Cyclophosphamide injection

What is cyclophosphamide injection?

CYCLOPHOSPHAMIDE (Cytoxan®, Neosar®) is a type of chemotherapy for treating various types of cancer. It also treats a number of immune-related diseases or conditions, such as systemic lupus erythematosus (SLE), lupus nephritis, rheumatoid arthritis or organ transplant rejection. Cyclophosphamide interferes with the growth of rapidly growing cancer cells and can suppress the immune system. Generic cyclophosphamide injections are available.

What should my health care professional know before I receive cyclophosphamide?

They need to know if you have any of these conditions:

• bleeding or blood disorders

• cystitis

• dehydration

• dental disease

• infection (especially virus infection such as chickenpox or cold sores)

• liver disease

• previous treatment with daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone

• previous radiation therapy

• receiving dialysis

• an unusual or allergic reaction to cyclophosphamide, other chemotherapy, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Cyclophosphamide is for injection into a vein. It is usually administered in a hospital or clinic setting by a health care professional. It also may be given by a trained nurse as part of home healthcare services.

What if I miss a dose?

It is important not to miss a dose. Notify your prescriber or health care professional if you are unable to keep an appointment.

What drug(s) may interact with cyclophosphamide?

• agents that treat or prevent blood clots (such as warfarin)

• bupropion

• carbamazepine

• cocaine

• digoxin

• etanercept

• herbal products that contain St. John's wort

• orphenadrine

• other medications for chemotherapy or immunosuppression

• phenobarbital

• phenytoin

• rifabutin

• rifampin

• rifapentine

• select medications for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)

• tamoxifen

• vaccines

Talk to your prescriber or health care professional before taking any of these medicines:

• acetaminophen

• aspirin

• ibuprofen

• naproxen

• ketoprofen

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking cyclophosphamide?

Visit your prescriber or health care professional for checks on your progress. You will need to have regular blood checks. The side effects of cyclophosphamide can continue after you finish your treatment; report side effects promptly.

Cyclophosphamide may make you feel generally unwell. This is not uncommon because cyclophosphamide affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Cyclophosphamide may decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Cyclophosphamide may increase your risk to bruise or bleed. Call your prescriber or health care professional if you notice any unusual bleeding. Be careful not to cut, bruise or injure yourself because you may get an infection and bleed more than usual.

Drink several glasses of water a day while you are receiving. Empty your bladder regularly, especially at night. This will help to reduce possible kidney and bladder problems.

Avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen (Aleve®), or ketoprofen (Orudis® KT) products as these may hide a fever, unless instructed to by your prescriber or health care professional.

Be careful brushing and flossing your teeth or using a toothpick while receiving cyclophosphamide because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are taking or have taken cyclophosphamide

Cyclophosphamide can decrease fertility in both men and women. Discuss options with your health care provider. In addition, cyclophosphamide can harm your unborn child if taken during pregnancy. Women who are able to have children should avoid becoming pregnant while taking cyclophosphamide.

If you are going to have surgery, tell your prescriber or health care professional that you are taking or have taken cyclophosphamide.

What side effects may I notice from receiving cyclophosphamide?

The side effects you may experience with cyclophosphamide therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:

• blood in the urine

• low blood counts - cyclophosphamide may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, nosebleeds

• signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness

• confusion, agitation

• difficulty breathing, wheezing

• joint or muscle pains

• mouth or throat sores

• pain or difficulty passing urine

• swollen feet or legs

• weight gain

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• decreased appetite

• hair loss

• missed menstrual periods

• muscle pains

• nausea, vomiting

• skin rash

• stomach pain

Where can I keep my medicine?

This does not apply. You will only receive cyclophosphamide injection in a hospital or clinic setting.

Cyclophosphamide tablets

What are cyclophosphamide tablets?

