapies (e.g., autologous stem cell transplant, checkpoint inhibitors) remain viable as needed.

Lupus nephritis and vasculitis protocols

Induction therapy for class III/IV lupus nephritis may include cyclophosphamide using either high-dose or low-dose IV protocols, based on patient-specific factors and clinician preference. In ANCA-associated vasculitis, cyclophosphamide induction can be highly effective at halting inflammatory damage to kidneys, lungs, and other organs. After induction, patients typically transition to maintenance regimens to sustain remission with fewer long-term toxicities. Throughout treatment, clinicians monitor blood counts, urinalysis, renal function, and disease activity markers.

Administration tips and supportive care

To reduce the risk of adverse effects and support treatment success:

• Hydrate well: Maintain good oral fluid intake on dosing days and as advised by your care team
• Bladder protection: Urinate frequently; report any urinary pain, urgency, or blood in urine promptly
• Mesna: If prescribed, take or receive mesna exactly as directed to prevent hemorrhagic cystitis
• Antiemetics: Use prescribed anti‑nausea medications proactively
• Infection vigilance: Monitor fever, chills, cough, urinary symptoms, or sores; seek care promptly
• Labs: Keep all scheduled blood and urine tests to allow timely dose adjustments
• Vaccinations: Avoid live vaccines during and shortly after therapy; ask about timing for inactivated vaccines

Pregnancy and breastfeeding

Cyclophosphamide can harm an unborn baby. It is generally contraindicated during pregnancy unless the potential benefit justifies the potential risk and it is deemed necessary by specialists. People who could become pregnant should use effective contraception during therapy and for a period after the last dose; those who can father a child should also use effective contraception during and after treatment for the timeframe advised by their clinician. Breastfeeding is not recommended during treatment and for a period after the last dose because the drug and its metabolites may be present in breast milk.

Pharmacist’s tips for taking cyclophosphamide

Take oral tablets exactly as prescribed, ideally in the morning with a full glass of water, unless your clinician advises otherwise. Do not crush or split tablets unless directed. Stay well hydrated throughout the day. If you miss a dose, follow your care team’s instructions—do not double up unless told to do so. For IV therapy, arrive on time for pre‑treatment labs, hydration, and premedications.

If you are receiving cyclophosphamide for kidney or systemic autoimmune diseases, your clinician may monitor urinalysis closely and adjust dosing based on lab trends. For oncology indications, expect periodic imaging for response assessment, in addition to routine labs and toxicity evaluations.

Tell your team immediately about fever (100.4°F/38°C or higher), unusual bleeding or bruising, new shortness of breath, chest pain, persistent vomiting, severe diarrhea, decreased urine output, or any signs of urinary irritation.

Safety Precautions

Do not use cyclophosphamide if you have a known hypersensitivity to the drug or any component of the formulation. Inform your clinician if you have severe bone marrow suppression, current urinary tract obstruction, active infections, liver impairment, kidney disease, pre‑existing bladder issues, prior pelvic radiation, or heart disease. Special caution is needed with high-dose regimens, in older adults, and in those with multiple comorbidities.

Avoid live vaccines during therapy and for a period after treatment as advised. Limit alcohol consumption and avoid smoking due to added risks. Follow safe handling and disposal instructions for any unused tablets at home; do not flush medications—use authorized take‑back programs where available.

Cyclophosphamide side effects

Side effects can vary by dose, route, and combination regimen. Common reactions include nausea, vomiting, decreased appetite, diarrhea or constipation, mouth sores, hair loss (alopecia), fatigue, and transient liver enzyme elevations. Cyclophosphamide can cause myelosuppression (lowered white cells, red cells, and platelets), increasing infection and bleeding risks. A key dose‑related toxicity is hemorrhagic cystitis, marked by urinary pain, frequency, and hematuria.

