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What is cyclophosphamide?
Cyclophosphamide is a cancer (chemotherapeutic) medication. Cyclophosphamide interferes with the growth of cancer cells and slows their growth and spread in the body. Cyclophosphamide is used to treat several types of cancer. Cyclophosphamide is also used to treat certain cases of nephrotic syndrome (kidney disease) in children. Cyclophosphamide may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of cyclophosphamide?

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);

• blood in the urine;

• black or tarry stools;

• painful or difficult urination;

• signs of infection such as fever; chills, or sore throat;

• jaundice (yellowing of the skin or eyes);

• lower back or side pain;

• chest pain, difficulty breathing, or swelling;

• unusual bleeding or bruising; or

• changes in bone marrow function (detected by blood tests).

Other less serious side effects may be more likely to occur. Talk to your doctor if you experience

• nausea, vomiting, or decreased appetite;

• mouth sores;

• abdominal pain;

• diarrhea;

• temporary hair loss;

• temporary or permanent sterility;

• rash;

• changes in skin color; or

• changes in nails.

In some cases, secondary cancers have been reported to occur during and following treatment with cyclophosphamide. Talk to your doctor about the risks and benefits of this medication.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take cyclophosphamide?
Take cyclophosphamide exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, nurse or pharmacist to explain them to you. Take each oral dose with a large glass of water. To avoid urinary bladder irritation during treatment with either oral or injectable cyclophosphamide, drink plenty of fluid during treatment and for 48 hours following treatment, usually 7 to 12 cups (3 quarts) per day, and empty your bladder frequently, every 2 to 3 hours including once during the night.

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What is the most important information I should know about cyclophosphamide?
Cyclophosphamide should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents. Serious side effects have been reported with the use of cyclophosphamide including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; fever or chills; or signs of infection such as fever; chills, or sore throat); bladder problems; and others. Talk to your doctor about the possible side effects from treatment with cyclophosphamide.

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What happens if I miss a dose?
Take the missed oral dose as soon as you remember. If it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose as directed. Do not take a double dose of this medication. Contact your doctor if you miss a dose of cyclophosphamide injection.

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What other drugs will affect cyclophosphamide?
Before taking cyclophosphamide, tell your doctor if you are taking any other medicines, especially any of the following: phenobarbital (Luminal, Solfoton); allopurinol (Zyloprim); digoxin (Lanoxin); warfarin (Coumadin); a thiazide diuretic (water pill) such as chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, HydroDiuril, Esidrix, Microzide, Oretic), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), and others; or another chemotherapy medicine. You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Cyclophosphamide has been assigned to pregnancy category D by the FDA. While normal newborns have been delivered to women who were exposed to cyclophosphamide during pregnancy, human data have revealed evidence of embryotoxicity and fetotoxicity. If this drug is used during pregnancy, or if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus. Women of childbearing potential should be advised to avoid becoming pregnant during therapy. The use of cyclophosphamide during pregnancy is contraindicated.

The use of cyclophosphamide during human pregnancy has resulted in severe and multiple abnormalities, including facial and palate defects, absent fingers and toes, absence of some coronary arteries, imperforate ani, hernias, growth retardation, multiple eye defects, microcephaly, hypotonia, and pancytopenia. Normal pregnancies and infantile development have resulted despite the use of cyclophosphamide during pregnancy. Use of this drug during the second and third trimesters does not seem to place the fetus at risk for congenital abnormalities. Nevertheless, use of cyclophosphamide during pregnancy is contraindicated.

Cyclophosphamide is excreted into human milk. Neutropenia, thrombocytopenia, and immune suppression have been observed in infants whose mothers were receiving this drug during lactation. The drug also has an unacceptable risk of carcinogenesis. The American Academy of Pediatrics considers the use of cyclophosphamide to be contraindicated during breast-feeding.

Cyclophosphamide has been found in human milk up to 6 hours after a single 500 mg IV dose. Absolute neutropenia has been described in a nursing infant whose mother received 800 mg of cyclophosphamide, along with vincristine and prednisone therapy. Neutropenia and thrombocytopenia were observed in another nursing infant whose mother received 6 mg/kg/day of cyclophosphamide IV. After the third dose, the nursing infants leukocyte an platelet counts fell from pretreatment values of 4,800/mm3 and 270,000/mm3 to 3,200/mm3 and 47,000/mm3, respectively.

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Who should NOT use this medication?

• Severely depressed bone marrow function.
• Known hypersensitivity to cyclophosphamide or any ingredient in the formulation.

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What does my medication look like?
Cyclophosphamide is available with a prescription under the brand names Cytoxan and Neosar. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Cytoxan 25 mg-round, white tablets with blue flecks Cytoxan 50 mg-round, white tablets with blue flecks Cytoxan Lyophilized 100 mg -vial for injection Cytoxan Lyophilized 200 mg -vial for injection Cytoxan Lyophilized 500 mg -vial for injection

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What happens if I overdose?
Seek emergency medical attention. Symptoms of a cyclophosphamide overdose may include decreased bone marrow function, infection, and heart problems.

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What should I discuss with my healthcare provider before taking cyclophosphamide?
Before taking cyclophosphamide, tell your doctor if you have an infection or have had recent vaccinations; have a low level of white blood cells or platelets (detected by blood tests); have bone marrow problems; have been previously treated with x-ray therapy; have been previously treated with other chemotherapy medicines (i.e., Alkeran, CeeNU, Leukeran, Myleran, and others); have had your adrenal glands removed; need to have surgery; have any unhealed wounds; have a history of heart disease;

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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