About your medicine
Cyclophosphamide belongs to a group of medicines called immuno-suppressants. It can also be used in bigger doses to treat some cancers. As the word immuno-suppressant suggests, the function of these drugs is to suppress the immune system, which is the body’s natural defence system. Cyclophosphamide is taken for some autoimmune diseases for example vasculitis. It is used to try and improve kidney function and to dampen down the disease, stopping it from causing any further damage to the body.
Cyclophosphamide can be taken for myeloma or vasculitis.
Vasculitis causing renal failure can be due to different conditions (see the vasculitis page).
Cyclophosphamide can be given as an injection, or in tablet form.
cyclophosphamide can be taken as a larger dose once a week or a smaller dose once a day. Your doctor will decide which is better for you.
Contraception should be used whilst taking cyclophosphamide and for 3 months afterwards because it could be harmful to unborn babies.
You should NOT be vaccinated with some vaccines whilst receiving cyclophosphamide. For vaccines that you can and cannot have, see the vaccine page. (Vaccines are injections that can be given to help prevent you from catching some diseases, for example, polio).
Taking your medicine
The tablets should be swallowed whole, not chewed or crushed. Ideally they should be taken with a full glass of water, you should check with your doctor about increasing your fluid intake.
If you are taking high dose cyclophosphamide with another tablet called mesna (see below), the mesna tablets can be broken in half or taken whole to get the dose needed.
Like all medicines cyclophosphamide can cause side effects.
With higher doses feeling sick is common, but this is reduced by a tablet called ondansetron which is taken one hour before your first dose of cyclophosphamide.
Cyclophosphamide can cause inflammation of the bladder so, with higher doses, you may be given a tablet called mesna which will protect your bladder.
Hair loss can occur during treatment. It is more likely with the higher dose cyclophosphamide, smaller daily doses are less likely to cause a problem. Hair growth comes back again after finishing treatment and often comes back whilst remaining on low doses daily.
Cyclophosphamide can also cause a decrease in “white blood cells”; your doctor will check your blood regularly to make sure this does not occur. A drop in white blood cells can make you more prone to catching infections. In particular, illnesses like chicken pox can be more severe in this situation – inform your doctor if you come into contact with anyone with chicken pox whilst on cyclophosphamide treatment or if you have had it before. Cyclophosphamide can also increase the chance of developing a lung infection called “pneumocystis”. You may be prescribed a preventative antibiotic called co-trimoxazole to reduce this risk.
Contact your doctor if you develop a temperature higher than 38ºc (100.5ºF), or if you feel unwell and develop unexplained bruising or bleeding at any point during treatment with cyclophosphamide.
Cyclophosphamide can cause in-fertility in some patients (being unable to have a baby). Infertility is usually temporary, but in some cases can be permanent. It can occur in both men and women. Your doctor will discuss your options, including sperm banking, before you start treatment.
In women, cyclophosphamide may also cause a temporary or permanent change in your monthly periods, causing them to become irregular or causing them to stop. Women may also experience an earlier menopause.
You are recommended to see your doctor about regular skin checks and, for women, regular cervical smears. This is because you are more likely to develop skin or cervical cancers which are not serious if noticed early.
Storing your medicine
Store the tablets in their original packet in a cool, dry place out of the sight and reach of children. Only remove the tablets from the container when it is time to take them.
Do not throw out any expired or unwanted medicine by flushing them down the toilet or throwing them away. Take them to your local pharmacy which will dispose of them for you.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.