Cyclophosphamide

Cyclophosphamide comes as a capsule to take by mouth once a day in the morning. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer or condition you have. Take cyclophosphamide at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cyclophosphamide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not open, chew, or crush them.

Your doctor may need to delay your treatment or adjust your dose of cyclophosphamide depending on your response to treatment and any side effects that you experience. Talk to your doctor about how you are feeling during your treatment. Do not stop taking cyclophosphamide without talking to your doctor.

Drink plenty of fluids while taking cyclosphosphamide capsules.

You should wear rubber or latex gloves when you handle the capsules so that your skin does not come into contact with the medication. If any of the capsules are broken or leaking, do not touch them with your bare hands and be careful not to breathe in the powder from the capsules. You should wear rubber or latex gloves when you handle broken or opened capsules so that your skin does not come into contact with the powder. If the capsule contents touch your skin, wash the area well with water right away.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking cyclophosphamide,

• tell your doctor and pharmacist if you are allergic to cyclophosphamide, other alkylating agents such as bendamustine, busulfan , carmustine , chlorambucil , ifosfamide , lomustine , melphalan , procarbazine , or temozolomide , any other medications, or any of the ingredients in cyclophosphamide capsules. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking cyclophosphamide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had urinary obstruction (a blockage of urine flowing out of the bladder). Your doctor may tell you not to take cyclophosphamide.
• tell your doctor if you have previously received treatment with other chemotherapy medications or if you have had radiation therapy to your chest or stomach area. Also tell your doctor if you have an open or healing wound or if you have or have ever had heart failure, a fast or irregular heartbeat, or any other heart problems; low blood levels of sodium; or kidney or liver disease.
• tell your doctor if you are pregnant or plan to become pregnant. Cyclophosphamide may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. If you can become pregnant, you must take a pregnancy test before starting treatment and use effective birth control. Cyclophosphamide may harm the fetus.
• tell your doctor if you are breastfeeding. You should not breastfeed while you are taking cyclcophosphamide and for 1 week after your last dose.
• you should know that this medication may cause permanent infertility in men and women. Talk to your doctor about the risks of taking cyclophosphamide.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking cyclophosphamide.
• you should know that cyclophosphamide may make you dizzy, or cause vision problems. Do not drive a car or operate machinery until you know how this medication affects you.
• you should not that cyclophosphamide may cause severe or life-threatening urinary problems. Tell your doctor if you have problems urinating of if you have a bladder infection. Call your doctor immediately if you experience any of the following: pink or red colored urine or blood in the urine; or frequent, urgent, or painful urination. You should also drink plenty of fluids and urinate frequently during your treatment to help reduce urinary side effects.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Cyclophosphamide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea, vomiting, diarrhea, weight loss, or stomach pain
• loss of appetite or weight
• hair loss
• sores on the mouth or tongue
• changes in skin color
• changes in color or growth of finger or toe nails

Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately:

• sore throat, fever, chills, or other signs of infection
• poor or slow wound healing
• black, tarry stools; nose bleed, or other unusual bruising or bleeding
• rash, hives, itching, difficulty breathing or swallowing
• shortness of breath; swelling of the legs, ankles, or feet; fast, irregular, or pounding heartbeat; weight gain (more than 5 pounds [about 2.3 kilograms] in 24 hours); dizziness; or loss of consciousness
• new or worsening cough, chest pain, or shortness of breath
• yellowing of the skin or eyes, extreme tiredness, nausea or vomiting, right sided-stomach pain, dark colored urine, decreased appetite

Cyclophosphamide may increase the risk that you will develop other cancers. Talk to your doctor about the risks of taking cyclophosphamide.

Cyclophosphamide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• black, tarry stools or other unusual bruising or bleeding
• pink or red colored urine or blood in the urine; or frequent, urgent, or painful urination
• sores in the mouth and throat
• unusual tiredness or weakness
• sore throat, cough, fever, or other signs of infection
• shortness of breath; swelling of the legs, ankles, or feet; fast, irregular, or pounding heartbeat; weight gain (more than 5 pounds [about 2.3 kilograms] in 24 hours); dizziness; or loss of consciousness
• new or worsening cough, chest pain

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to cyclophosphamide.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.