Your pulmonologist has informed you that you will be treated with cyclophosphamide. In this leaflet, you will find information about this medication, the diseases for which it is prescribed, and possible side effects.
What is cyclophosphamide?
Cyclophosphamide is a medication that inhibits cell division (cytostatic) and temporarily suppresses the immune system. Cyclophosphamide is excreted through the urine.
Why is cyclophosphamide necessary?
Cyclophosphamide is given when it is desirable to temporarily suppress the immune system. This is the case, for example, in autoimmune diseases and certain forms of pulmonary fibrosis, when the immune system is overly active against the body’s own tissues. In high doses, cyclophosphamide is also used as a cytostatic in cancers such as leukemia.
In what dosage is cyclophosphamide given?
Cyclophosphamide can be given as tablets or as short courses via an intravenous infusion. In your case, a series of one-day infusions has been chosen. For lung diseases, cyclophosphamide is given in a dose of 1.000 to a maximum of 2.000 milligrams.
Your treating physician will calculate exactly which dose is optimal for you. Because cyclophosphamide is excreted through the urine, it is important to drink enough during and after administration.
How long should cyclophosphamide be used?
Cyclophosphamide in pulse form is usually given every 4 weeks. The exact number of courses you will receive will be decided in consultation with your treating physician. This also depends on the results of lung function and X-ray examinations.
What happens during admission?
The administration of cyclophosphamide takes place during a day admission. Before you go to the ward, blood will be drawn at the outpatient laboratory to check your blood cells, liver, and kidney function. Then you will be admitted by a nurse. Your blood pressure, heart rate, and weight will be checked, and an IV will be inserted. If there are no special findings, the administration of cyclophosphamide will begin after delivery by the pharmacy.
What are the side effects?
At the doses used here, side effects of cyclophosphamide are usually mild. If you do experience side effects, these are usually nausea (with or without vomiting). To prevent nausea, you will receive a medication for this (Zofran®). Other side effects of cyclophosphamide mainly occur at high doses, as used in cancer treatment.
Although uncommon at the doses used here, after several months of treatment, disorders in blood cell production can sometimes occur. This is because the production of blood cells in the bone marrow is also suppressed by cyclophosphamide. This side effect manifests as an increased risk of infections, spontaneous bruising, or nosebleeds. To detect this as early as possible, your blood will be checked before each course.
Much less frequently mentioned side effects are dark discoloration of the skin and nails and hair loss (which is not permanent). Very rarely, men may experience impaired sperm production and women may experience changes in their menstrual pattern. With long-term use (tablets), a bloody inflammation of the bladder lining can occur. Although this complication is rarely reported, it is important to watch for blood in the urine and report this to your treating physician immediately.
Interaction of cyclophosphamide with other medications
When used together with Allopurinol® (used for gout), suppression of bone marrow function can occur.
When should you not use cyclophosphamide?
If you have an active infection, cyclophosphamide should not be given, as the immune system should not be suppressed. Because of the possible effects on the bladder, cyclophosphamide should not be used in severe bladder or urinary tract disorders. Cyclophosphamide should not be used during pregnancy or while breastfeeding.
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- Note: It is recommended not to become pregnant for up to 3 months after using cyclophosphamide.
Questions?
If you have any questions or doubts, please contact the Pulmonary Diseases outpatient clinic using the contact details known to you.