- What is cyclophosphamide? How does it work (mechanism of action)?
- What are the uses for cyclophosphamide?
- What are the side effects of cyclophosphamide?
- What is the dosage for cyclophosphamide?
- Which drugs or supplements interact with cyclophosphamide?
- Is cyclophosphamide safe to take if I'm pregnant or breastfeeding?
- What else should I know about cyclophosphamide?
What is cyclophosphamide? How does it work (mechanism of action)?
Cyclophosphamide is a drug that is used primarily for treating several types of cancer. In order to work, cyclophosphamide first is converted by the liver into two chemicals, acrolein and phosphoramide. Acrolein and phosphoramide are the active compounds, and they slow the growth of cancer cells by interfering with the actions of deoxyribonucleic acid (DNA) within the cancerous cells. Unfortunately, normal cells also are affected, and this results in serious side effects. In addition to slowing the growth of cancerous cells, cyclophosphamide also suppresses the immune system and is referred to as immunosuppressive.
The FDA approved Cytoxan in November 1959.
What are the uses for cyclophosphamide?
- breast cancer,
- ovarian cancer, and
- nephrotic syndrome (a disease of the kidneys) in children.
Unapproved uses include the treatment of
What are the side effects of cyclophosphamide?
Side effects of cyclophosphamide include:
- Hair loss
- Mouth sores
- Weight loss
- Stomach pain
- Mouth sores (stomatitis)
- Skin pigmentation
- Nail changes
Cyclophosphamide causes kidney failure, and it also may affect the heart and lungs. Cyclophosphamide suppresses production of blood cells from the bone marrow, including white blood cells (leukopenia), red blood cells (anemia) and platelets (thrombocytopenia). Leukopenia reduces the ability of the body to fight infection, thrombocytopenia impairs the ability of blood to clot, and anemia reduces the ability of blood to carry oxygen. Cyclophosphamide suppresses the immune system which may result in serious and sometimes fatal infections. Severe allergic reactions also may occur. Cyclophosphamide may cause inflammation of the urinary bladder with bleeding (hemorrhagic cystitis). This can result in lower abdominal pain from the bladder, problems urinating due to blood clots, and anemia due to loss of blood.
What is the dosage for cyclophosphamide?
The usual initial dose of cyclophosphamide for adults and children is 40-50 mg/kg administered intravenously over 2-5 days in divided doses. This dose may repeated at 2-4 week intervals. The usual oral dose is 1-5 mg/kg daily. Subsequent maintenance doses are adjusted based on the response of the tumor to treatment and the side effects.
Which drugs or supplements interact with cyclophosphamide?
Allopurinol (Zyloprim) enhances the ability of cyclophosphamide to reduce production of blood cells from the bone marrow.
Cyclophosphamide increases the occurrence of heart failure that is caused by doxorubicin (Adriamycin), increases the action of blood thinners such as warfarin (Coumadin), and decreases the effectiveness of quinolone antibiotics ciprofloxacin (Cipro, Cipro XR, Proquin XR).
Latest Cancer News
Is cyclophosphamide safe to take if I'm pregnant or breastfeeding?
- Use of cyclophosphamide during pregnancy may affect the fetus. Fetuses exposed to cyclophosphamide may be born with missing fingers, toes and a poorly-developed heart. Cyclophosphamide should not be administered during pregnancy.
- Cyclophosphamide is excreted in breast milk and could cause serious problems in the nursing infant.
What else should I know about cyclophosphamide?
Cyclophosphamide is available as:
- Powder for intravenous injection: 100, 200, 500, 1000, and 2000 mg)
- Tablets: 25, 50 mg.
Powder and tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F). Solutions prepared with bacteriostatic water are usable up to 24 hours if stored at room temperature and up to 6 days if stored in the refrigerator.
Cyclophosphamide is available in generic form, and you need a prescription to obtain it.
Cyclophosphamide (Cytoxan) is a drug prescribed for the treatment of certain cancers including breast cancer, leukemia, and ovarian cancer. Side effects, drug interactions, patient safety information, and pregnancy and breastfeeding information should be reviewed prior to taking any medication.
Multimedia: Slideshows, Images & Quizzes
Rheumatoid Arthritis (RA) Symptoms & Treatment
What is rheumatoid arthritis (RA)? Learn about juvenile rheumatoid arthritis. Discover rheumatoid arthritis (RA) symptoms,...
Understanding Cancer: Metastasis, Stages of Cancer, and More
Learn the basics about cancer including types, causes, how it spreads, symptoms and signs, stages and treatment options. Read...
Breast Cancer Diagnosis and Treatment
Learn about breast cancer causes, symptoms, tests, recovery, and prevention. Discover the types of treatments such as surgery and...
