Acrolein
from cyclophosphamide
“Ketchup bloodies the bladder”
direct injury to bladder urothelium
the other metabolite of cyclophosphamide is phosphoramide mustard
What it isReactive aldehyde metabolite of cyclophosphamide and ifosfamide.
Why it mattersConcentrates in urine and attacks the bladder wall, causing the oxazaphosphorines’ hemorrhagic cystitis and bladder-cancer signal.
What it changesMesna exists solely to neutralize it in the urine, which is why mesna co-administration and hydration are standard with these agents.
NO BOXED WARNINGS
Classes and tags
Open Acrolein in the interactive console ↗
Self-check
- Which protective drug neutralizes acrolein in urine?
Mesna. - Which bladder injury is caused by urinary acrolein?
Hemorrhagic cystitis.