CYCLOPHOSPHAMIDE

Brand & Generic Names

Cytoxan
Neosar
Procytox

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Immunosuppressant, antineoplastic

Uses

• Treatment for cancer.
• Treatment for severe rheumatoid arthritis.
• Treatment for blood vessel disease.
• Treatment for skin disease.

Dosage & Usage Information

How to take:
Tablet or liquid--Swallow with liquid. If you can't swallow whole, crumble tablet and take with liquid or food.

When to take:
Works best if taken first thing in morning. However, may take with food to lessen stomach irritation. Don't take at bedtime.

If you forget a dose:
Take as soon as you remember up to 12 hours late. If more than 12 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Kills cancer cells.
Suppresses spread of cancer cells.
Suppresses immune system.

Time lapse before drug works:
7 to 10 days continual use.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Bloody urine, water retention, weight gain, severe infection.

WHAT TO DO:

Overdose unlikely to threaten life. If person takes much larger amount than prescribed, call doctor, poison-control center or hospital emergency room for instructions.

Possible Adverse Reactions or Side Effects

Life-threatening:

Hives, rash, intense Seek emergency itching, faintness treatment immediately. soon after a dose (anaphylaxis).

Common:

• Sore throat, fever.
• Dark skin, nails; nausea; appetite loss; vomiting; missed menstrual period.

Infrequent:

• Rash, hives, itch; shortness of breath; rapid heartbeat; cough; blood in urine, painful urination; pain in side; bleeding, bruising; increased sweating; hoarseness; foot or ankle swelling.
• Confusion, agitation, headache, dizziness, flushed face, stomach pain, joint pain, fatigue, weakness, diarrhea.

Rare:

• Mouth, lip sores; black stool; unusual thirst; jaundice.
• Blurred vision, increased urination, hair loss.

Warnings & Precautions

Don't take if:

• You are allergic to any alkylating agent.
• You have an infection.
• You have bloody urine.
• You will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Before you start, consult your doctor:

• If you have impaired liver or kidney function.
• If you have impaired bone marrow or blood cell production.
• If you have had chemotherapy or X-ray therapy.
• If you have taken cortisone drugs in the past year.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons. To reduce risk of chemical bladder inflammation, drink 8 to 10 glasses of water daily.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Use only under medical supervision.

Prolonged use:

• Development of fibrous lung tissue.
• Possible jaundice.
• Swelling of feet, lower legs.
• Cancer.
• Infertility in men.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit), urine, liver function.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Avoid if you feel dizzy or have blurred vision. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:

• Frequently causes hair loss. After treatment ends, hair should grow back.
• Avoid vaccinations.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Allopurinol or other	Possible anemia;
medicines to treat gout	decreased anti-gout effect.
Antidiabetics*,	Increased antidiabetic
oral	effect.
Bone marrow	Increased bone marrow depressant
depressants*, other	effect.
Clozapine	Toxic effect on bone marrow.
Cyclosporine	May increase risk of infection.
Digoxin	Possible decreased digoxin
	absorption.
Immunosuppressants,* other	Increased risk of infection.
Insulin	Increased insulin effect.
Levamisole	Increased risk of bone marrow
	depression.
Lovastatin	Increased heart and kidney damage.
Phenobarbital	Increased cyclophosphamide effect.
Probenecid	Increased blood uric acid.
Tiopronin	Increased risk of toxicity to bone
	marrow.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	No problems expected.
Beverages:	No problems expected. Drink at
	least 2 quarts fluid every day.
Cocaine:	Increased danger of brain damage.
Foods:	None expected.
Marijuana:	Increased impairment of immunity.
Tobacco:	None expected.