Physiological saline should not be used as a solvent to avoid hyperosmolarity.
Endoxan vials with dry injectable powder are stored at room temperature not exceeding 25°C. After preparation, the injectable solution is used within 24 hrs. In this period, the solution is kept in the refrigerator, at temperatures lower than 8°C.
During transport or storage of Endoxan, temperature influences can lead to melting of the active ingredient cyclophosphamide. Vials containing melted substance can easily be optically differentiated from those containing the intact active ingredient: Melted cyclophosphamide is clear or yellowish viscous liquid (usually found as connected phase or in droplets in the affected vials). Do not use injection vials with the melted content.
With doses of ≥10 mg/kg and in high-risk patients (previous cystitis during earlier treatment with Endoxan or similar drugs, previous irradiation of the small pelvis and in preexisting urinary tract damage) Uromitexan (mesna) should always be given to protect the bladder.
The known procedures of safe handling of cytotoxic drugs should be followed.