Rheumatoid Arthritis (RA) Exercises Slideshow: Joint-Friendly Fitness Routines
Regular exercise boosts fitness and helps reverse joint stiffness for people with rheumatoid arthritis (RA). Our experts offer...
10 Things Young Women Should Know About Breast Cancer
Is breast cancer genetic? Should I get tested for the BRCA gene? What every young women should know about breast cancer. Discover...
Breast Cancer Quiz: Symptoms & Signs
This Breast Cancer Quiz features signs, symptoms, facts, causes, common forms, terms, risk factors, statistics, and more. ...
Ovarian Cancer Quiz: Test Your Medical IQ
How common is ovarian cancer and who is at risk? Take our Ovarian Cancer Quiz to learn the causes, symptoms, and treatment for...
Rheumatoid Arthritis Quiz: What is Rheumatoid Arthritis?
How is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid...
Systemic Lupus Erythematosus Quiz: Test Your SLE IQ
This Lupus Quiz covers causes, signs, symptoms, facts, and treatments for this inflammatory autoimmune disease.
Top 10 Cancers Quiz
Take this quiz to learn the causes of cancer. Get the facts about the causes, symptoms, and treatments for the world's most...
Ovarian Cancer Symptoms, Signs, Stages
Ovarian cancer symptoms and signs include abdominal pain, bloating, frequent urination, and a feeling of fullness. Ovarian cancer...
Signs of Cancer in Women: Symptoms You Can't Ignore
Cancer symptoms can surprise women if they don't know what to watch out for. 15 cancer symptoms women ignore such as weight loss,...
Picture of Systemic Lupus Erythematosus 1
A chronic inflammatory condition caused by an autoimmune disease. See a picture of Systemic Lupus Erythematosus (SLE) and learn...
Picture of Uterine Cancer
A malignant tumor of the uterus (womb), which occurs most often in women between the ages of 55 and 70. Abnormal bleeding after...
Picture of Lupus
A chronic inflammatory condition caused by an autoimmune disease. See a picture of Lupus Rash and learn more about the health...
Picture of Systemic Lupus Erythematosus 2
Erythematous, edematous plaques appear in a "butterfly" distribution on the face. See a picture of Systemic Lupus Erythematosus...
Picture of Acute Systemic Lupus
Acute systemic lupus erythematosus. See a picture of Acute Systemic Lupus and learn more about the health topic.
Cancer-Fighting Foods in Pictures: Resveratrol, Green Tea, and More
Experts have praised certain foods for their ability to reduce cancer risks. Learn which foods and eating strategies may help...
Famous Faces With Rheumatoid Arthritis
Learn more about the famous faces of rheumatoid arthritis such as Lucille Ball, Glenn Frey, and more.
Related Disease Conditions
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease. The 16 characteristic early RA signs and symptoms include the following. Anemia Both sides of the body affected (symmetric) Depression Fatigue Fever Joint deformity Joint pain Joint redness Joint stiffness Joint swelling Joint tenderness Joint warmth Limping Loss of joint function Loss of joint range of motion Many joints affected (polyarthritis)
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including being over age 50, having endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, and/or having colorectal cancer. Symptoms and signs of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Second Source article from WebMD
Pain Management and Rheumatoid Arthritis
Second Source article from WebMD
Breast Cancer in Men
Second Source WebMD Medical Reference
Myasthenia gravis, a chronic autoimmune neuromuscular disease. Varying degrees of weakness of the voluntary muscles of the body are the main characteristics. A defect in the transmission of nerve impulses of the muscles is the cause of myasthenia gravis. Myasthenic crisis is when the muscles that control breathing weaken, which requires immediate medical attention. Symptoms include weakness of the eye muscles, facial expression, and difficulty swallowing. Treatment of myasthenia gravis includes medical therapies to control the symptoms of the disease.
Vasculitis (arteritis, angiitis) is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
There are many types of ovarian cancer, epithelial carcinoma is the most common. Women with a family history of ovarian cancer have an increased risk of developing the disease. Some ovarian cancer symptoms include abdominal pain, nausea, diarrhea, constipation, and abnormal vaginal bleeding, however, they usually do not present until the disease has progressed. Early diagnosis is important for successful treatment.
Rheumatoid Arthritis vs. Fibromyalgia
Though rheumatoid arthritis (RA) and fibromyalgia have similar symptoms, RA is an autoimmune disease and fibromyalgia is a chronic pain syndrome. RA symptoms include joint redness, swelling, and pain that lasts more than six weeks. Fibromyalgia symptoms include widespread pain, tingling feet or hands, depression, and bowel irritability. Home remedies for both include stress reduction, exercise, and getting enough sleep.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Male Breast Cancer
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Breast cancer is an invasive tumor that develops in the mammary gland. Breast cancer is detected via mammograms, breast self-examination (BSE), biopsy, and specialized testing on breast cancer tissue. Treatment of breast cancer may involve surgery, radiation, hormone therapy, chemotherapy, and targeted therapy. Breast cancer risk may be lowered by managing controllable risk factors.
