Cyclophosphamide is used to treat and prevent cancers in the body and also to suppress the immune system. It belongs to a class of medicines called ‘alkylating agents’
Uses of Cyclophosphamide
- Treatment of cancer of certain type of white blood cells (acute and chronic
- lymphocytic leukemia)
- As conditioning for bone marrow transplantation, in certain cancers of white blood
- cells that start in the bone marrow (acute lymphoblastic, acute and chronic
- myelogenous leukemia)
- Cancer of immune white blood cells (plasma cells, a condition called multiple
- myeloma), and cancer of the lymph nodes (glands of the immune system, conditions
- called as hodgkin’s and non-hodgkin’s lymphoma)
- Advanced cancers of the breast and the ovary (that are spreading)
- ‘Add-on’ treatment to other medicines for treatment of breast cancer (that is not
- A type of cancer of the soft tissues (muscles, tendons, ligaments etc) or the bones
- (ewing’s sarcoma)
- A type of lung cancer (small cell lung cancer)
- Advanced cancer of immature nerve cells (neuroblastoma)
- Life-threatening diseases of the immune system (lupus nephritis that affects the
- kidney, a condition called wegener’s granulomatosis that affects the blood vessels)
Contraindications of Cyclophosphamide
When should one not use Cyclophosphamide
- Allergy to cyclophosphamide or to any of the components
- Any acute infections
- Bone marrow depression or aplasia (severely reduced cells of the bone marrow)
- Urinary tract infections, urinary outflow obstruction
- Damage to the lining of the lower urinary tract (damaged urothelium of the urinary
- tube between the kidney and outlet)
- Cyclophosphamide should not be used for any conditions other than cancer except
- for suppression of the immune system in life-threatening situations
Side effects of Cyclophosphamide
Common side effects of this drug are:
- Decreased activity of the bone marrow causing (myelosuppression)
- Decreased production of white blood cells (leucopenia, neutropenia)
- Hair loss
- Burning sensation and increased frequency of passing urine (cystitis)
- Suppression of the immune system (increase in infections due to reduced resistance)
- Irritation of lining of some organs (mucositis)
- Blood in the urine (microhematuria)
- Feeling unwell, weakness
- Liver problems
- Infertility in men
- Low red blood cells and platelet counts (anemia and thrombocytopenia)
- Lung infections (pneumonia), sepsis (wide spread infection), allergic reactions, chest
- pain, fast heart beats, redness of skin, numbness, nerve pain, decreased hunger,
- deafness, infertility in females (uncommon)
- Allergic reactions with difficulty in breathing, high heart rate, low blood pressure,
- tiredness, swelling of face and lips, rashes and itching (Anaphylactic reactions – rare,
- but serious)
Precautions and Warnings of Cyclophosphamide
Can I take Cyclophosphamide during pregnancy?
Do not use Cyclophosphamide if you are pregnant Cyclophosphamide might affect the unborn baby. Follow contraceptive measures while you are on this medicine. Inform your doctor if you are pregnant or planning pregnancy
Can I take Cyclophosphamide while breastfeeding?
Do not take cyclophosphamide if you are breastfeeding, as it appears in human milk in toxic amounts and can harm the baby. Please consult before taking this medicine if you are breastfeeding
Can I drive if I have consumed Cyclophosphamide?
Caution is recommended as Cyclophosphamide can cause side effects such as dizziness, vision problem after taking this medicine. Do not drive if you experience any of these symptoms
Can I consume alcohol with Cyclophosphamide?
Cyclophosphamide causes nausea and vomiting, if you drink alcohol while on this treatment increase the risk of nausea and vomiting It is important to note that alcohol delays healing in conditions like cancer
Other General Warnings
Talk to your doctor if
- Low blood cell counts
- Severe infections
- Liver or kidney problems
- Your adrenal glands (hormone releasing glands present on top of the kidney) have
- been removed
- Received treatment for cancer by radiation (radiotherapy) or by medicines
- Heart problems or radiation treatment in your chest area
- Weak, elder or have poor oral health
- Had recent surgery (less than 10 days ago)
Mode of Action of Cyclophosphamide
How Does It Work?
Cyclophosphamide acts by killing the cancer cells in the body after being activated in the liver. At lower doses, it suppresses certain regulatory (T-cells) cells of the immune system and causes immunosuppression
Interactions of Cyclophosphamide
Interactions with other medicines
- Medicines used to treat HIV/ AIDS (zidovudine, ritonavir, nelfinavir)
- Medicines used to treat high blood pressure (ACE inhibitors – ramipril, enalapril,
- lisinopril; diuretics – furosemide, torsemide)
- Medicines used to treat immune disorders (natalizumab, azathioprine, cyclosporine,
- Certain anti-cancer medicines (paclitaxel, anthracyclines, cytarabine, pentostatin,
- trastuzumab, tamoxifen, radiation treatment of the chest region)
- Medicines that increase the number of blood cells (CSF-colony stimulating factors)
- Medicines used to treat heart disease (amiodarone)
- Metronidazole (an antibiotic)
- Muscle relaxants (succinyl choline etc)
Interactions with food items
No known food interaction with this medicine
Dietary Restrictions of Cyclophosphamide
- Drink plenty of water and fluids to avoid any urinary complications while you are
- taking Cyclophosphamide
- Consumption of Grapefruit (fruit or juice) is not recommended while taking
Dosage of Cyclophosphamide
Overdose leads to life threatening situations at very high doses You are advised to take this injection or infusion (slow drip into the veins) in a hospital setting under supervision This will minimize any chances of overdosing But if you experience any serious symptoms like heart problems, altered consciousness, urinary or liver problems, inform your doctor immediately and seek medical care without any delay
Missed a Dose
Take the missed dose as soon as you remember If the missed dose falls at the time of you next scheduled dose then skip it Do not take a double dose to make up for the missed dose
Frequently Asked Questions (FAQs)
Q: Are there any special precautions I need to follow while taking
A: Females should not try for pregnancy up to 12 months after discontinuing treatment with Cyclophosphamide Males on Cyclophosphamide should use birth control up to 6 months after stopping the treatment If you are of reproductive age, it may be advisable to preserve your sperms or eggs as Cyclophosphamide may irreversibly affect your fertility Cyclophosphamide interferes with wound healing Exercise caution and reduce the incidence of any cuts, injuries, burns etc and give immediate attention Cyclophosphamide can cause mouth ulcers and sore gums You are advised to maintain good oral health
Q: What else do I need to know while taking Cyclophosphamide?
A: White blood cell and platelet count need to be done regularly while on treatment with Cyclophosphamide If the medicine is given by infusion (slow drip) or by direct injection (through the veins), it has to be done by trained personnel You are advised not to do it on your own Infusion (slow drip into the veins) should be done over a period of 30 minutes to 2 hours
- MHRA UK Cyclophosphamide [Accessed on 27 Aug 2019](online)
- EMC Cyclophosphamide [Accessed on 27 Aug 2019] (online)
- Drugbank Cyclophosphamide [Accessed on 27 Aug 2019] (online)
- Dailymed Cyclophosphamide [Accessed on 27 Aug 2019] (online)
- EMC Cyclophosphamide [Accessed on 27 Aug 2019] (online)
- Drugs and Lactation Database (LactMed) [Internet] Bethesda (MD): National Library of Medicine (US); 2006- Cyclophosphamide [Updated 2019 Apr 1]
Last Updated on: 05 Oct 2020 | 10:47 PM (IST)
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