What is this medicine?

CYCLOPHOSPHAMIDE (sye kloe FOSS fa mide) is a chemotherapy drug. It slows the growth of cancer cells. This medicine is used to treat many types of cancer like lymphoma, myeloma, leukemia, breast cancer, and ovarian cancer, to name a few. It is also used to treat nephrotic syndrome in children.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush or chew this medicine. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• low blood counts - this medicine may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine

• signs of decreased red blood cells - unusually weak or tired, fainting spells, lightheadedness

• breathing problems

• dark urine

• dizziness

• palpitations

• swelling of the ankles, feet, hands

• trouble passing urine or change in the amount of urine

• weight gain

• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• changes in nail or skin color

• hair loss

• missed menstrual periods

• mouth sores

• nausea, vomiting

What may interact with this medicine?

This medicine may interact with the following medications:

• amiodarone

• amphotericin B

• azathioprine

• certain antiviral medicines for HIV or AIDS such as protease inhibitors (e.g., indinavir, ritonavir) and zidovudine

• certain blood pressure medications such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, monopril, perindopril, quinapril, ramipril, trandolapril

• certain cancer medications such as anthracyclines (e.g., daunorubicin, doxorubicin), busulfan, cytarabine, paclitaxel, pentostatin, tamoxifen, trastuzumab

• certain diuretics such as chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide, metolazone

• certain medicines that treat or prevent blood clots like warfarin

• certain muscle relaxants such as succinylcholine

• cyclosporine

• etanercept

• indomethacin

• medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim

• medicines used as general anesthesia

• metronidazole

• natalizumab

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature at or below 25 degrees C (77 degrees F). This medicine can be stored at room temperatures of up to 30 degrees C (86 degrees F) for a short time. Protect from temperatures above 30 degrees C (86 degrees F). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• blood disorders

• infection

• kidney disease

• liver disease

• recent or ongoing radiation therapy

• an unusual or allergic reaction to cyclophosphamide, other chemotherapy, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor for checks on your progress. This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

Drink water or other fluids as directed. Urinate often, even at night.

In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you.

Do not become pregnant while taking this medicine or for 1 year after stopping it. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. Men should not father a child while taking this medicine and for 4 months after stopping it. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

This medicine may interfere with the ability to have a child. This medicine has caused ovarian failure in some women. This medicine has caused reduced sperm counts in some men. You should talk with your doctor or health care professional if you are concerned about your fertility.

If you are going to have surgery, tell your doctor or health care professional that you have taken this medicine.