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Endoxan^®

What cyclophosphamide is and what it is used for?

• Cyclophosphamide is an alkylating agent that exerts its anticancer activity by reacting with DNA and interfering with DNA replication and cell division. This stops the growth and spread of cancer cell in the body.
• Cyclophosphamide is used in combination with other medicines to treat leukemias, lymphomas, breast cancer, ovarian cancer, brain tumors,or as the conditioning regimen prior to stem cell transplantation. This medicine may also be used to treat other cancers, as determined by your doctor.

How cyclophosphamide is given?

• The infusion time is dependent on the treatment plan. This drug may be given over several hours.

What should I know while receiving cyclophophamide?

• An allergic reaction may happen during or shortly after the infusion, causing fever and chills, breathing difficulties, swelling of throat or face, or hives. Tell your nurse right away if you feel unwell during an infusion.
• Do not receive this drug when you are pregnant or breastfeeding.
• Men and women should use effective contraception during treatment and for at least 6 months after the treatment ends.
• Cyclophosphamide may affect fertility. You can talk to your doctor about methods of preserving fertility before treatment starts.
• There are many drugs may affect how cyclophosphamide works.Tell your doctor about all the medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
• You will have regular blood tests to make sure you have enough blood cells and have adequate organ functions to receive cyclophosphamide. The timing and dosing of your treatment may be changed based on the test results or side effects.
• Do not receive any kind of vaccination without doctor's approval.
• The existing health problems may affect the use of cyclophosphamide. You should let your doctor know if you have any other medical problems, especially liver or kidney problems.

Common side effects

• Low white blood cell count

You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.

• Low red blood cell count

You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.

• Low platelet count

You may have a higher risk of bleeding. Let your doctor know if you find red or purple dots on the skin, bleeding from the nose or gums, or any bruising or bleeding that you cannot explain.

• Hair loss

It may begin 2-3 weeks after your first treatment. Hair growth should return after treatment has finished.

• Nausea and vomiting

Medicines may be given before the treatment to prevent it happening. Eating and drinking often in small amounts may reduce the discomfort.

• Loss of appetite

Try to eat in small quantities and have frequent meals. If your appetite does not get any better after a few days, tell your doctor.

• Diarrhea

Ask your doctor about medicines that can relieve diarrhea. Drinking plenty of water and dietary changes may help.

• Taste alteration

Foods may taste differently or you may have a metallic taste in the mouth. Taste may return slowly after the treatment has ended.

• Skin reactions

Symptoms include rash or changes in the color ofskin.Tell your doctor about any skin changes that you have. Your doctor can give you medicines and advices that help you feel better.

• Nail changes

The color or shape of nails may change and the nails may also become brittle or crack. The nails usually grow back slowly once the treatment is over.

Less common side effects

• Mouth sores

Your doctor may give you medicines that help you feel better. Good mouth care will help prevent mouth sores.

• Hemorrhagic cystitis

Cyclophosphamide may irritate your bladder and cause stinging, pain and discomfort when you pass urine. You may also have blood in your urine. Make sure you drink plenty of water so that you will pass more urine to prevent damage to the bladder.

Rare but serious side effects

• Secondary cancer

Cyclophosphamide may cause an increased risk of developing secondary cancer years later. Treatment benefits may outweigh the risk of secondary cancer. Your doctor can talk you about this.

More Information

• Drink at least 6 to 8 glasses of water every day during treatment can help make your recovery a smoother process.
• Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.
• Avoid the use of St. John's Wort products as it may make cyclophosphamide less effective.
• Since grapefruitsmay increase the risk of side effects from cyclophosphamide, it's sensible to avoid eating the grapefruit products during treatment.
• Your skin may more sensitive to sunlight, which can result in severe sunburn or rash. If you must go out in the sun, wear protective clothing and use sunscreen.