Cytoxan

DRUG DESCRIPTION

CYTOXAN® (cyclophosphamide for injection, USP) is a sterile white powder containing cyclophosphamide monohydrate. Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen mustards. Cyclophosphamide is a white crystalline powder with the molecular formula C7H15Cl2N2O2P•H2O and a molecular weight of 279.1. The chemical name for cyclophosphamide is 2-[bis(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate. Cyclophosphamide is soluble in water, saline, or ethanol and has the following structural formula:

CYTOXAN® (cyclophosphamide) structural formula illustration

What are the possible side effects of cyclophosphamide (Cytoxan, Cytoxan Lyophilized, Neosar)?

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);
  • blood in the urine;
  • black or tarry stools;
  • painful or difficult urination;
  • signs of infection such as fever; chills, or sore throat;
  • jaundice (yellowing of the skin or...

Read All Potential Side Effects and See Pictures of Cytoxan »

What are the precautions when taking cyclophosphamide (Cytoxan)?

Before taking cyclophosphamide, tell your doctor or pharmacist if you are allergic to it; or to other chemotherapy drugs (e.g., busulfan, chlorambucil); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: decreased bone marrow function (e.g., anemia, leukopenia, thrombocytopenia).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, surgery to remove your adrenal glands.

Do not have immunizations/vaccinations without...

Read All Potential Precautions of Cytoxan »


Cytoxan Consumer (continued)

SIDE EFFECTS: Nausea, vomiting, loss of appetite, stomach ache, diarrhea, or darkening of the skin/nails may occur. Nausea and vomiting can be severe. In some cases, drug therapy may be necessary to prevent or relieve nausea and vomiting. Changes in diet such as eating several small meals or limiting activity may help lessen some of these effects. If these effects persist or worsen, notify your doctor or pharmacist promptly.

Temporary hair loss may occur. Hair growth should return after treatment has ended or may even return during treatment. However, new hair may have a different color or texture.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: pink/bloody urine, unusual decrease in the amount of urine, mouth sores, unusual tiredness or weakness, joint pain, easy bruising/bleeding, stopping of menstrual periods, existing wounds that are slow healing.

Tell your doctor immediately if any of these rare but very serious side effects occur: black/bloody stools, severe stomach/abdominal pain, yellowing eyes or skin, dark urine, mental/mood changes, muscle weakness/spasm, swelling of the ankles/feet, sudden or unusual weight gain.

This medication may rarely cause very serious effects on the heart, especially when used in high doses, or in combination with radiation treatment or certain other chemotherapy drugs (e.g., doxorubicin). Seek immediate medical attention if you develop: chest pain, jaw/left arm pain, trouble breathing, irregular heartbeat.

This medication can lower the body's ability to fight an infection. Notify your doctor promptly if you develop any signs of an infection such as fever, chills or persistent sore throat.

Cyclophosphamide may lessen the chance of having children in both men and women. Sterility is usually temporary with this medication, but can be permanent in some cases. Consult your doctor for more details.

Although cyclophosphamide is used to treat cancer, in some patients it may increase the risk of developing another form of cancer, sometimes months to years after treatment. Consult your doctor for more details. It is important to be closely monitored by your doctor during treatment. You should also see your doctor regularly after treatment is finished. Tell your doctor immediately if you develop: unusual growths or lumps, swollen glands, unexplained or sudden weight loss, night sweats, pain in the pelvis, painful or frequent urination.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking cyclophosphamide, tell your doctor or pharmacist if you are allergic to it; or to other chemotherapy drugs (e.g., busulfan, chlorambucil); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: decreased bone marrow function (e.g., anemia, leukopenia, thrombocytopenia).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, surgery to remove your adrenal glands.

Do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received oral polio vaccine.

Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised or injured.

Wash your hands well to prevent the spread of infections.

Before having surgery, tell your doctor or dentist that you are using this medication.

Caution is advised when using this drug in the elderly because they may be more sensitive to its effects.

Caution is advised when using this drug in children because they may be more sensitive to its effects, especially possible infertility later in life.

This drug is not recommended for use during pregnancy. It may cause harm to an unborn baby. Women of childbearing age and men should use reliable form(s) of birth control during treatment with this drug and for some period afterwards. Consult your doctor for more details.

This drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.


Cytoxan Patient Information Including Side Effects

Brand Names: Cytoxan, Cytoxan Lyophilized, Neosar

Generic Name: cyclophosphamide (oral/injection) (Pronunciation: sye kloe FOSS fah mide)

  • What is cyclophosphamide (Cytoxan)?
  • What are the possible side effects of cyclophosphamide (Cytoxan)?
  • What is the most important information I should know about cyclophosphamide (Cytoxan)?
  • What should I discuss with my healthcare provider before taking cyclophosphamide (Cytoxan)?
  • How should I take cyclophosphamide (Cytoxan)?
  • What happens if I miss a dose (Cytoxan)?
  • What happens if I overdose (Cytoxan)?
  • What should I avoid while taking cyclophosphamide (Cytoxan)?
  • What other drugs will affect cyclophosphamide (Cytoxan)?
  • Where can I get more information?

What is cyclophosphamide (Cytoxan)?

Cyclophosphamide is a cancer (chemotherapeutic) medication. Cyclophosphamide interferes with the growth of cancer cells and slows their growth and spread in the body.

Cyclophosphamide is used to treat several types of cancer. Cyclophosphamide is also used to treat certain cases of nephrotic syndrome (kidney disease) in children.

Cyclophosphamide may also be used for purposes other than those listed in this medication guide.

What are the possible side effects of cyclophosphamide (Cytoxan)?

If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (shortness of breath; closing of your throat; difficulty breathing; swelling of your lips, face, or tongue; or hives);
  • blood in the urine;
  • black or tarry stools;
  • painful or difficult urination;
  • signs of infection such as fever; chills, or sore throat;
  • jaundice (yellowing of the skin or eyes);
  • lower back or side pain;
  • chest pain, difficulty breathing, or swelling;
  • unusual bleeding or bruising; or
  • changes in bone marrow function (detected by blood tests).

Other less serious side effects may be more likely to occur. Talk to your doctor if you experience

  • nausea, vomiting, or decreased appetite;
  • mouth sores;
  • abdominal pain;
  • diarrhea;
  • temporary hair loss;
  • temporary or permanent sterility;
  • rash;
  • changes in skin color; or
  • changes in nails.

In some cases, secondary cancers have been reported to occur during and following treatment with cyclophosphamide. Talk to your doctor about the risks and benefits of this medication.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about cyclophosphamide (Cytoxan)?

Cyclophosphamide should only be administered under the supervision of a qualified healthcare provider experienced in the use of cancer chemotherapeutic agents.

Serious side effects have been reported with the use of cyclophosphamide including: allergic reactions (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); decreased bone marrow function and blood problems (extreme fatigue; easy bruising or bleeding; black, bloody or tarry stools; fever or chills; or signs of infection such as fever; chills, or sore throat); bladder problems; and others. Talk to your doctor about the possible side effects from treatment with cyclophosphamide.

In some cases, secondary cancers have been reported to occur during and following treatment with cyclophosphamide. Talk to your doctor about the risks and benefits of this medication.

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