Cyclophosphamide (Endoxan, Cytoxan, Neosar,
Warning: Although very rare, second cancers can develop in some
patients treated with
cyclophosphamideused alone or in association with other cancer chemotherapy
drugs. Be sure to inform your
physician of any allergies you might have with this drug. Patients
must be careful not to conceive during the treatment period and some weeks after.
Cyclophosphamide is a drug used to combat cancer by slowing or completely stopping the growth of cancerous cells in
patients. Besides being a part of chemotherapy, it is also effective
in treating a certain form of child kidney disease. This drug has
other applications as well, including treatment of rheumatoid arthritis and lupus. It can be administered to transplant patients to prevent organ
In general, Cyclophosphamide is, most of the times, used to treat the following cancers:
- testicular cancer
- endometrial cancer
- ovarian cancer
- Ewing's sarcoma
Lymphomas: Hodgkin’s lymphomas and non-Hodgkin's
Leukemias: chronic lymphocytic leukemia (CLL),
chronic myelocytic leukemia (CML), acute myelocytic leukemia (AML), acute lymphocytic leukemia
doctor prescribed according to the conditions of the individual patient. The medication can be taken by mouth in tablet form or by injection into a
vein. When a
health care professional does not administer the doses, the patient must strictly follow the instructions provided
by his physician. The patient should also take care to wash hands after any handling.
Cyclophosphamide, also known
by its generic form Cytoxan, should be taken under very careful control by children or the elderly, who can be
more susceptible to its effects.
Keep Cyclophosphamide out
of children reach. Store the medication at room temperature below 25 degrees Celsius (77 degrees Fahrenheit),
and strictly away from temperatures exceeding 30 degrees Celsius. Always store Cyclophosphamide away from
moisture and heat. Discard any unused doses after the expiration date. Talk
to your pharmacist about the proper disposal of the medication.
Cyclophosphamide is given in hospital by professionals, the risk of overdose is virtually nonexistent. When the
drug is taken by mouth chance of overdose increases; either voluntary or involuntary, it may happen that some
patients take higher dose. Cyclophosphamide overdose can cause severe and even fatal health problems. An accidental
overdose in elderly and especially among young children can lead to death.
If you think you have taken an overdose of Cyclophosphamide, contact a poison control center or go to an emergency
as soon as possible.
If you are recommended to take Cyclophosphamide by mouth in tablet form at home, you can easily forget to take it.
If you forgot to take the drug for less than 12 hours, take the usual dose. Beyond 12 hours, it is better to wait
for the next dose to continue taking the medication as usual; do not double.
Interactions: Cyclophosphamide has
significant interactions with specific drugs. It can be used with
Allopurinol (Zyloprim), to enhance the ability of the drug to control and lesson the production of blood cell
that is produced in the bone marrow.
This medication should not
be taken in conjunction with Doxorubicin (Adriamycin), which can increase chances of heart failure. Blood thinners such as Coumarin
(Coumadin) may perform their job too well in the presence of this drug. Drugs like Cipro and other Quinolone antibiotics will be less effect in
patients taking this drug.
Contraindications: It is important for patients to understand that they
cannot plan to have children or actually be pregnant during the time of treatment with this
medication. Further, there is a period of time after delivery that
a mother must postpone treatment in order to avoid transmission to her newborn, primarily through mother’s
milk. This drug can also affect family planning in other
ways. Though postponing the drug indefinitely may not be an option,
couples need to be aware that this medication can cause temporary sterility for some time, and in some cases the
sterility becomes permanent.
Although often not a
consideration for a life-saving drug, appearance can be affected drastically by the drug and may be an issue for
those whose occupation depends on a healthy, robust appearance. In
some cases, patients experience temporary hair loss, darkening of the nails, and yellowing of the
eyes. It can also cause abdominal pains, muscle spasms, and general
weakness. Time should be allowed during and after treatment to deal
with these possible side effects.
possible that Cyclophosphamide interacts with the following substances:
St. John's wort
Anti anemia drugs such as filgrastim and pegfilgrastim
In addition to attacking cancer cells, Cyclophosphamide can also affect normal cells, which can cause various
adverse effects in some patients. Some Cyclophosphamide side effects include:
- hair loss
nausea and vomiting
- mouth sores
darkened and thickened skin
blistering skin or acne
- Absence of
menstrual bleeding (amenorrhea).
If the side
effects above become severe or persist for long, contact your oncologist. In addition, contact your doctor
immediately if you experience any of these symptoms:
constipation or diarrhea
- severe depression
of breath or difficulty breathing
bruising or bleeding
of the feet or ankles
or red urine.