Cyclophosphamide
(Brand name Endoxana)

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What does the drug do?

Cyclophosphamide is an alkylating agent which slows the growth of cancer cells.

Why is it needed?

Cyclophosphamide is used in the treatment of Leukaemias, Lymphomas, Myeloma and other cancers. It is also used to suppress the immune system in some non-malignant conditions.

How is it taken?

Cyclophosphamide may be taken as tablets and or it also may be given as an injection into the blood stream via a vein.

Store tablets securely in a dry place out of reach of children.

Dosage

Each tablet contains 50 mg cyclophosphamide. The dose prescribed depends on the height and weight of the patient, and on the condition being treated.

The tablets are best taken after a light breakfast.

How long does it take to work?

Cyclophosphamide can suppress normal blood counts within 10 days but the maximum effect on a cancer may take several courses of tablets over a number of weeks.

Special precautions

A substance produced when a by-product of cyclophosphamide breakdowns in the body can cause an irritation in the bladder and blood may appear in the urine. You should drink plenty of fluid (not alcohol) to counteract this while you are taking the tablets (a rough guide is to double your usual fluid intake).

It is important that you use effective contraception (such as condoms) as Cyclophosphamide may cause birth defects, when taken by either the man or woman.

What to do if you miss a dose

Take the dose later in the day if you remember.

Do not double the dose the next day.

Other drugs/medicines

A number of drugs interact with chemotherapy so it is important that these, whether prescribed or obtained over the counter, are known to your hospital doctor.

If you intend to have any immunizations, always let your hospital doctor know. Live vaccines must be avoided.

Alcohol in moderation is allowed but you may find its effect greater when you are receiving treatment.

What are the alternatives?

There are a number of other chemotherapy drugs which can be used if cyclophosphamide cannot be tolerated. Your hospital doctor will discuss this with you.

Possible side effects

Cyclophosphamide may cause nausea, vomiting and mouth ulcers. Hair loss can occur. Prolonged use may cause shortness of breath due to fibrosis (scarring) of the lung.

What are the risks?

Cyclophosphamide suppresses the bone marrow and may lead to a low white cell count and risk of infection. The platelet count may become low and lead to bruising or bleeding.

Cyclophosphamide may lead to sterility so if your family is not complete, please discuss this with your hospital doctor before starting treatment.

Keep your Chemotherapy Alert Card to hand at all times.

Follow-up

The response to cyclophosphamide will be monitored with regular blood tests.

• Consultant Haematologist 01271 349198

• Mrs Melanie Bowyer Haematology Specialist Nurse 01271 349198

• Mrs C Peters Chemotherapy Specialist Nurse 01271 322577 Bleep 174

• North Devon Hospital Chemotherapy Unit 01271 311579

• BACUP booklet on Chemotherapy Freephone 0808 800 1234

• Drug information package insert obtained with medicines

• Latest edition of British National Formulary (BNF)

• Internet sites such as
  www.cancerbacup.org.uk
  www.cancer.gov/cancertopics
  www.macmillan.org.uk

PALS

The Patient Advice and Liaison Service (PALS) ensures that the NHS listens to patients, relatives, carers and friends, answers questions and resolves concerns as quickly as possible. If you have a query or concern, please visit them in the Information Centre on Level 2 at North Devon District Hospital or contact them on 01271 314090.

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