What is cyclophosphamide?

By

Generic Name: Cyclophosphamide Brand Name(s): Generics only. No brands available.

Know the basics

What is cyclophosphamide used for?

Cyclophosphamide is used to treat various types of cancer. It is a chemotherapy drug that works by slowing or stopping cell growth.

Cyclophosphamide also works by decreasing your immune system’s response to various diseases. It is used to treat a certain type of kidney disease in children after other treatments have not worked.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Cyclosporine may also be used for various conditions such as lupus and rheumatoid arthritis, and to prevent organ transplant rejection.

How should I take cyclophosphamide?

Take cyclosporine by mouth exactly as directed by your doctor. The dosage is based on your medical condition, weight, response to treatment, and other treatments (such as other chemotherapy drugs, radiation) you may be receiving. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, non-prescription drugs, and herbal products).

During treatment with cyclosporine, you must drink more fluids than usual and pass urine frequently to help avoid kidney and bladder side effects. Ask your doctor how much you should drink and how often to empty your bladder each day, and follow these instructions carefully.

If you are using the capsules, swallow them whole. Do not open, chew, or crush the capsules. If you have accidental contact with broken capsules, wash your hands thoroughly right away.

Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle cyclophosphamide or breathe dust from the tablets or capsules.

Do not increase your dose or take cyclophosphamide more often without your doctor’s approval. Your condition will not improve any faster and the risk of serious side effects may be increased.

How do I store cyclophosphamide?

Cyclophosphamide is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store cyclophosphamide in the bathroom or the freezer. There may be different brands of cyclophosphamide that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush cyclophosphamide down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using cyclophosphamide?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

This medicine has been tested in children and has not been shown to cause different side effects or problems than it does in adults.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of cyclophosphamide in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.

Is it safe to take cyclophosphamide during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown.

Know the side effects

What are the side effects of cyclophosphamide?

 Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • Blood in your urine or stools, pain or burning when you urinate;
  • Pale skin, feeling light-headed, rapid heart rate, trouble concentrating;
  • Sudden chest pain or discomfort, wheezing, dry cough or hack, feeling short of breath on exertion;
  • Fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • Extreme thirst with headache, vomiting, and weakness;
  • Jaundice (yellowing of the skin or eyes); or
  • Severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Other common side effects may include:

  • Nausea, loss of appetite, stomach pain or upset, diarrhea;
  • Temporary hair loss;
  • A wound that will not heal;
  • Missed menstrual periods;
  • 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.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with cyclophosphamide?

Cyclophosphamide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, non-prescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live, Adenovirus Vaccine Type 7, Live, Allopurinol, Amprenavir ,Atazanavir, Bacillus of Calmette and Guerin Vaccine, Live, Boceprevir, Carbamazepine, Ceritinib, Cobicistat, Cyclosporine, Darunavir, Doxorubicin, Doxorubicin Hydrochloride Liposome, Eslicarbazepine Acetate, Etanercept, Fosamprenavir, Fosphenytoin, Hydrochlorothiazide, Indinavir, Influenza Virus Vaccine, Live, Lopinavir, Measles Virus Vaccine, Live, Mumps Virus Vaccine, Live, Nelfinavir, Nevirapine, Nilotinib, Nitisinone, Pentostatin, Phenytoin, Ritonavir, Rubella , Virus Vaccine, Live, Saquinavir, Siltuximab, Smallpox Vaccine, St John’s Wort, Tamoxifen, Telaprevir, Tipranavir, Trastuzumab, Typhoid Vaccine, Varicella , Virus Vaccine, Warfarin, Yellow Fever Vaccine.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ondansetron, Thiotepa.

Does food or alcohol interact with cyclophosphamide?

Cyclophosphamide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with cyclophosphamide?

Cyclophosphamide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Chickenpox (including recent exposure);
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body.
  • Gout, history of;
  • Kidney stones, history of—Cyclophosphamide may increase levels of uric acid in the body, which can cause gout or kidney stones.
  • Infection—May decrease body’s ability to fight infection.
  • Kidney disease—The effects of cyclophosphamide may be increased because of slower removal from the body.
  • Liver disease—The effect of cyclophosphamide may be decreased.
  • Prior removal of adrenal gland(s)—Toxic effects of cyclophosphamide may be increased, dosage adjustment may be necessary.
  • Tumor cell accumulation—Increased risk of tumor cells entering the bone marrow, due to bone marrow depression from high doses of cyclophosphamide.

Understand the Dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.

What is the dose of Cyclophosphamide for an adult?

Usual Adult Dose for Malignant Disease:

Intravenous: When used alone, the initial dose for patients with no hematologic deficiency is 40 to 50 mg/kg usually in divided doses over 2 to 5 days. Alternatively, 10 to 15 mg/kg may be administered every 7 to 10 days or 3 to 5 mg/kg twice a week.

Oral: Usual Range: 1 to 8 mg/kg/day for initial and maintenance dosing.

Usual Adult Dose for Ovarian Cancer:

For use in the treatment of epithelial ovarian cancer:

600 mg/m2 intravenously on day one in combination with carboplatin or cisplatin

Repeat cycle every 28 days.

Usual Adult Dose for Multiple Myeloma:

(In combination with other chemotherapeutic agents as a part of the M2 protocol)

10 mg/kg intravenously on day 1

What is the dose of Cyclophosphamide for a child?

Usual Pediatric Dose for Malignant Disease:

Intravenous: When used alone, the initial dose for patients with no hematologic deficiency is 40 to 50 mg/kg usually in divided doses over 2 to 5 days. Alternatively, 10 to 15 mg/kg may be administered every 7 to 10 days or 3 to 5 mg/kg twice a week.

Oral: Usual Range: 1 to 8 mg/kg/day for initial and maintenance dosing.

Usual Pediatric Dose for Nephrotic Syndrome:

When use for biopsy proven “minimal change” nephrotic syndrome in children, a dose of 2.5 to 3 mg/kg/day orally for 60 to 90 days is recommended.

How is cyclophosphamide available?

Cyclophosphamide is available in the following dosage forms and strengths:

Tablet 25 mg; 50 mg

Injection 500 mg; 1 g; 2 g

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include the following:

  • Black, tarry stools;
  • Red urine;
  • Unusual bruising or bleeding;
  • Unusual tiredness or weakness;
  • Sore throat, cough, fever, or other signs of infection;
  • Swelling in the legs, ankles, or feet;
  • Chest pain.

What should I do if I miss a dose?

If you miss a dose of cyclophosphamide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

 

Sources

Review Date: May 30, 2016 | Last Modified: January 4, 2017

You might also like