Protocol for using monthly IV CYC

Protocol for using monthly IV CYC

There are many different protocols that can be used. The following is one example:

  • a) Prior to CYC
    • • Premedication 15–30 minutes prior to CYC: dexamethasone 10 mg, lorazepam 1 mg, and ondansetron (Zofran) 8 mg or ganisetron (Kytril) 1 mg in 100 cc normal saline IV
    • • Mesna (25% of CYC dose in milligrams) in 250 cc normal saline
  • b) CYC infusion
    • • CYC 0.5–1.0 g/m of body surface area in 1000 cc normal saline for initial dose. If creatinine clearance is less than 35–40 cc/minute, then start initial dose at 0.50 g/m of bovine serum albumin. If on dialysis, give 0.4–0.5 g/m 8–10 hours before or after dialysis.
    • • Subsequent monthly doses depend on WBC counts at 10 to 14 days post CYC.
      • • If nadir < 3000/mm , reduce dose by 0.25 g/m 2
      • • If nadir > 4000/mm , dose can be increased if necessary to maximum of 1 g/m 2
    • • Consider the use of gonadotropin-releasing hormone (Lupron) 3.75 mg intramuscularly (IM) 10 days prior to each of the monthly CYC dose or testosterone supplementation (200 mg IM every 2 weeks) for men to prevent premature gonadal failure from longstanding therapy (data is limited).
  • c) Post CYC infusion
    • • Mesna (25% of CYC dose in mg) in 250 cc normal saline
    • • Compazine SR 15 mg twice a day as needed or compazine 10 mg thrice a day (TID) as needed for 2–3 days
  • d) Dose interval for CYC
    • • Monthly for 6 doses, then
    • • Maintenance with AZA or MMF
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top