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Cyclophosphamide (Non-Cancer)

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Cyclophosphamide (Non-Cancer) - What is it for

  • Cyclophosphamide belongs to a class of medications called immunosuppressant. It reduces the body's immune response by stopping or slowing the grow of cells. It helps to reduce inflammation, improve symptoms, reduce flare, stop disease from progressing and prevent death from certain severe autoimmune condition.

Disclaimer: Cyclophosphamide is also used in non-autoimmune diseases. It is not within the scope of this material to cover information for such conditions.    

Cyclophosphamide (Non-Cancer) - Side Effects, Precautions, and Contraindications

What side effects can Cyclophosphamide (Non-Cancer) cause?

  • Nausea, vomiting
    • If you are on infusion: Medication may be given before the infusion to prevent these side effects.
    • If you are on oral medication: Take medication after food to minimise the side effects. Sucking hard, sugar-free candy may reduce nausea and vomiting.  
  • Infusion reactions: symptoms include flushing, headache
  • Bladder pain
    • Drink plenty of water (at least 2 litres per day, unless instructed otherwise by the doctor)
  • Infection: symptoms include colds, sinusitis, urinary tract infections and skin infections
    • If you develop a fever, sore throat or feel generally unwell, see a doctor immediately. The doctor whom you consult should be told that you are on cyclophosphamide.
  • Loss of hair
    • This is harmless and may not be obvious. It often resolves spontaneously.
  • Low blood cell count (platelet, red and/or white blood cell)
  • Diarrhea
  • Decreased appetite
  • Dizziness
  • Skin rash
  • Changes in the color of your skin and nails
  • No/ irregular menses for child-bearing ager women
It is important to monitor the effects of your treatment. For your safety, you need to do regular blood tests for monitoring.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

Some rare but serious side effects include:

  • Combined low blood cell count (symptoms include infection, feeling very tired or weak, bleeding)
  • Liver injury (symptoms include yellowing of eye whites or skin, dark or tea-coloured urine or constant abdominal pain)
  • Hemorrhagic cystitis, a condition where the breakdown substance of cyclophosphamide irritate the bladder (symptoms include blood in the urine, bladder pain)

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Cyclophosphamide may also cause:

  • Severe infections such as fungal infection, activation of tuberculosis and hepatitis B
  • Increase risk
  • Infertility in both men and women using the medication
  • Birth defect and miscarriage in woman using the medication
  • Increase the risk of certain cancers such as bladder cancer. You may be more at risk if you are also taking certain immunosuppressant. Your doctor will monitor you on any signs of cancer.


Before taking Cyclophosphamide (Non-Cancer) , what precautions must I follow?

  • Inform your healthcare professional if:
    • You are allergic to this medication or any of the other ingredients of this medication.
    • You are taking any other medications, including over-the-counter medicines, supplements, traditional medications and herbal remedies. 
  • Avoid overcrowded places and stay away from people who are sick to prevent getting an infection.
  • Reactivation of infection such as tuberculosis (TB) and hepatitis B may happen when you are on medication, hence, your doctor will check for such infection before starting cyclophosphamide.
  • Both men and women of childbearing age should use a reliable method of contraception to avoid an unplanned pregnancy during an a few months after stopping or completing cyclophosphamide. If you are planning to have a child, discuss it with your doctor before you begin the treatment.

What food or medicine must I avoid when I take Cyclophosphamide (Non-Cancer) ?

  • Avoid eating raw, undercooked or half-cooked food.
  • Pneumococcal and influenza (flu) vaccinations are safe and may be given if required. Avoid live vaccines such as MMR (measles, mumps and rubella), OPV (oral polio vaccine), yellow fever or BCG (tuberculosis). Discuss with your doctor before receiving any vaccines. Also, direct contact with persons who have taken oral polio vaccine or those with infections should be avoided.

Cyclophosphamide (Non-Cancer) - Dosage and How to Use

How should Cyclophosphamide (Non-Cancer) be used?

  • It may be given as
    • Intravenous infusion (inject into the blood vessel). This has to be done in the hospital for typically a few hours.
    • By mouth
      • Take the tablets with or after food to reduce stomach upset. It can cause nausea and vomiting at the start of therapy, but if the dose is increased slowly, your body will usually get used to it.
      • Do not take the tablets at bedtime when the urine concentrates overnight to minimize the risk of irritation to the bladder.
      • The tablets should be swallowed whole, with a glass of water. The tablets should not be crushed or chewed.
  • Dosage and duration of cyclophosphamide will depend on your body weight, disease activity and response to the medication. 
  • This medication does not work immediately. It may take between 6 to 12 weeks before you notice any benefit. Thus, it is important that you take your medication or come back for infusion regularly, otherwise you may not benefit at all.
  • Do not stop taking your medication without checking with your healthcare professional.
  • Other medications such as corticosteroids (e.g. prednisolone) or disease modifying anti-rheumatic drugs (DMARDs) may be taken with cyclophosphamide.

What should I do if I miss a dose?

If you miss a dose, take the 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 dose. Do not take double doses to make up for the missed dose.

If you miss your infusion appointment, book another appointment as soon as possible. Inform your doctor about the missed/ late dose.

What should I do if I overdose?

Cyclophosphamide (Non-Cancer) - Handling

How should I handle Cyclophosphamide (Non-Cancer) safely?

Cyclophosphamide (Non-Cancer) - Storage

How should I store Cyclophosphamide (Non-Cancer) ?

;#Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#Store at room temperature;#

How should I dispose of Cyclophosphamide (Non-Cancer) safely?

Cyclophosphamide should not be disposed of via wastewater or household waste. Consult your pharmacist or specialty nurse on disposal measures for unused medicines.

You may bring the unused medicines to the pharmacy or clinic for proper disposal.

Cyclophosphamide (Non-Cancer) - Additional Information

  • Updated on 12/31/2022 12:00:00 AM
  • Article contributed by PSS National Medication Information Workgroup PSS National Medication Information Workgroup
The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

This leaflet answers some common questions about Cyclophosphamide. It does not contain all the available information. It also does not take the place of talking to your doctor or pharmacist.

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