Table 1:

Cyclophosphamide regimen.

Route	Dose	Special considerations
Intravenous	15 mg/kg at weeks 0, 2, 4, 7, 10, 13 (16, 19, 21, 24 if required)	If eGFR <30 mL/min/1.73 m2 reduce by 2.5 mg/kg If age 60–69 years use 12.5 mg/kg If age >70 years use 10 mg/kg
Oral	2 mg/kg/day for 3–6 months	If eGFR <30 mL/min/1.73 m2 reduce by 0.5 mg/kg/day If age 60–69 years use 1.5 mg/kg/day If age >70 years use 1 mg/kg/day

Adapted from [16]