Cyclophosphamide(Endoxan, Cytoxan, Neosar, Procytox, Revimmune)

Warning: Cyclophosphamide or its generic equivalent Cytoxan, can cause allergic reactions in some people. Be sure to inform you physician if you are aware of a susceptibility to an allergic reaction with this medication. Very elderly patients and children can be sensitive to the effects of this drug. Men and women of child-bearing age must plan to use contraceptives during the treatment.

 

Indications:  Cyclophosphamide is primarily used for the treatment of various forms of cancer.  It is a member of the chemotherapy class of drugs that work to slow or completely stop cancerous cell growth.  It can also be used to treat a certain form of kidney disease in children, but is only used after other treatments have proved ineffective.  Some health care professional will also use this drug to treat lupus, rheumatoid arthritis, and to help the body prevent rejection of transplanted organs.

 

Cyclophosphamide is used in the treatment of a variety of cancers; mainly:

·         breast cancer

·         testicular cancer

·         endometrial cancer

·         ovarian cancer

·         lung cancers

·         Ewing’s sarcoma

·         multiple myeloma

·         Mycosis

·         fungoides

·         neuroblastoma

·         retinoblastoma

·         rhabdomyosarcoma

·         retinoblastoma

·         Lymphomas: Hodgkin’s lymphomas and non-Hodgkin’s lymphomas

·         Leukemias: chronic lymphocytic leukemia, chronic myelocytic leukemia, acute myelocytic leukemia, acute lymphocytic leukemia

Dosage:  Cyclophosphamide is taken orally, exactly according to a doctor’s prescription.  He will determine the dosage depending on medical condition, the size of the patient, and can be adjusted during the treatment according to the patient’s response to the medication.  Be sure to drink plenty of fluids during the treatment.

 

Storage:  Keep Cyclophosphamide out of children reach. Store the medication at room temperature below 25 degrees Celsius (77 degrees Fahrenheit), and strictly away from temperatures exceeding 30 degrees Celsius. Always store Cyclophosphamide away from moisture and heat. Discard any unused doses after the expiration date. Talk to your pharmacist about the proper disposal of the medication.

 

Overdose:  when Cyclophosphamide is given in hospital by professionals, the risk of overdose is virtually nonexistent. When the drug is taken by mouth chance of overdose increases; either voluntary or involuntary, it may happen that some patients take higher dose. Cyclophosphamide overdose can cause severe and even fatal health problems. An accidental overdose in elderly and especially among young children can lead to death.  If you think you have taken an overdose of Cyclophosphamide, contact a poison control center or go to an emergency as soon as possible.

 

Missing dose:  When Cyclophosphamide is given by injection, it is administered in hospital; missing dose is very difficult. If for some reasons you cannot be present at the hospital for the treatment, contact your health care provider before the appointment. If you are recommended to take Cyclophosphamide by mouth in tablet form, you can easily forget to take it. If you forgot to take the drug for less than 12 hours, take the usual dose. Beyond 12 hours, it is better to wait for the next dose to continue taking the medication as usual; do not double.

Contraindication: There are several considerations for potential patients of this medication.  One of the most important is that it cannot be taken during pregnancy.  It also cannot be taken for up to several years after delivery since the drug can be transmitted to the baby, particularly through breast feeding.  Recipients of this medication must also be prepared some physical debilitations including nausea, vomiting, and a general weakness.  Patients must postpone treatment if they have cuts, wounds, or have recently given blood.

For young people hoping to start families, they must make the decision to use this medication knowing that it can cause temporary sterility which, in some few cases, becomes permanent.

This medication can affect salespeople and other patients with occupations that depend on their appearance.  Hair loss can sometimes occur, and although it tends to grow back, it may not be the same color.

 

Interactions:  Patients taking Cyclophosphamide should be aware of several important interactions with other medications.  If this drug is taken with Allopurinol (Zyloprim), the ability of the drug to reduce production of blood cells from the bone marrow is enhanced.

This medication increases the chances of heart failure caused by Doxorubicin (Adriamycin).  It increases the actions of Coumarin (Coumadin) and similar blood thinners.  It decreases the effects of Quinolone antibiotics such as Cipro.

It is always a good idea for the patient to compile a list of drugs he is currently taking, and let the physician and pharmacist review for potential interactions.

 

Cyclophosphamide may interact with certain substances; talk to your doctor before taking these products:

·         vaccins

·         acetaminophen

·         aspirin

·         ibuprofen

·         ketoprofen

·         naproxen

·         doxorubicin

·         etanercept

·         St. John’s wort

·         Phenobarbital

·         succinylcholine chloride

·         trastuzumab

·         Pain Killers

·         Anti-anemia drugs such as filgrastim and pegfilgrastim

Side effects:  In addition to attacking cancer cells, Cyclophosphamide can also affect normal cells, which can cause various adverse effects in some patients. Some Cyclophosphamide side effects include:

  • fatigue
  • hairloss
  • dizziness
  • nausea and vomiting
  • mouth sores
  • darkened and thickened skin
  • blistering skin or acne
  • decreased appetite
  • weight loss
  • Absence of menstrual bleeding (amenorrhea).

 

If the side effects above become severe or persist for long, contact your oncologist. In addition, contact your doctor immediately if you experience any of these symptoms:

  • fever
  • persistent coughing
  • black, tarry stools
  • persistent constipation or diarrhea
  • sore throat
  • shortness of breath or difficulty breathing
  • unusual bruising or bleeding
  • swelling of the feet or ankles
  • Painful urination
  • Bloody or red urine.

 

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