About cyclophosphamide

Cyclophosphamide is used to treat a variety of different cancers. It is also sometimes used to treat severe symptoms of some connective tissue diseases (such as rheumatoid arthritis) which are not cancers.

In cancer, certain cells in the body grow and multiply too fast. Cytotoxic medicines like cyclophosphamide work by preventing cells from increasing in number, which stops the increase in the number of cancer cells. Cyclophosphamide is often given alongside other medicines to help treat your condition.

Cyclophosphamide is also an immunosuppressant, which means that it suppresses your body's immune or defence system. Because of this, it is sometimes used to treat severe symptoms of conditions such as rheumatoid arthritis.

Before taking cyclophosphamide

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking cyclophosphamide it is important that your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have an infection or feel unwell.
• If you have kidney or liver problems.
• If you have diabetes mellitus (sugar diabetes).
• If you have porphyria (this is a rare inherited blood disorder).
• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have ever had an allergic reaction to any medicine.

How to take cyclophosphamide

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about cyclophosphamide, and a full list of possible side-effects from taking it.
• Cyclophosphamide will be given to you by a specialist doctor who is experienced in treating your condition. Your doctor will calculate what dose is right for you and will tell you how to take the tablets - it is important that you take cyclophosphamide exactly as you have been told. Your dose will also be on the label of your pack. If you are unsure about what to do, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
• Swallow cyclophosphamide tablets whole, with a glassful of water. Do not break, crush or chew the tablets.
• Cyclophosphamide tablets are best taken early in the day about an hour before a meal. However, if your stomach feels queasy after taking the tablets, you may be better taking your doses after eating some food, as this can help prevent feelings of sickness.
• While you are on cyclophosphamide, it is important that you drink plenty. Drinking lots of water and other fluids will help prevent a serious type of cystitis sometimes caused by this medicine.
• If you are sick shortly after taking a dose, or if you forget a dose, contact your doctor or clinic for advice of what to do. You will be told whether to take the dose again, or wait until the next dose is due.

Getting the most from your treatment

• You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular blood tests during your treatment with cyclophosphamide.
• If you find you are passing urine less than you would expect, or if your ankles begin to swell, let your doctor know about this as soon as possible. You may need to take another medicine to help with this.
• If you have diabetes, this medicine can affect the levels of sugar in your blood. Check regularly to ensure your blood sugar level is unaffected, and report any major changes to your doctor.
• It is important that you do not get pregnant or father a child while you are taking cyclophosphamide. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
• If you intend to have children in the future, you should ask your doctor for advice about family planning before you begin taking cyclophosphamide. This is particularly important if you are a man, as there is a risk of reduced fertility after cyclophosphamide treatment.
• While you are taking cyclophosphamide and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Cyclophosphamide lowers your body's resistance and there is a chance that you may get an infection from some vaccines.

Can cyclophosphamide cause problems?

Cyclophosphamide can lower the number of white cells in your blood, increasing the chance of you getting an infection. You should take certain precautions to reduce the risk of infection - if possible, avoid people with infections and let your doctor know if you think you are getting a sore throat or if you have a high temperature.

Your doctor will have discussed with you the possibility of unwanted side-effects of treatment with cyclophosphamide. Let your doctor know if you experience any of the following:

Important: if you experience any of the following, speak with your doctor immediately or go to your local accident and emergency department straightaway:

• Any sign of fever or infection, or any blood in your urine.
• Any swelling of your mouth or face, any sudden wheeziness or difficulties with your breathing. These may be signs of an allergic reaction.
• A skin rash, with spots or blisters. This may be a sign of a rare but serious skin condition.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store cyclophosphamide

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines