Hemorrhagic cystitis is caused by: September 2005, March 2013

Ans. C: Cyclophosphamide The oxazaphosphorine-alkylating agents cyclophosphamide is chemotherapeutic drug that is useful in the treatment of lymphoma, leukemia, and ceain solid tumors.It is inactive as such: prodeuces few acute effects and is not locally damaging.Transfromation into active metabolites (aldophosphamide, phosphoramide mustard) occurs in the liver. It is less damaging to the platelets, but alopecia and cystitis (due to another metabolite acrolein) are prominent. Congener of cyclophosphamide is Ifosfamide, whose dose limiting toxicity is hemorrhagic cystitis.To prevent it, mesna is routinely given with it. In rare cases, penicillins have been repoed to cause hemorrhagic cystitis in ceain patients. Case repos have implicated methicillin, carbenicillin, ticarcillin, piperacillin, and penicillin VK. Treatment with danazol, a semisynthetic anabolic steroid, has caused hemorrhagic cystitis in patients with hereditary angioedema. Other medications that have been implicated in the development of hemorrhagic cystitis in limited repos include temozolomide, bleomycin, tiaprofenic acid, allopurinol, methaqualone, methenamine mandelate, gentian violate, nonoxynol-9 suppositories inadveently placed in the urethra, and intravesical acetic acid. Risperidone has been associated with hemorrhagic cystitis but is also used as treatment for hemorrhagic cystitis due to JK virus.