What Is Cyclophosphamide?
Cyclophosphamide (
Cytoxan®) is a prescription chemotherapy medication that is used to treat various types of cancer. It is also approved to treat certain kidney problems in children. Specifically, it is approved to treat the following cancers:
Cyclophosphamide is approved to treat "minimal change" nephrotic syndrome in children (a kidney disorder) when other treatments have failed.
As with any medicine, side effects are possible with cyclophosphamide. However, not everyone who takes the drug will have problems. In fact, some people tolerate it quite well. If side effects do occur, in some cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Side effects of cyclophosphamide include, but are not limited to:
(Click Cyclophosphamide Side Effects to learn more about the possible side effects of this drug, including potentially serious side effects that you should report immediately to your healthcare provider.)
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking cyclophosphamide if you have:
- A history of low levels of white blood cells in the blood (known medically as neutropenia) or low platelets (thrombocytopenia)
- Undergone previous radiation treatment
- Undergone previous chemotherapy treatment
- A tumor that has spread to bone marrow
- Any infection
- Kidney disease, including kidney failure (renal failure)
- Liver disease, including liver failure or cirrhosis
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
You should also make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
How Does Cyclophosphamide Work?
Cyclophosphamide is part of a group of medications called alkylating agents. Cyclophosphamide itself is not active against cancer, but it is metabolized by the liver into its active form. The active form causes "cross-linking" of DNA cells. When DNA is cross-linked, it can no longer function properly. Since DNA is essential for cells to grow and multiply, alkylating medications prevent cell growth and multiplication and may cause cell death.
While cyclophosphamide can kill both healthy and cancerous cells, it has a greater effect on cells that are multiplying rapidly. Generally, cancer cells multiply more rapidly than healthy cells and are, therefore, more affected by cyclophosphamide.
Cyclophosphamide also suppresses the immune system, which is probably how it works to treat nephrotic syndrome.
When and How to Take Cyclophosphamide
Some general considerations for when and how to take this medication include:
- Cyclophosphamide comes in two forms: a tablet that is taken by mouth and an injection given through an IV. Some people take cyclophosphamide every day, while others take it intermittently.
- Try to take cyclophosphamide tablets on an empty stomach if possible. If the drug upsets your stomach too much, try taking it with food.
- In general, it is usually best to take cyclophosphamide tablets in the morning or afternoon. Taking them at night may increase your risk of bladder damage. Your healthcare provider may also recommend drinking large amounts of water to flush your bladder out and protect it from damage.
- For the injectable form, most people receive their cyclophosphamide injection at a healthcare provider's office, a hospital, or an "infusion center."
- For the medication to work properly, it must be taken as prescribed. It will not work as well if you stop taking it before your healthcare provider recommends.
The dosage that your healthcare provider recommends will vary depending on a number of factors, including:
- Whether you are taking cyclophosphamide tablets or the injection form of the medicine
- The type of cancer being treated
- Your height and weight
- Other medications you may be taking
- Other medical conditions you may have.
As always, do not adjust your cyclophosphamide dose unless your healthcare provider specifically instructs you to do so.
Drug Interactions With Cyclophosphamide
What If I Take an Overdose?
People who take too much cyclophosphamide may have overdose symptoms that could include:
- Bone marrow depression (a decreased ability of the bone marrow to make blood cells)
- Infections
- Heart problems.
If you happen to overdose, seek medical attention immediately.
What Should I Do If I Miss a Dose?
If you do not take your cyclophosphamide as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Is There a Generic Version of Cyclophosphamide?
Currently, both brand-name and generic cyclophosphamide versions are licensed for sale
(see Generic Cytoxan).
Cyclophosphamide is made by Bristol-Myers Squibb.
Strengths of Cyclophosphamide
Cyclophosphamide tablets are available in the following strengths:
- Cyclophosphamide 25 mg
- Cyclophosphamide 50 mg.
Injectable cyclophosphamide is available in various vial sizes.