CYCLOPHOSPHAMIDE (Cytoxan®) is a type of chemotherapy for treating various types of cancer. It also treats a number of immune-related diseases or conditions, such as systemic lupus erythematosus (SLE), lupus nephritis, rheumatoid arthritis or organ transplant rejection. Cyclophosphamide interferes with the growth of rapidly growing cancer cells and can suppress the immune system. Generic cyclophosphamide tablets are available.

What should my health care professional know before I take cyclophosphamide?

They need to know if you have any of these conditions:

• bleeding or blood disorders

• cystitis

• dehydration

• dental disease

• infection (especially virus infection such as chickenpox or cold sores)

• liver disease

• previous treatment with daunorubicin, doxorubicin, epirubicin, idarubicin, or mitoxantrone

• previous radiation therapy

• receiving dialysis

• an unusual or allergic reaction to cyclophosphamide, other chemotherapy agents, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I take this medicine?

Take cyclophosphamide tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. Do not break or crush the tablets. Take your doses at regular intervals. Do not take your medicine more often than directed. Finish the full course prescribed by your doctor or health care professional, even if the tablets make you feel unwell. Do not stop taking except on your prescriber's advice.

What if I miss a dose?

If you miss a dose do not take that dose, or double the next dose. Continue with your regular schedule. If you vomit after taking a dose, call your prescriber or health care professional for advice.

What drug(s) may interact with cyclophosphamide?

• agents that treat or prevent blood clots (such as warfarin)

• bupropion

• carbamazepine

• cocaine

• digoxin

• etanercept

• herbal products that contain St. John's wort

• orphenadrine

• other medications for chemotherapy or immunosuppression

• phenobarbital

• phenytoin

• rifabutin

• rifampin

• rifapentine

• select medications for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)

• tamoxifen

• vaccines

Talk to your prescriber or health care professional before taking any of these medicines:

• acetaminophen

• aspirin

• ibuprofen

• naproxen

• ketoprofen

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking cyclophosphamide?

Visit your prescriber or health care professional for checks on your progress. You will need to have regular blood checks. The side effects of cyclophosphamide can continue after you finish your treatment; report side effects promptly.

Cyclophosphamide may make you feel generally unwell. This is not uncommon because cyclophosphamide affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Cyclophosphamide may decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Cyclophosphamide may increase your risk to bruise or bleed. Call your prescriber or health care professional if you notice any unusual bleeding. Be careful not to cut, bruise or injure yourself because you may get an infection and bleed more than usual.

Do not take your doses of cyclophosphamide in the evening or right before you go to bed. Drink several glasses of water a day while taking cyclophosphamide. Empty your bladder regularly, especially at night. This will help to reduce possible kidney and bladder problems.

Avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen (Aleve®), or ketoprofen (Orudis® KT) products as these may hide a fever, unless instructed to by your prescriber or health care professional.

Be careful brushing and flossing your teeth or using a toothpick while receiving cyclophosphamide because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are taking or have taken cyclophosphamide

Cyclophosphamide can fertility in both men and women. Discuss options with your health care provider. In addition, cyclophosphamide can harm your unborn child if taken during pregnancy. Women who are able to have children should avoid becoming pregnant while taking cyclophosphamide.

If you are going to have surgery, tell your prescriber or health care professional that you are taking or have taken cyclophosphamide.

What side effects may I notice from taking cyclophosphamide?

The side effects you may experience with cyclophosphamide therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:

• blood in the urine

• low blood counts - cyclophosphamide may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, nosebleeds

• signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness

• confusion, agitation

• difficulty breathing, wheezing

• joint or muscle pains

• mouth or throat sores

• pain or difficulty passing urine

• swollen feet or legs

• weight gain

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• decreased appetite

• hair loss

• missed menstrual periods

• muscle pains

• nausea, vomiting

• skin rash

• stomach pain

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature below 25 degrees C (77 degrees F). Brief exposure up to 30 degrees C (86 degrees F) will be tolerated. Throw away any unused medicine after the expiration date.