This is a synthetic antineoplastic drug chemically related to the nitrogen mustards.

Indications: chronic lymphocytic leukaemia, lymphomas, and solid tumours; rheumatoid arthritis.

Cautions: reduce dose in renal impairment; increased fluid intake for 24 to 48 hours to avoid haemorrhagic cystitis.

Contra-indications: Severe bone-marrow depression; pregnancy & breast feeding.

Side effect: myelosuppression, alopecia, nausea and vomiting, haemorragic cystitis (absolute withdrawal of treatment).

Dose: According to individual protocol.

Children

In SLE: IV 500 – 750mg/m2 every month. Max. 1 g/ m2 JRA/Vasculitis: IV 10mg/kg every 2 weeks.

Children and adults:

Oral: 500–750mg/m2/day as continuous therapy or 400 – 1000mg/ m2 in divided doses over 4–5 days as intermittent therapy.

IV: Single doses: 400–1800mg /m2 (30–50mg/kg) per treatment course (1-5 days) which can be repeated at 2–4 week intervals.

Continuous daily doses: 60 – 120mg/m2 (1–2.5mg/kg) per day.