Generic name: CyclophosphamideBrand names: Cytoxan
Cytoxan, an anticancer drug, works by interfering with the growth of malignant cells. It may be used alone but is often given with other anticancer medications.
Cytoxan is used in the treatment of the following types of cancer:Breast cancerLeukemias (cancers affecting the white blood cells)Malignant lymphomas (Hodgkin's disease or cancer of the lymph nodes)Multiple myeloma (a malignant condition or cancer of the plasma cells)Advanced mycosis fungoides (cancer of the skin and lymph nodes)Neuroblastoma (a malignant tumor of the adrenal gland or sympathetic nervous system)Ovarian cancer (adenocarcinoma)Retinoblastoma (a malignant tumor of the retina)
In addition, Cytoxan may sometimes be given to children who have "minimal change" nephrotic syndrome (kidney damage resulting in loss of protein in the urine) and who have not responded well to treatment with steroid medications.
Cytoxan may cause bladder damage, probably from toxic byproducts of the drug that are excreted in the urine. Potential problems include bladder infection with bleeding and fibrosis of the bladder.
While you are being treated with Cytoxan, drink 3 or 4 liters of fluid a day to help prevent bladder problems. The extra fluid will dilute your urine and make you urinate frequently, thus minimizing the Cytoxan byproducts' contact with your bladder.
Take Cytoxan exactly as prescribed. You will undergo frequent blood tests, and the doctor will adjust your dosage depending on your white blood cell count; a dosage reduction is necessary if the count drops below a certain level. You will also have frequent urine tests to check for blood in the urine, a sign of bladder damage.
Take Cytoxan on an empty stomach. If you have severe stomach upset, then you may take it with food.
If you are unable to swallow the tablet form, you may be given an oral solution made from the injectable form of Cytoxan and Aromatic Elixir. This solution should be used within 14 days.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor immediately. Only your doctor can determine if it is safe for you to continue using Cytoxan.
One possible Cytoxan side effect is the development of a secondary cancer, typically of the bladder, lymph nodes, or bone marrow. A secondary cancer may occur up to several years after the drug is given.
Cytoxan can lower the activity of your immune system, making you more vulnerable to infection.
Noncancerous bladder problems may occur during Cytoxan therapy (see "Most important fact about Cytoxan" section, above).
Do not take Cytoxan if you have ever had an allergic reaction to it.
Also, tell your doctor if you have ever had an allergic reaction to another anticancer drug such as busulfan, chlorambucil, estramustine, lomustine, melphalan, or streptozocin.
In adults, Cytoxan should not be given for "minimal change" nephrotic syndrome or any other kidney disease.
Also, Cytoxan should not be given to anyone who is unable to produce normal blood cells because the bone marrow—where blood cells are made—is not functioning well.
You are at increased risk for toxic side effects from Cytoxan if you have any of the following conditions:Blood disorder (low white blood cell or platelet count)Bone marrow tumorsKidney disorderLiver disorderPast anticancer therapyPast X-ray therapy
If Cytoxan is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Cytoxan with the following:Anticancer drugs such as doxorubicinAllopurinolPhenobarbital
If you take adrenal steroid hormones because you have had your adrenal glands removed, you are at increased risk for toxic effects from Cytoxan; your dosage of both the steroids and Cytoxan may need to be modified.
If you are pregnant or plan to become pregnant, inform your doctor immediately. When taken during pregnancy, Cytoxan can cause defects in the unborn baby. Women taking Cytoxan should use effective contraception. Cytoxan does appear in breast milk. A new mother will need to choose between taking Cytoxan and nursing her baby.
ADULTS AND CHILDREN
Your doctor will tailor your dosage according to your condition and other drugs taken with Cytoxan.
The recommended oral dosage range is 1 to 5 milligrams per 2.2 pounds of body weight per day.
"Minimal Change" Nephrotic Syndrome
The recommended oral dosage is 2.5 to 3 milligrams per 2.2 pounds of body weight per day for a period of 60 to 90 days.
Although there is no specific information on Cytoxan overdose, any medication taken in excess can have serious consequences. If you suspect an overdose of Cytoxan, seek medical attention immediately.