cyclophosphamide (oral/injection)

What is the most important information I should know about cyclophosphamide?

What is cyclophosphamide?

Cyclophosphamide is used to treat several types of cancer.

Cyclophosphamide is also used to treat minimal change nephrotic syndrome (kidney disease) in children who cannot use other treatments or when other treatments have failed.

Cyclophosphamide may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using cyclophosphamide?

• a bladder obstruction.

Tell your doctor if you have ever had:

• a weak immune system (caused by disease or by using certain medicines);
• an active or chronic infection (including a bladder infection);
• bladder problems;
• kidney disease (or if you are on dialysis);
• lung disease;
• heart disease;
• liver disease; or
• if you are receiving other cancer treatments or radiation.

Using cyclophosphamide may increase your risk of developing other types of cancer such as bladder cancer, thyroid cancer, or leukemia. Talk with your doctor about your specific risk.

• If you are a woman, do not use cyclophosphamide if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 1 year after your last dose.
• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 4 months after your last dose.
• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using cyclophosphamide.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because cyclophosphamide can harm an unborn baby.

Cyclophosphamide may cause you to stop having menstrual periods. Your periods should return to normal within a few months after you stop using cyclophosphamide. However, older women may have early menopause due to this effect. Talk to your doctor about this risk.

How is cyclophosphamide given?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Cyclophosphamide oral is taken by mouth.

Cyclophosphamide injection is given as an infusion into a vein. A healthcare provider will give you this injection.

Cyclophosphamide affects your immune system. You may get infections more easily, even serious or fatal infections. Your doctor will need to examine you on a regular basis.

Cyclophosphamide can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

If you need surgery, tell the surgeon ahead of time that you are using cyclophosphamide. You may need to stop using the medicine for a short time.

What happens if I miss a dose?

For cyclophosphamide oral: Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include mouth sores, trouble breathing, fast heartbeats, rapid weight gain, stomach pain, or yellowing of your skin or eyes.

What should I avoid while using cyclophosphamide?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

What are the possible side effects of cyclophosphamide?

• new worsening cough, shortness of breath, trouble breathing while lying down;
• a light-headed feeling, like you might pass out;
• pink or red urine, pain or burning when you urinate;
• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• any wound that will not heal;
• heart problems --swelling, rapid weight gain, pounding heartbeats or fluttering in your chest;
• liver problems --loss of appetite, stomach pain (upper right side), bloating, dark urine, jaundice (yellowing of the skin or eyes);
• low sodium level --headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or
• low blood cell counts --fever, chills, tiredness, blisters or ulcers in your mouth, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.

Common side effects may include:

• fever, low blood cell counts;
• mouth sores;
• nausea, vomiting, diarrhea;
• hair loss; or
• missed menstrual periods.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect cyclophosphamide?

Tell your doctor about all your current medicines. Many drugs can affect cyclophosphamide, especially:

• medicine to prevent organ transplant rejection;
• medicine to treat an infection;
• medicine to treat multiple sclerosis, psoriasis, rheumatoid arthritis, or other autoimmune disorders; or
• other cancer medicine (especially tamoxifen).

This list is not complete and many other drugs may affect cyclophosphamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about cyclophosphamide.