$Unique_ID{BRK03113} $Pretitle{} $Title{cyclophosphamide} $Subject{Cytoxan Bristol Myers USP Antineoplastic anticancer drug cyclophosphamide alkylating agents nitrogen mustards cancers cancer cells immunosuppressant severe rheumatoid arthritis} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. cyclophosphamide ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) Cytoxan (Bristol Myers USP) TYPE OF DRUG Antineoplastic (anticancer drug) INGREDIENT cyclophosphamide DOSAGE FORM Tablets (25 mg and 50 mg) STORAGE Cyclophosphamide should be stored at room temperature in a tightly closed container. USES Cyclophosphamide belongs to a group of drugs known as alkylating agents or nitrogen mustards. It is used to treat a variety of cancers. Cyclophosphamide works by binding to the rapidly growing cancer cells, preventing their multiplication and growth. Cyclophosphamide has also been used as an immunosuppressant in order to treat severe rheumatoid arthritis. TREATMENT In order to obtain maximum benefit, you should take cyclophosphamide on an empty stomach. However, if stomach upset occurs, you can take it with food or milk (unless your doctor directs you to do otherwise). The timing of the doses of this anticancer medication is important. Be sure you completely understand your doctor's instructions on how and when this medication should be taken. Try not to miss any doses. If you miss a dose of this medication, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Diarrhea, loss of appetite, nausea, or vomiting. These side effects may disappear as your body adjusts to the medication. However, it is important to continue taking this medication despite the nausea and vomiting that may occur. Cyclophosphamide also causes hair loss, which is reversible when the medication is stopped. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about blood in the urine, chills, cough, darkening of the skin or fingernails, difficult or painful urination, fever, menstrual irregularities, mouth sores, sore throat, unusual bleeding or bruising, or yellowing of the eyes or skin. INTERACTIONS This drug interacts with several other types of drugs: 1. It can decrease the absorption of digoxin from the gastrointestinal tract. 2. Phenobarbital can increase the side effects of cyclophosphamide. 3. Concurrent use of allopurinol, chloramphenicol, chlorpromazine, or thiazide diuretics (water pills) with cyclophosphamide can lead to bone marrow suppression. 4. It can increase the effect of warfarin (blood thinner). Before starting to take this medication, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to cyclophosphamide. * Before starting to take this medication, be sure to tell your doctor if you have ever had blood disorders, chronic or recurrent infections, gout, kidney disease, or liver disease. * Before having surgery or any other medical or dental treatment, tell your doctor or dentist you are taking this drug. * Cyclophosphamide tablets contain the color additive FD&C Yellow No. 5 (tartrazine), which can cause allergic-type reactions (fainting, shortness of breath, rash) in certain susceptible individuals. * You should not receive any immunizations or vaccinations while taking this medication. Cyclophosphamide decreases the effectiveness of the vaccine and may result in an infection if a live-virus vaccine is administered. * It is important to drink plenty of fluids (three quarts each day) while taking this medication. If the drug is allowed to concentrate in the bladder, it can cause bloody urine and can damage the kidneys or bladder. * This medication can lower your platelet count, which can decrease your body's ability to form blood clots. You should, therefore, be especially careful while brushing your teeth, flossing, or using toothpicks, razors, or fingernail scissors. Try to avoid falls and other injuries. * This drug can decrease fertility in both men and women. * Be sure to tell your doctor if you are pregnant. Birth defects have been reported in both animals and humans whose mothers received cyclophosphamide during pregnancy. The risks should be discussed with your doctor. Also, tell your doctor if you are breast-feeding an infant. Since the drug passes into breast milk, a woman should stop breast-feeding before starting cyclophosphamide therapy. Women of childbearing potential who are not already pregnant when treatment with cyclophosphamide is begun need to use some sort of birth control to prevent pregnancy from occurring. However, oral contraceptives (birth control pills) may not be recommended by your doctor since they may interfere with this medication. Consult with your physician about alternative methods of birth control. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.