Cytoxan (Cyclophosphamide)

Do's

• Take Cytoxan medication by mouth exactly as directed by your healthcare provider. 
• Follow your healthcare provider's instructions closely. 
• Swallow the tablets or capsules whole.  
• Wash your hands thoroughly immediately if you accidentally come into contact with broken tablets or capsules. 
• Drink more fluids than usual and urinate frequently during treatment with Cytoxan to prevent kidney and bladder side effects. 
• Consult your healthcare provider for specific instructions on how much fluid to drink and how often to empty your bladder each day. Follow these instructions carefully. 

Don'ts

• Do not chew or crush Cytoxan tablets.  

• Do not open the capsules. 
• Do not increase your dose or take Cytoxan more frequently without the approval of your healthcare provider as taking higher doses or increasing the frequency of use will not improve your condition faster and may increase the risk of serious side effects. 
• Avoid handling Cytoxan medication or breathing dust from the tablets or capsules if you are pregnant or may become pregnant, as the drug can be absorbed through the skin and lungs and may harm an unborn baby.

The dosage is determined based on your medical condition, weight, response to treatment, and other treatments you may be receiving, such as other chemotherapy drugs or radiation therapy.  

Some common side effects that may occur include:

• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Hair loss
• Mouth sores
• Skin rash
• Fatigue
• Changes in taste
• Bladder irritation
• Darkening of the skin or nails
• Changes in menstrual periods

Serious side effects are rare but can occur. 

• Allergic reactions, such as rash, itching, swelling, severe dizziness, or trouble breathing
• Signs of infection, such as fever, chills, sore throat, or cough
• Unusual bleeding or bruising
• Blood in urine or stool
• Yellowing of the skin or eyes (jaundice)
• Severe stomach pain or persistent nausea/vomiting
• Unexplained weight loss
• Painful or frequent urination

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Cytoxan,  contact your healthcare provider for medical advice.

Before taking Cytoxan, it is important to be aware of the following warnings and precautions:

1. Bone Marrow Suppression: Cytoxan can cause a decrease in blood cell counts, leading to an increased risk of infection, anemia, and bleeding. Regular blood tests are necessary to monitor these levels.
2. Risk of Infection: Because of its impact on the immune system, Cytoxan may increase susceptibility to infections. Contact your healthcare provider if you experience signs of infection, such as fever or persistent sore throat.
3. Fertility Issues: Cytoxan may affect fertility, leading to temporary or permanent infertility. Discuss fertility preservation options with your healthcare team if fertility is a concern.
4. Potential for Secondary Cancers: Long-term use of Cytoxan may increase the risk of developing secondary cancers. This risk should be weighed against the potential benefits of the treatment.
5. Liver and Kidney Function: Cytoxan can affect liver and kidney function. Regular monitoring of liver and kidney function is essential during treatment.
6. Pregnancy and Breastfeeding: Cytoxan can harm the fetus during pregnancy. Avoid pregnancy during treatment, and both men and women should use effective contraception. Cytoxan may also be present in breast milk, so breastfeeding is not recommended during treatment.
7. Cardiotoxicity: Cytoxan may have cardiotoxic effects, and individuals with pre-existing heart conditions may be at higher risk. Regular cardiac monitoring may be necessary.
8. Lung Complications: Cytoxan can cause lung problems, such as interstitial pneumonitis. Inform your healthcare provider if you experience shortness of breath, persistent cough, or chest pain.
9. Hemorrhagic Cystitis: Cytoxan can lead to a condition called hemorrhagic cystitis, causing bleeding and inflammation in the bladder. Adequate hydration and the use of certain medications can help prevent this complication.