Cyclophosphamide

uses

What is cyclophosphamide used for?Cyclophosphamide is commonly used to treat multiple myeloma,  leukemias, mycosis fungoides, neuroblastoma, retinoblastoma, breast cancer, adenocarcinoma of the ovary, and certain lymphomas, such as Hodgkin’s disease, lymphocytic lymphoma, mixed-cell type lymphoma, histiocytic lymphoma, and Burkitt’s lymphoma. Cyclophosphamide is also used to treat a certain type of kidney problem called minimal change nephrotic syndrome in certain people.Cyclophosphamide may also be used for other conditions as determined by your health care provider.How does cyclophosphamide work (mechanism of action)?Cyclophosphamide is a type of medicine known as chemotherapy. Cyclophosphamide is an alkylating agent, which damages DNA, preventing the ability of cancer cells to multiply. To treat minimal change nephrotic syndrome, cyclophosphamide suppresses the activity of your immune system.How is cyclophosphamide supplied (dosage forms)?Brands and other namesCytoxanNeosarDosage forms and strengths25 mg oral capsules50 mg oral capsules25 mg oral tablets50 mg oral tabletsCyclophosphamide is also available in injectable forms.How should I store cyclophosphamide?Oral Tablets and Capsules. Cyclophosphamide tablets and capsules should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry place.Injection. Cyclophosphamide injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

how to use

capsule or tablet that is swallowed, liquid that is injected into a blood vessel

drug interactions

Does cyclophosphamide interact with foods or drinks?There are no known interactions between cyclophosphamide and foods or drinks.It is unknown if drinking alcohol will affect cyclophosphamide, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.Does cyclophosphamide interact with other medicines (drug interactions)?Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.In particular, make sure that you discuss if you are using any of the following before using or taking cyclophosphamide.A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIVWarfarin, which is a blood thinnerCyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine that suppresses your immune systemMany other medicines may alter the blood levels of cyclophosphamide. Tell your health care provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with cyclophosphamide. Always check with your health care provider.

side effects

What are the most common side effects of cyclophosphamide?The most common side effects of cyclophosphamide are listed below. Tell your health care provider if you have any of these side effects that bother you. Specific side effects may differ, based on the form of cyclophosphamide you are taking or using. Blood disorders (see below)Hair lossNausea or vomitingDiarrheaMouth soresThere may be other side effects of cyclophosphamide that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of cyclophosphamide?While less common, the most serious side effects of cyclophosphamide are described below, along with what to do if they happen.Severe Allergic Reactions. Cyclophosphamide may cause allergic reactions, which can be serious. Stop taking cyclophosphamide and get help right away if you have any of the following symptoms of a serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the face, lips, mouth, tongue, or throatTrouble swallowing or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint painBlood Disorders. Cyclophosphamide can cause your bone marrow to not make enough cells (myelosuppression). This can lead to low blood levels of important cells, such as low neutrophils (neutropenia), low red blood cell levels (anemia), low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia). These can be dangerous and even life-threatening. Keep all appointments to have your blood checked.  Get help right away if you have any of the following symptoms of blood disorders.FeverShortness of breathPale or yellowish skinEasy bruising or bleedingFrequent infectionUnusual weakness or tirednessDizziness, lightheadedness, or feeling like you are about to pass outHeadacheFast or abnormal heartbeatReactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Cyclophosphamide may increase your risk of a latent microbe becoming active again, causing an infection. Before you start treatment with cyclophosphamide, tell your health care provider if you have ever had tuberculosis (TB), hepatitis B, or any other serious infections.Kidney or Bladder Problems. Cyclophosphamide can cause problems in your bladder and urinary tract, such as cystitis. These problems can require surgery and be life-threatening. Do not get dehydrated. Talk with your health care provider about how much water to drink each day. Tell your health care provider right away if you have blood in your urine (pee) or it looks pink or red.Heart Problems. Cyclophosphamide may increase your risk of heart inflammation (myocarditis), fluid around the heart (pericardial effusion), heart failure, and an irregular heartbeat and fainting. In rare cases, this may cause the heart to suddenly stop beating (cardiac arrest). Some people have a higher risk of problems, including people with heart disease, who’ve had radiation treatment to the chest area, or who take other certain medicines that can damage the heart like anthracyclines. Get emergency help if you have any of the following signs of heart problems.Chest painFeeling dizzy, lightheaded, or faintingShortness of breath or trouble breathing, especially while lying downSwelling in your feet, ankles, or legsUnusually fast weight gainUnusual tirednessLung Problems. Cyclophosphamide can cause scarring of your lungs (pulmonary fibrosis) or inflammation in your lungs, also called interstitial lung disease or pneumonitis. Lung damage can lead to dangerous and even life-threatening breathing problems even years after stopping this medicine. Tell your health care provider right away if you have a cough or shortness of breath. You may also have a fever or chest pain.Cancer. Cyclophosphamide can cause a new cancer to develop or cause a previously treated cancer to recur. Tell your health care provider about any new symptoms that you may get.Liver Disease. Cyclophosphamide can cause a type of liver disease called veno-occlusive liver disease. This happens when the small blood vessels that go into and out of the liver get blocked. Call your health care provider right away if you have any of the following symptoms of liver disease.Nausea or vomitingStomach or belly painFeverWeakness or unusual tirednessItchingLoss of appetiteLight-colored poopDark-colored urine (pee)Your skin or the whites of your eyes turning yellowish in color (also called jaundice)Wound Healing Problems. Cyclophosphamide can make it difficult for your body to heal wounds. Tell your health care provider if you have any planned or emergency surgeries or if you have any injuries that happen while taking cyclophosphamide.Low Sodium Levels (Hyponatremia). Cyclophosphamide may cause low sodium levels, which can be life-threatening. Call your health care provider right away or get emergency help if you have any of the following symptoms of a low sodium level.HeadacheDrowsinessMuscle weakness or crampsNausea, vomiting, or loss of appetiteTiredness or sleepinessDizzinessWeight gainRestlessness or crankinessChange in your mental condition such as hallucinations, confusion, decreased awareness, or less alertnessSeizures

