Cyclophosphamide Administration Container
Cyclophosphamide does not require administration in a glass bottle and can be safely administered in standard polyethylene (plastic) infusion bags. 1
Container Compatibility Evidence
Cyclophosphamide is chemically stable in polyethylene infusion bags when properly stored, with solutions maintaining at least 90% of initial drug concentration for 48 hours when refrigerated at 4°C 1
Room temperature storage in polyethylene bags allows for safe infusion over 6 hours without significant drug degradation, though longer storage at room temperature (beyond 96 hours) results in drug concentrations falling below 80% of initial values 1
pH stability is concentration and temperature dependent in polyethylene containers, with refrigerated solutions showing better pH maintenance (decrease of only 1.46 units) compared to room temperature storage (decrease of 4.31-4.44 units) 1
Practical Administration Recommendations
Intravenous Pulse Therapy
Administer 15 mg/kg (maximum 1500 mg) in standard IV bags with mesna protection for bladder toxicity prevention 2, 3
Mesna should be co-administered to prevent hemorrhagic cystitis, which occurs in up to 6% of patients without protection, and can be mixed with cyclophosphamide in the same polyethylene infusion bag 4, 2, 3
Storage Guidelines
Prepare admixtures fresh or store refrigerated at 4°C for up to 48 hours in polyethylene bags to maintain drug stability 1
Infuse at room temperature within 6 hours of preparation if not refrigerated to ensure adequate drug concentration 1
Critical Safety Measures (Unrelated to Container Type)
Adequate hydration is essential: Patients should receive intravenous fluids or drink plenty of fluids (>8 glasses of 8 oz water daily) on the day of infusion to dilute toxic metabolites in urine 4
Pneumocystis jirovecii prophylaxis is mandatory: Trimethoprim/sulfamethoxazole (800/160 mg on alternate days or 400/80 mg daily) should be given to all patients receiving cyclophosphamide 4, 2, 3
Monthly monitoring required: Complete blood count and urinalysis for red blood cells should be performed monthly to detect early signs of bone marrow suppression or hemorrhagic cystitis 4