cyclophosphamide

Cyclophosphamide can cause your red blood cell, white blood cell, and platelet counts to drop. When the number of these cells are lower than normal, you’re at risk of developing anemia, infections, and bleeding or bruising. Your provider will closely monitor your blood counts through routine lab work while you’re receiving cyclophosphamide. If your blood counts are low, you might have to skip or delay your cyclophosphamide dose. Let your provider know as soon as possible if you experience fevers, chills, tiredness, or bleeding and bruising that doesn’t stop or go away because you might need to stop this medication.

Cyclophosphamide can cause injury to your kidneys and urinary tract, including a serious condition where the bladder becomes inflamed and starts bleeding (hemorrhagic cystitis). This can happen with both short-term and long-term use of cyclophosphamide. To lessen this risk, try to stay well hydrated, either by mouth or through IV, and urinate often to clear cyclophosphamide from your body. Some providers may use a medication called mesna (Mesnex) to help prevent bladder damage in certain situations. Reach out to your provider right away if you experience blood in the urine, pain or problems while urinating, or changes in the color or cloudiness of the urine. These can be signs of a serious bladder or kidney problem.

Cyclophosphamide can cause new or worsening heart failure, fluid or blood buildup around the heart, inflammation of the heart muscle, and irregular heartbeats. This can affect how well your heart pumps blood through your body. If you have heart problems, your provider will monitor your heart more regularly while you receive cyclophosphamide treatment to make sure your condition doesn’t get worse. Reach out to your provider and seek medical attention right away if you have chest pain, fast heartbeat, shortness of breath that usually worsens with activity or while lying flat, swelling of your legs or feet, sudden weight gain, fatigue, or dizziness.

Although rare, cyclophosphamide use can cause lung damage and scarring (pulmonary fibrosis). This can take several years to develop after receiving cyclophosphamide. Notify your provider right away if you start experiencing a cough or difficulty breathing.

While rare, some people who received treatment with cyclophosphamide have reported developing secondary cancers, such as bladder cancer and blood cancers. Talk to your provider if you’re concerned about your risk for other cancers.

There’s a small chance that cyclophosphamide can cause liver injury. This can lead to serious problems where blood flow gets blocked in your liver (hepatic veno-occlusive disease). Your provider will monitor your liver labs regularly while you’re receiving cyclophosphamide. Let your provider know right away if you experience right-side stomach pain, yellowing of the eyes or skin, dark urine, tiredness, nausea, vomiting, or loss of appetite, as these can be signs of liver problems.

Based on animal studies, cyclophosphamide can harm an unborn baby or raise the risk for miscarriage (pregnancy loss). Because of this risk, regardless of your sex, you should use birth control during treatment with cyclophosphamide to prevent pregnancy. After treatment, continue to use birth control for at least another 4 months (for males) or for up to 1 year (for females). Let your provider know right away if you or your partner becomes pregnant during this time.