Cytoxan - Cyclophosphamide Injection

What is this medication?

CYCLOPHOSPHAMIDE (sye kloe FOSS fa mide) treats some types of cancer. It works by slowing down the growth of cancer cells.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Cyclophosphamide, Cytoxan, Neosar

What should I tell my care team before I take this medication?

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

  • Heart disease
  • Irregular heartbeat or rhythm
  • Infection
  • Kidney problems
  • Liver disease
  • Low blood cell levels (white cells, platelets, or red blood cells)
  • Lung disease
  • Previous radiation
  • Trouble passing urine
  • An unusual or allergic reaction to cyclophosphamide, other medications, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breast-feeding

How should I use this medication?

This medication is injected into a vein. It is given by your care team in a hospital or clinic setting.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your care team if you are unable to keep an appointment.

What may interact with this medication?

  • Amphotericin B
  • Amiodarone
  • Azathioprine
  • Certain antivirals for HIV or hepatitis
  • Certain medications for blood pressure, such as enalapril, lisinopril, quinapril
  • Cyclosporine
  • Diuretics
  • Etanercept
  • Indomethacin
  • Medications that relax muscles
  • Metronidazole
  • Natalizumab
  • Tamoxifen
  • Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

This medication 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 care team tells you to stop.

You may need blood work while you are taking this medication.

This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Avoid taking medications that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your care team. These medications may hide a fever.

Be careful brushing or 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 medication.

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

Some products may contain alcohol. Ask your care team if this medication contains alcohol. Be sure to tell all care teams you are taking this medicine. Certain medicines, like metronidazole and disulfiram, can cause an unpleasant reaction when taken with alcohol. The reaction includes flushing, headache, nausea, vomiting, sweating, and increased thirst. The reaction can last from 30 minutes to several hours.

Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects if taken during pregnancy and for 1 year after the last dose. A negative pregnancy test is required before starting this medication. A reliable form of contraception is recommended while taking this medication and for 1 year after the last dose. Talk to your care team about reliable forms of contraception. Do not father a child while taking this medication and for 4 months after the last dose. Use a condom during this time period.

Do not breast-feed while taking this medication or for 1 week after the last dose.

This medication may cause infertility. Talk to your care team if you are concerned about your fertility.

Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancer if you take this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Dry cough, shortness of breath or trouble breathing
  • Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
  • Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
  • Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
  • Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
  • Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
  • Low sodium level—muscle weakness, fatigue, dizziness, headache, confusion
  • Red or dark brown urine
  • Unusual bruising or bleeding

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

  • Hair loss
  • Irregular menstrual cycles or spotting
  • Loss of appetite
  • Nausea
  • Pain, redness, or swelling with sores inside the mouth or throat
  • Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

© 2024 Elsevier/Gold Standard (2023-05-05 00:00:00)


Additional Information From Chemocare.com About Cytoxan

Self-Care Tips

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • It is important to void (empty your bladder) frequently especially in the first 24 hours after taking cyclophosphamide. Report any pain or burning on urination to your health care provider.
  • You may be at risk of infections so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty or rest.
  • Maintain good nutrition.
  • Remain as active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Pain or burning with urination
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers

Always inform your health care provider if you experience any unusual symptoms.


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