Cyclophosphamide Capsules or Tablets

What is this medication?

CYCLOPHOSPHAMIDE (sye kloe FOSS fa mide) treats some types of cancer. It works by slowing down the growth of cancer cells. It may also be used to treat nephrotic syndrome, a type of kidney disease. It works by slowing down an overactive immune system.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Cytoxan

What should I tell my care team before I take this medication?

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

• Heart disease
• Irregular heartbeat or rhythm
• Infection
• Kidney problems
• Liver disease
• Low blood cell levels (white cells, platelets, or red blood cells)
• Lung disease
• Previous radiation
• Trouble when passing urine
• An unusual or allergic reaction to cyclophosphamide, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with water. Take it as directed on the prescription label at the same time every morning. Do not cut, crush, or chew this medication. Swallow the tablets whole. Keep taking it unless your care team tells you to stop. There may be unused or extra doses in the bottle after you finish the dosing cycle. Talk to your care team if you have questions about your dose.

Handling this medication may be harmful. Wear gloves while touching the medication or bottle. Talk to your care team about how to handle this medication. Special instructions may apply.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

• Amiodarone
• Amphotericin B
• Azathioprine
• Certain antivirals for HIV or hepatitis
• Certain medicines for blood pressure, such as enalapril, lisinopril, quinapril
• Cyclosporine
• Diuretics
• Etanercept
• Indomethacin
• Medications that relax muscles
• Metronidazole
• Natalizumab
• Tamoxifen
• Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

This medication may make you feel generally unwell. This is not uncommon as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your care team tells you to stop.

You may need blood work while you are taking this medication.

This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Avoid taking medications that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your care team. These medications may hide a fever.

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

Drink water or other fluids as directed. Urinate often, even at night.

Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects if taken during pregnancy or for 1 year after stopping therapy. A negative pregnancy test is required before starting this medication. A reliable form of contraception is recommended while taking this medication and for 1 year after stopping therapy. Talk to your care team about reliable contraception.

Use a condom during sex and for 4 months after stopping therapy. Tell your care team right away if you think your partner might be pregnant. This medication can cause serious birth defects.

Do not breast-feed while taking this medication or for 1 week after stopping it.

This medication may cause infertility. Talk to your care team if you are concerned about your fertility.

Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Dry cough, shortness of breath or trouble breathing
• Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
• Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
• Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
• Red or dark brown urine
• Unusual bruising or bleeding

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

• Hair loss
• Irregular menstrual cycles or spotting
• Loss of appetite
• Nausea
• Pain, redness, or swelling with sores inside the mouth or throat
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take back program. Check with your pharmacy or local law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.