1 What is Cytoxan?

Brand: Cytoxan, Cytoxan Lyophilized

Generic: Cyclophosphamide (Oral Route, Intravenous Route)

Brand name:

Cytoxan and Cytoxan Lyophilized.

Cyclophosphamide, an alkylating drug, is indicated for patients who have certain kinds of cancer including ovarian, breast, blood and lymph system cancers. It is also used in the treatment of retinoblastoma, mycosis fungoides and multiple myeloma.

Cyclophosphamide can be used to treat patients with minimal change nephrotic syndrome who have failed adrenocorticosteroid therapy as well. However, its efficacy in renal disease treatment has not been established.

Cyclophosphamide has also demonstrated effectiveness in treating:

  • Cancer of the Adrenal Cortex, Bladder, Bones, Cervix, Endometrium, Lungs, Prostate, and Testicles.
  • Ewing's Sarcoma
  • Germ Cell Tumors in the Ovaries
  • Gestational Trophoblastic Tumors
  • Histiocytosis X
  • Organ Transplant Rejection
  • Rheumatoid Arthritis
  • Soft Tissue Sarcomas
  • Systemic Dermatomyositis
  • Systemic Lupus Erythematosus
  • Thymoma
  • Tumors in the Brain
  • Waldenström's Macroglobulinemia
  • Wegener's Granulomatosis
  • and Wilms' Tumor

It is marketed under several forms including:

  • Powder for Reconstitution
  • Tablet
  • and Capsule
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2 What to Know Before Using

The benefits and risks associated with cyclophosphamide should be discussed carefully with your doctor. You need to consider a variety of factors.

This medication should not be given to patients who have had allergic reactions to any of its components or to similar drugs. Inform your doctor about any allergies as well.

Cyclophosphamide causes the same effects in children as it does in adults. Little research has been done regarding the effects of this medication on the elderly population. However, it is expected to have the same effects in geriatric patients as in younger adults.

Cyclophosphamide is a pregnancy category D which means that it puts the unborn child at risk as demonstrated by research.

Studies have also shown that cyclophosphamide can be detrimental to nursing babies and, therefore, should not be used in lactating mothers. Cyclophosphamide can also cause adverse reactions if used concomitantly with certain medications.

You should not get a live rotavirus vaccine while on cyclophosphamide treatment. The following medications should not be used together with cyclophosphamide but can be required in special circumstances:

  • Allopurinol
  • Amprenavir
  • Boceprevir
  • Ceritinib
  • Darunavir
  • Eslicarbazepine Acetate
  • Fosphenytoin
  • Hydrochlorothiazide
  • Lopinavir
  • Nelfinavir
  • Nilotinib
  • Pentostatin
  • Ritonavir
  • Saquinavir
  • Tamoxifen
  • Tipranavir
  • and Warfarinn among others

Concomitant use of ondansetron and thiotepa can lead to unwanted side effects.

Cyclophosphamide can make the following medical conditions worse:

  • Chickenpox
  • Herpes Zoster
  • Gout
  • Kidney Disease/Stones
  • Any kind of Infection
  • Liver Disease
  • Prior Removal of Adrenal Gland/s
  • and Tumor Cell Accumulation

3 Proper Usage

Follow your physician’s instructions as to when and how often to take cyclophosphamide. If you are on a combination therapy, make sure you take each medication at the right time.

You need to drink plenty of fluids when you are taking cyclophosphamide. This allows proper excretion of the medication in urine and prevents accumulation in the urinary tract, which can lead to toxicity.

This also helps prevent kidney damage. Usually, cyclophosphamide is to be taken in the morning to ensure adequate diuresis.

Common effects of this medication include:

Make sure your finish your cyclophosphamide course. Do not stop taking your medication without prior consultation with your doctor.

Dosage and frequency depend on the severity of your condition. Intravenous cyclophosphamide must be administered by a physician or a trained healthcare professional.

For tablets, adult cancer patients usually take 1-5 mg/kg of body weight daily. The recommended does for children with cancer depends on their body weight.

Check with your doctor if you missed a dose. Normally, you can take the medication as soon as you remember as long as the next schedule is still far off. Keep your medications safe and away from children’s reach.

4 Precautions to Take

There are precautions you need to take when you are on cyclophosphamide treatment. Cyclophosphamide decreases the number of white blood cells in your body. This can have a number of effects, one of which is immunosuppression.

This medication can compromise your body’s ability to fight off infections. During this time, you should not get any vaccinations done.

Your physician may also put you on antibiotic therapy as a preemptive approach to treatment. You need to avoid contact with people who have active infections. You can also wear a protective face mask.

Cyclophosphamide can also increase your risk of bleeding. Do not engage in strenuous activities and contact sports while taking this medication.

Report to your physician if you have unusual bruising or bleeding and practice oral hygiene with care. Inform your dentist and other physicians that you are currently taking cyclophosphamide before undergoing any kind of surgery, dental work, or medical treatment.

Hair loss can also occur. However, hair will regrow after treatment. Go to your regular checkups so that your physician can monitor your condition and prevent any kind of side effects. You will also need to undergo regular laboratory exams.

5 Potential Side Effects

There are multiple side effects associated with cyclophosphamide treatment. Notify your healthcare provider if you experience the following:

  • Coughing
  • Fever/Chills
  • Lower Back or Side Pain
  • Painful Urination
  • and Missing Menstrual Periods

High doses and prolonged use of cyclophosphamide can also lead to:

The following symptoms may not need medical attention:

  • Darkening of the Skin and Fingernails
  • Loss of Appetite
  • and Nausea/Vomiting

Less common effects include:

  • Diarrhea
  • Flushing or Redness of the Face
  • Increased Sweating
  • Headache
  • Skin Rash
  • Stomach Pain
  • and Swollen Lips

Inform your doctor of these signs and symptoms do not improve or get worse.