Cyclophosphamide (Non-Cancer)

Side effects may occur when taking Cyclophosphamide, but the majority of these effects tend to resolve spontaneously. Common side effects include:

• Nausea and vomiting (can be controlled with anti-nausea medicines)
• Hair loss (reversible once the medicine is stopped)
• Loss of appetite or weight
• Feeling tired or weakness
• Darkened skin colour
• Change in colour or growth of finger or toe nails

Consult your doctor or pharmacist about any symptoms that becomes bothersome.             

• ​STOP taking Cyclophosphamide and let your doctor know if you develop an allergic reaction. Rash due to allergic reaction to Cyclophosphamide is rare. Possible symptoms of allergic reaction are:
• rash, hives, or itching
• red, swollen, blistered or peeling skin with or without fever
• wheezing or tightness in the chest or throat
• trouble breathing or talking
• unusual hoarseness
• swelling of the mouth, face, lips, tongue or throat
• Cyclophosphamide may increase risk of developing certain kinds of infections due to reduced white blood cells (a key component of the body's immune system that helps to fight infections). Tell your doctor immediately if you experience any symptoms of infection such as temperature exceeding 38°C, chills, cough, painful or bloody urination, feeling very tired or weak.
• Drink plenty of water to prevent irritation of the bladder or cystitis.
• Although rare, Cyclophosphamide may increase the risk of developing certain kinds of cancers, such as bladder cancer. The risk is higher with long term use and higher cumulative doses of Cyclophosphamide. Your doctor will perform periodic screening to manage the risk.
• While having treatment with Cyclophosphamide, you must see your doctor as scheduled to monitor response to treatment and minimize any possible side effect.
• Cyclophosphamide may cause infertility in both men and women. Although women taking Cyclophosphamide can stop having menses or may experience early menopause, they can still become pregnant. Both men and women of childbearing age must use a reliable method of contraception to avoid the risk of an unplanned pregnancy as Cyclophosphamide can cause serious defects to an unborn child. You should not plan to have children while taking Cyclophosphamide and for a while after treatment. If you are planning to have a child, discuss it with your doctor before you begin the treatment
• Cyclophosphamide passes into human breast milk and may cause serious unwanted effects to the child. You should not breastfeed if you are taking Cyclophosphamide.
• Cyclophosphamide may interact with other medicine or supplement that you are taking. Inform the doctor, pharmacist or specialty nurse (such as dermatology, gastroenterology or rheumatology) before starting on a new medicine or supplement.
• Immunization status should be current before starting the medicine. Do not receive any live vaccine while you are on Cyclophosphamide. Always consult your doctor before going for immunisation.

Cyclophosphamide should be taken as prescribed by the doctor. It is usually given orally after food once in the morning, taken at the same time daily.

A typical adult dose ranges from 50 milligrams to 150 milligrams daily by mouth. For children, the dose is usually calculated based on body weight or body surface area. The dose varies for each person depending upon many factors such as how active your disease is and how you respond to or tolerate the medicine. Your doctor may reduce the dose if you have kidney or liver problem.

Drink plenty of water (preferably at least 8 glasses of water per day, unless otherwise advised by your doctor) while you are taking Cyclophosphamide to prevent this medicine from irritating your kidneys and bladder. Also, do not take the medicine at bedtime when the urine concentrate overnight to minimize the risk of irritation.

Cyclophosphamide tablets should be swallowed whole, with a glass of water. The tablets should not be crushed or chewed.

However, for people who are unable to swallow tablets whole, your pharmacist may advise you to soak the tablets in water for a few minutes before grinding them to minimise the inhalation of medicine powder. Talk to your pharmacist for further details if you have difficulty swallowing.

You may start to see improvement within a few weeks, but it may take several months to experience its full benefit.

If you forget to take the tablet, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose. Resume the next dose at the regular timing. Do not take a double dose to make up for a forgotten tablet.

If you forget your appointment and miss your injection, please make another appointment as soon as possible to arrange for next injection. Inform your doctor that you have missed your injection.

Cyclophosphamide should not be disposed of via wastewater or household waste. Consult your pharmacist or specialty nurse on disposal measures for unused medicines.

You may bring the unused medicines to the pharmacy or clinic for proper disposal.

If you have further questions about Cyclophosphamide, please call ______________________ (office number) to discuss with your doctor / pharmacist / specialty nurse (please circle as appropriate).