Tags: Drug.
4-Hydroxycyclophosphamide is the main active metabolite of cyclophosphamide. It is then partially tautomerized into aldophosphamide which in turn easily enters live cells and then is partially detoxified into inactive carboxycyclophosphamide by the enzyme ALDH but partially is hydrolyzed by another cell’s enzyme phosphatase to the two directly cytotoxic metabolites – phosphoramide mustard and acrolein.