Serious but less common effects include cardiotoxicity (especially with high doses), pulmonary toxicity, hyponatremia due to SIADH, infertility, and secondary malignancies (e.g., bladder cancer, leukemia) with cumulative exposure. Promptly report any concerning symptoms to your care team for evaluation and management.

Side effects by body system

Potential adverse effects include, but are not limited to:

• Hematologic: neutropenia, anemia, thrombocytopenia, febrile neutropenia
• Gastrointestinal: nausea, vomiting, stomatitis/mucositis, abdominal discomfort, diarrhea or constipation
• Genitourinary: dysuria, urinary urgency, hematuria, hemorrhagic cystitis
• Hepatic: elevated AST/ALT, rare hepatotoxicity
• Dermatologic: alopecia, rash, skin or nail changes
• Neurologic: headache, dizziness; rare neuropathy or encephalopathy
• Cardiovascular: tachycardia, arrhythmias, myocarditis or cardiomyopathy (mainly with high-dose regimens)
• Respiratory: cough, dyspnea; rare interstitial pneumonitis or pulmonary fibrosis
• Endocrine/metabolic: SIADH with hyponatremia; appetite or weight changes
• General: fatigue, fever, chills

Seek urgent medical attention for high fever, difficulty breathing, chest pain, severe bleeding, confusion, or signs of severe allergic reaction (e.g., facial swelling, hives, trouble breathing).

Reporting side effects

If you experience any side effects, contact your clinician or pharmacist. In the USA, you can also report adverse events to FDA MedWatch at 1‑800‑FDA‑1088 or via the MedWatch website.

Drug interactions with cyclophosphamide

Cyclophosphamide is metabolized by hepatic CYP enzymes, so inhibitors and inducers can alter exposure. Always share a complete list of prescription medications, OTC drugs, vitamins, and herbal supplements with your healthcare team. Examples of potential interactions include:

• Strong CYP3A4/CYP2B6 inhibitors (e.g., azole antifungals like itraconazole or ketoconazole; macrolide antibiotics; some protease inhibitors) which may increase toxicity
• CYP inducers (e.g., rifampin, phenytoin, phenobarbital, carbamazepine, St. John’s wort) which may reduce efficacy by increasing clearance
• Warfarin: potential changes in anticoagulant effect; monitor INR closely
• Anthracyclines and other cardiotoxic agents: higher risk of cardiac adverse effects at intensive doses
• Live vaccines: avoid due to immunosuppression
• Alcohol: may exacerbate GI and hepatic side effects; limit intake

This is not a complete list. Your care team will individualize guidance, adjust doses as needed, and recommend monitoring to minimize interaction risks.

Recommendations from our specialists

In the USA, cyclophosphamide therapy should be coordinated by specialists familiar with its benefits and risks. Before starting, review fertility preservation options, vaccination status, and baseline labs. During treatment, adhere to hydration, bladder protection strategies, and infection precautions. Keep all appointments for labs and follow-up visits, and communicate any side effects early so that supportive care can be optimized or doses adjusted. Whether you receive care at a comprehensive cancer center or a local infusion clinic, your team will help you navigate insurance coverage, financial assistance, and pharmacy selection.

Ready to begin your therapy? Request Cyclophosphamide in the USA

Work with your US-licensed provider to determine whether cyclophosphamide is appropriate for your condition. With a valid prescription, you can access high‑quality medication through licensed pharmacies or receive treatment at accredited infusion centers.

• Prescription required — dispensed only by licensed US pharmacies
• Coordinated care — oncology and rheumatology teams manage dosing, labs, and supportive care
• Reliable sourcing — FDA‑approved generic options and quality-assured products
• Coverage support — assistance with insurance benefits, prior authorizations, and copay programs
• Expert counseling — pharmacists and nurses available to answer questions

Join thousands of patients across the United States who receive cyclophosphamide safely through coordinated, guideline-based care. Your healthcare team is ready to help you start and stay on track with treatment.

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