Cyclophosphamide: High Dose for SCT(Generic Name)
Other Names: Cytoxan®, Neosar®
About this Drug
Cyclophosphamide is used to treat cancer. It is frequently included in pre-transplant chemotherapy. In addition to its anti-cancer effects, it also helps to suppress your immune system. Cyclophosphamide also can be used before apheresis to increase the number of peripheral stem cells in the peripheral blood. This drug is given intravenously (IV).
Possible Side Effects (More Common)
- Nausea and vomiting. These symptoms may occur within one to six hours after you receive the drug and may last up to 48 to 72 hours.
- Flushing or redness, rash, or itching
- Headache, nasal congestion, or other sinus symptoms
- Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs five to seven days after the drug is given and may increase your risk of infection, fatigue, and bleeding. Transfusions of blood products may be required.
- Effects on the bladder. This drug may cause irritation and bleeding in the bladder. You may have blood in your urine. To help prevent this, you will receive extra fluids to help you pass more urine. You may receive a drug called mesna, which helps to prevent irritation and bleeding. You also may receive a medication to increase your urine output. You may have a catheter placed in your bladder so that your bladder will be continually washed with this drug.
- Soreness of the mouth and throat. You may have red areas, white patches, or sores that may be painful.
- Hair loss. Most patients experience scalp and body hair loss. You may notice hair thinning within five days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
- Decreased appetite
- Blurred vision
- Diarrhea that may last for several days
Possible Side Effects (Less Common)
- Changes in lung tissue may occur with high amounts of this drug. These changes may not be permanent, and your lung tissue may return to normal. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.
- Congestive heart failure. You may be short of breath. Your arms, hands, legs and feet may swell
- Darkening of the skin or fingernails
Sexual Problems and Reproductive Concerns
Sexual problems and reproduction concerns may occur. In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
- Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
- Genetic counseling is available to you to discuss the effect of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
- Speak with your doctor or nurse if you plan to have children in the future. Ask for information on sperm or egg banking.
- Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.
- Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
Treating Side Effects
- You must drink plenty of fluids and urinate at least once every six hours. Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
- Ask your doctor or nurse about medication that is available to help prevent or lessen nausea, vomiting, diarrhea, headache, nasal congestion and/or sinus symptoms.
- Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medication if your rash is bothersome.
- Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of ½ teaspoon salt in 8 ounces of water or 1/2 teaspoon sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
- Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because these can irritate your mouth or throat.
- Speak with your nurse about obtaining a wig before you lose your hair. Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “ Look Good...Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
Food and Drug Interactions
There are no known interactions of cyclophosphamide with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's advice.
When to Call the Doctor
Call your doctor or nurse immediately if you have any of the following symptoms:
- Fever of 100.5 F (38 C) or above
- Unusual bleeding or bruising
- Blurred vision or other changes in vision
- Painful urination; blood in urine
- Pain in your lower back or side
- Cough or difficulty catching your breath
- Swelling of legs, ankles, or feet
- Confusion; agitation
- Yellowing of skin or eyes
- Unusual thirst or frequent urination
- Uncontrolled nausea that prevents you from eating or drinking
- Vomiting more than twice in one day
- Diarrhea of five stools in a day or diarrhea with weakness or lightheadedness
Call your doctor or nurse as soon as possible if you have any of the following symptoms:
- Painful mouth or throat that makes it difficult to eat or drink
- Nausea unrelieved by prescribed medication
- Rash that is not relieved by prescribed medications
- Prolonged, heavy menstruation
- Whenever you tell a doctor or nurse your health history, always tell them that you have received high dose cyclophosphamide.
Revised January 2011