cyclophosphamide (Cytoxan) Cancer Drug Side Effects (original) (raw)

What is cyclophosphamide? How does it work (mechanism of action)?

Cyclophosphamide is a drug that is used primarily for treating several types of cancer. In order to work, cyclophosphamide first is converted by the liver into two chemicals, acrolein and phosphoramide. Acrolein and phosphoramide are the active compounds, and they slow the growth of cancer cells by interfering with the actions of deoxyribonucleic acid (DNA) within the cancerous cells. Unfortunately, normal cells also are affected, and this results in serious side effects. In addition to slowing the growth of cancerous cells, cyclophosphamide also suppresses the immune system and is referred to as immunosuppressive.

The FDA approved Cytoxan in November 1959.

What are the side effects of cyclophosphamide?

Side effects of cyclophosphamide include:

Cyclophosphamide causes kidney failure, and it also may affect the heart and lungs. Cyclophosphamide suppresses production of blood cells from the bone marrow, including white blood cells (leukopenia), red blood cells (anemia) and platelets (thrombocytopenia). Leukopenia reduces the ability of the body to fight infection, thrombocytopenia impairs the ability of blood to clot, and anemia reduces the ability of blood to carry oxygen. Cyclophosphamide suppresses the immune system which may result in serious and sometimes fatal infections. Severe allergic reactions also may occur. Cyclophosphamide may cause inflammation of the urinary bladder with bleeding (hemorrhagic cystitis). This can result in lower abdominal pain from the bladder, problems urinating due to blood clots, and anemia due to loss of blood.

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What is the dosage for cyclophosphamide?

The usual initial dose of cyclophosphamide for adults and children is 40-50 mg/kg administered intravenously over 2-5 days in divided doses. This dose may repeated at 2-4 week intervals. The usual oral dose is 1-5 mg/kg daily. Subsequent maintenance doses are adjusted based on the response of the tumor to treatment and the side effects.

Which drugs or supplements interact with cyclophosphamide?

Allopurinol (Zyloprim) enhances the ability of cyclophosphamide to reduce production of blood cells from the bone marrow.

Cyclophosphamide increases the occurrence of heart failure that is caused by doxorubicin (Adriamycin), increases the action of blood thinners such as warfarin (Coumadin), and decreases the effectiveness of quinolone antibiotics ciprofloxacin (Cipro, Cipro XR, Proquin XR).

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Is cyclophosphamide safe to take if I'm pregnant or breastfeeding?

What else should I know about cyclophosphamide?

Cyclophosphamide is available as:

Powder and tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F). Solutions prepared with bacteriostatic water are usable up to 24 hours if stored at room temperature and up to 6 days if stored in the refrigerator.

Cyclophosphamide is available in generic form, and you need a prescription to obtain it.

Summary

Cyclophosphamide (Cytoxan) is a drug prescribed for the treatment of certain cancers including breast cancer, leukemia, and ovarian cancer. Side effects, drug interactions, patient safety information, and pregnancy and breastfeeding information should be reviewed prior to taking any medication.

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References

FDA Prescribing Information