Cyclophosphamide (also called "cyclo", Cytoxan®, or CTX) is an anticancer medicine. It is given by mouth as a 25-mg tablet, a 50-mg tablet, or as a clear liquid. It also can be given as a clear liquid into a vein (IV).
Cyclophosphamide can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”
Possible side effects
- Nausea and vomiting (especially when given by IV)
- Metal taste during the IV infusion
- Loss of appetite
Later (more than a day after treatment starts)
- Burning when urinating
- Blood in the urine (also called hemorrhagic cystitis). A medicine called mesna may be given while you are receiving cyclophosphamide to help prevent this problem.
- Decrease in blood counts after 7-14 days
- Hair loss
- Mouth sores
- Skin or fingernails darken
These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.
In case of a severe side effect or reaction, call the doctor, nurse or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.
- Make sure you drink a lot of liquid starting one (1) day before cyclophosphamide therapy starts and continue for 2 days after cyclophosphamide therapy ends. The doctor or nurse will tell you how much you should drink. If you are given IV cyclophosphamide therapy, you will receive IV fluids. The IV fluids may be given by a portable pump while you are away from the hospital.
- Take cyclophosphamide tablets on an empty stomach with a full glass of water.
- The oral liquid cyclophosphamide can be added to juice or grape syrup right before it is taken.
- Tell the doctor or nurse right away if you are not urinating as often as you usually do. You need to urinate more often than usual when receiving cyclophosphamide therapy. This will help prevent blood in the urine.
- If the liquid form is used, each dose will be measured in advance by the pharmacy and put in an oral syringe. Each oral syringe holds one (1) dose.
- Store the oral liquid cyclophosphamide in the refrigerator.
- If you vomit within 20 minutes of taking cyclophosphamide by mouth, take another dose. If more than 20 minutes has passed since you took cyclophosphamide by mouth and you vomit, do not take another dose. Please call the St. Jude doctor or nurse to report any doses wasted or vomited.
- If you are taking itraconazole, fluconazole, or ketoconazole, tell the doctor before you receive cyclophosphamide. Taking one of these medicines while you are receiving cyclophosphamide may result in more side effects from the cyclophosphamide.
All chemotherapy drugs taken by mouth can pose a health hazard to caregivers and patients. You should be careful when handling this medicine and try to keep the drug from touching the skin. Taking precautions will ensure that both the patient and the caregiver are protected as well as possible.
- Prepare a clean area where the drug can be handled safely (away from areas where food is prepared, out of the reach of children, and out from under any air vents or fans).
- We suggest you or the caregiver wear gloves while handling this medicine. Wash your hands right away if your skin comes in contact with the medicine.
- Carefully wash tablet cutters with warm soapy water after each use and allow to dry. Completely clean up any spills in the area where the medicine is prepared.
- For the liquid, use each oral syringe only one (1) time and then discard it in the trash. Do not try to wash and reuse the syringes.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).
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