overdose and misseddose

What should I do if I accidentally use too much cyclophosphamide?If you or someone else has used too much cyclophosphamide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of cyclophosphamide?Oral Tablets and Capsules. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.Injection. Cyclophosphamide is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving cyclophosphamide as scheduled. If you miss an appointment to get your cyclophosphamide dose, call to make another appointment as soon as possible.Â

warnings and Precautions

Who should not use cyclophosphamide?Allergies to Ingredients. People who are allergic to any of the following should not take cyclophosphamide.CyclophosphamideCytoxanNeosarAny of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific cyclophosphamide products they stock.Urinary Tract Blockage. Cyclophosphamide is not for people who have trouble peeing because of a blockage in your urinary tract.What should I know about cyclophosphamide before using it?Do not take cyclophosphamide unless it has been prescribed to you by a health care provider. Take it as prescribed.Do not share cyclophosphamide with other people, even if they have the same condition as you. It may harm them.Keep cyclophosphamide out of the reach of children.Cyclophosphamide should be taken in the morning with water. Talk with your health care provider about how much water to drink. You want to pee to lower the risk of kidney or bladder problems from this medicine. Swallow cyclophosphamide tablets and capsules whole. Do not open, chew, split, or crush them. Caregivers should wear gloves when handling the tablets and capsules to avoid having accidental exposure to the medicine. If they do touch a broken tablet or capsule, they should wash their hands well right away.If you are given medicine to prevent or treat certain side effects, like nausea and vomiting, take them exactly as your health care provider tells you.Cyclophosphamide can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how cyclophosphamide affects you.If you are able to get your partner pregnant, use effective birth control while using cyclophosphamide and for four months after your last dose.Cyclophosphamide may make it hard for you to get pregnant or get your partner pregnant. Infertility may be permanent. If you may want to have a child someday, talk to your health care provider.What should I tell my health care provider before using cyclophosphamide?Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if cyclophosphamide is right for you.In particular, make sure that you discuss any of the following.Kidney or bladder problems, such as kidney stones or an infectionHeart problemsBreathing problemsElectrolyte imbalance, such as low levels of sodiumTuberculosis (TB), hepatitis B, or any other serious infection.Enlarged prostateLiver problemsOther Medicines and Supplements. Cyclophosphamide may interact with other medicines and supplements. Before using or taking cyclophosphamide, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.Problems with Alcohol. Certain forms of cyclophosphamide have alcohol in them. This can be dangerous for people who should avoid or limit their use of alcohol. Tell your health care provider if you have a history of alcohol use disorder or need to avoid alcohol.Pregnancy. Cyclophosphamide can harm an unborn baby. Your health care provider will ensure you are not pregnant before you start taking or using cyclophosphamide. If you can become pregnant, use effective birth control while taking or using cyclophosphamide and for one year after your last dose. Tell your health care provider right away if you are pregnant, think you may be pregnant, or plan to become pregnant.Breastfeeding. Cyclophosphamide passes into breast milk. Do not breastfeed while using cyclophosphamide and for one week after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.Â

about

Cyclophosphamide is used to treat certain cancers and a type of kidney problem in certain people. Common side effects include nausea, diarrhea, and hair loss. Talk with your health care provider about how much water to drink each day. Tell your health care provider right away if you get unusual bleeding, red or pink urine (pee), sudden weight gain, a cough, or symptoms of an infection, such as a fever. Get emergency help if you have trouble breathing or chest pain.