What is Endoxan® (cyclophosphamide) used for?
Cyclophosphamide is an antineoplastic. It works by stopping or slowing the growth or spread of certain cancer cells.
Endoxan® is commonly used for treating certain types of the following cancers such as lymphoma, multiple myeloma, leukemia, mycosis fungoides, neuroblastoma, ovarian cancer, eye cancer, and breast cancer. It is usually used in combination with other medicines.
It may also be used to treat certain kidney problems (nephrotic syndrome) in children or for other conditions as determined by your doctor.
How should I take Endoxan® (cyclophosphamide)?
Cyclophosphamide is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using cyclophosphamide at home, a health care provider will teach you how to use it. Be sure you understand how to use cyclophosphamide. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
Do not use cyclophosphamide if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
If you experience nausea, vomiting, diarrhea, or loss of appetite, contact your doctor to discuss ways to reduce these side effects.
Drinking extra fluids and emptying your bladder regularly while you are taking cyclophosphamide is recommended. Check with your doctor for instructions.
Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
How do I store Endoxan® (cyclophosphamide)?
Cyclophosphamide is usually handled and stored by a health care provider. If you are using cyclophosphamide at home, store cyclophosphamide as directed by your pharmacist or health care provider. Keep cyclophosphamide out of the reach of children and away from pets.
Precautions & warnings
What should I know before using Endoxan® (cyclophosphamide)?
- Cyclophosphamide may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
- Cyclophosphamide may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
- Tell your doctor or dentist that you take cyclophosphamide before you receive any medical or dental care, emergency care, or surgery.
- Cyclophosphamide may decrease your body’s ability to heal wounds. Discuss any questions or concerns with your doctor.
- Cyclophosphamide may increase your chance of developing a second cancer, sometimes even years after stopping treatment with cyclophosphamide. Discuss any questions or concerns with your doctor.
- Cyclophosphamide may cause infertility that is sometimes permanent. Discuss any questions or concerns with your doctor.
- Check with your doctor before receiving any vaccinations while you are using cyclophosphamide.
- The use of birth control is recommended while using cyclophosphamide.
- Lab tests, including complete blood cell counts, platelet counts, and urine tests, may be performed while you use cyclophosphamide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use cyclophosphamide with caution in the elderly; they may be more sensitive to its effects.
Is it safe during pregnancy or breastfeeding?
Cyclophosphamide has been shown to cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using cyclophosphamide while you are pregnant.
Cyclophosphamide is found in breast milk. Do not breastfeed while taking cyclophosphamide.
What side effects can occur from Endoxan® (cyclophosphamide)?
All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most common side effects persist or become bothersome:
- Appetite loss
- Absence of menstrual periods
- Color change in skin
- General unwell feeling
- Hair loss
- Skin rash
- Stomach discomfort or pain
- Texture change in nails
Seek medical attention right away if any of these severe side effects occur:
- Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
- Blood in urine
- Bloody or black tarry stools
- Chest pain
- Increased or decreased urination
- Lower back or abdominal pain
- Pain, swelling, or redness at the injection site
- Painful urination
- Persistent cough
- Red, swollen, or blistered skin
- Severe stomach pain
- Shortness of breath
- Sore throat
- Sores in the mouth
- Swelling of the hands or feet
- Unusual bruising or bleeding
- Unusual or severe tiredness or weakness
- Yellowing of the skin or eyes
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.
What drugs may interact with Endoxan® (cyclophosphamide)?
Endoxan® 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, nonprescription 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.
Some medicines may interact with cyclophosphamide, including:
- TNF-blocking medicines (e.g., etanercept) because the risk of certain types of cancer may be increased.
- Doxorubicin or trastuzumab because the risk of heart-related side effects and toxicity may be increased.
- Imidazoles (e.g., ketoconazole) or phenobarbital because they may increase the risk of cyclophosphamide’s side effects.
- Ondansetron because it may decrease cyclophosphamide’s effectiveness.
- Succinylcholine because its actions and the risk of its side effects may be increased by cyclophosphamide.
- Indomethacin because the risk of its side effects may be increased by cyclophosphamide.
- Digoxin because its effectiveness may be decreased by cyclophosphamide.
Does food or alcohol interact with Endoxan® (cyclophosphamide)?
Endoxan® 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 Endoxan® (cyclophosphamide)?
Some medical conditions may interact with cyclophosphamide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- You have an infection, chickenpox, a suppressed immune system, bone marrow suppression or other bone marrow problems, low levels of white blood cells or platelets, or liver or kidney problems.
- You are receiving or have received cytotoxic therapy or x-ray or radiation therapy.
- You have had an adrenal gland removed (adrenalectomy).
- You are receiving or have received chemotherapy or radiation therapy.
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Endoxan® (cyclophosphamide).
What is the dose of Endoxan® (cyclophosphamide) for an adult?
Initial treatment is:
- Daily IV injections of 3-6 mg/kg body weight (120-240 mg/m2).
- Massive intermittent therapy, 10-15 mg/kg body weight (400-600 mg/m2), with therapy-free intervals of 2 or 5 days.
- Massive intermittent therapy, 20-40 mg/kg body weight (800-1600 mg/m2), with therapy-free intervals of 10-20 days.
Endoxan® should be given in the morning with liberal amounts of liquids, during and immediately after administrations. For continuation or maintenance therapy, 50-200 mg/day may be given orally.
Preparation of solutions:
Dissolve 200 mg in 10 ml of water for injection (double-distilled water). Do not use physiological saline as a solvent. The solutions should be used within 24 hrs after preparation. The substance dissolves readily when the vial is shaken vigorously for ½-1 min after addition of the solvent. If complete dissolution is not achieved immediately, allow the solution to stand for some minutes until it is thoroughly clear.
What is the dose of Endoxan® (cyclophosphamide) for a child?
Usual pediatric dose for malignant disease
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.
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 Endoxan® (cyclophosphamide) available?
Endoxan® is available in the following dosage forms and strengths:
- Coated tablet 50 mg
- Powder for injection (vial) 1000 mg
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.
What should I do if I miss a dose?
If you miss a dose of Endoxan®, 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.
Endoxan® (cyclophosphamide). http://www.mims.com/singapore/drug/info/Endoxan?type=full. Accessed November 3, 2016
Cyclophosphamide. https://www.drugs.com/cdi/cyclophosphamide.html. Accessed November 3, 2016
Review Date: December 25, 2016 | Last Modified: September 13, 2019