EXTRACTED FROM "SYSTEMIC VASCULITIS & RPGN"
 
Abbreviated medical protocols from EdREN, the website of the Renal Unit of the Royal Infirmary of Edinburgh

Pulses of cyclophosphamide are generally preferred in the absence of evidence that oral cyclophosphamide is better. Oral cyclophosphamide is associated with higher cumulative doses and possibly greater short term and long term toxicity.

The regimen suggested below is derived from the CYCLOPS protocol which showed non-inferiority of IV pulsed versus daily oral cyclophosphamide. It is slightly different from the protocols we are currently using in SLE.

Pulsed IV cyclophosphamide (CYC) should initially be given 2 weekly at time 0, 2 and 4 weeks. It is then given every 3 weeks at weeks 7, 10 and 13.  If a patient has not achieved remission at 3 months pulsed CYC should be continued every 3 weeks with doses given at weeks 16, 19, 22 and 25.
Dosage is determined from the following table:

PULSED INTRAVENOUS CYCLOPHOSPHAMIDE CALCULATION FOR ADULTS

                                                    Reference:  http://renux.dmed.ed.ac.uk/edren/Handbookbits/HDBKsystvasc.html  (Last updated 2-19-08)
                                                  
               Creatinine clearance (estimated by Cockroft-Gault equation)               
Age in Years
 Less than 31         More than 30
Less than 60 15 mg/kg/pulse 12.5 mg/kg/pulse
60-70 12.5 mg/kg/pulse 10 mg/kg/pulse
More than 70 10 mg/kg/pulse 7.5 mg/kg/pulse

                                                              MAXIMUM DOSE PER PULSE NOT TO EXCEED 1.2 GRAMS.                    

Figure Kilograms = pounds divided by 2.2

Example:  175 lb adult = 79.5 kilograms 
If less than 60 years and 28 creatinine clearance, the dosage would be 79.5 x 15 = 1193 mg, rounded off to 1200 mg.