Cancer survivors face ongoing physical, mental, occupational, and relationship challenges. Cancer survivors must coordinate follow-up care with the doctor and develop a wellness plan to stay healthy. This includes reducing stress, eating well, and exercising to support optimal health and minimize the risk of the cancer returning.
Takayasu disease (also referred to as Takayasu arteritis) is a chronic inflammation of the aorta and its branch arteries. Takayasu disease is most common of Women of Asian descent and usually begins between 10 and 30 years of age. Symptoms include painful extremities, dizziness, headaches, chest and abdominal pain, and a low-grade fever. Treatment for Takayasu disease includes cortisone medication to suppress the inflammation.
Rheumatology is the study of rheumatic diseases and conditions. Rheumatologists are internal medicine physicians who treat these illnesses, in particular arthritis.
Juvenile Rheumatoid Arthritis (JRA)
Juvenile rheumatoid arthritis (JRA) annually affects one child in every thousand. There are six types of JRA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Granulomatosis With Polyangiitis
Granulomatosis with polyangiitis is a condition that usually affects young or middle-aged adults, is an inflammation of the arteries supplying blood to the sinuses, lungs, and kidneys. Symptoms of granulomatosis with polyangiitis include bloody sputum, fatigue, weight loss, joint pain, sinusitis, shortness of breath, and fever. Granulomatosis with polyangiitis may be fatal within months without treatment. Treatment aims to stop inflammation with high doses of prednisone and cyclophosphamide.
Breast Cancer and Lymphedema
Lymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Paget Disease of the Breast (Paget's Disease of the Nipple)
Paget's disease is a rare form of cancer that forms in or around the nipple and frequently coexists with breast cancer. The exact cause of Paget's disease is unknown. Symptoms and signs include redness, scaling, and flaking of the nipple skin. A biopsy and imaging studies are needed to diagnose the disease. Treatment may include surgery, radiation, and adjuvant therapy.
Cancer fatigue is a lack of energy that is caused by cancer or cancer treatment, including chemotherapy, radiation, biological therapy, or bone marrow transplantation. Strategies to combat cancer fatigue include scheduling rest, pacing oneself, planning ahead and prioritizing work and activities, eating the right foods, exercising, and practicing proper body mechanics.
Breast Cancer in Young Women
About 5% of cases of breast cancer occur in women under the age of 40 years old. Some risk factors for breast cancer in young women include a personal history of breast cancer or breast disease, family history of breast cancer, prior radiation therapy, and the presence of BRCA1/BRCA2 gene mutations. Breast self-exams, clinical breast exams, and screening mammograms may help detect breast cancer. Treatment may include surgery, chemotherapy, radiation, and hormone therapy.
Breast Cancer Clinical Trials
Breast cancer clinical trials are research programs designed to evaluate new medical treatments, drugs, or devices for the treatment of breast cancer. Clinical trials are designed to test the safety and efficacy of new treatments as well as assess potential side effects. Clinical trials also compare new treatment to existing treatments to determine if it's any better. There are many important questions to ask your doctor before taking part in a breast cancer clinical trial.
Breast Cancer During Pregnancy
Breast cancer occurs in about 1 in every 1,000 pregnant women. Treatment of breast cancer during pregnancy involves surgery, but it is very difficult to protect the baby from the dangerous effects of radiation and chemotherapy. It can be an agonizing to decide whether or not to undergo breast cancer treatment while one is pregnant.
Cancer pain results from the tumor pressing on nerves or invading bones or organs. Cancer treatments like chemotherapy, radiation, or surgery can also cause pain. Over-the-counter pain relievers, prescription medications, radiation, biofeedback, and relaxation techniques are just some treatments for cancer pain.
Treatment & Diagnosis
- Rheumatoid Arthritis (RA)
- Atrial Fibrillation (AFib)
- Multiple Myeloma
- Systemic Lupus Erythematosus (SLE)
- Breast Cancer
- Ovarian Cancer
- Polyarteritis Nodosa (PAN)
- Sjogren's Syndrome
- Mixed Connective Tissue Disease (MCTD)
- Interstitial Lung Disease
- Behcet's Syndrome
- Doctor: Checklist to Take To Your Doctor's Appointment
- Henoch-Schonlein Purpura
- Pulmonary Fibrosis
- Carcinoid Syndrome
- Granulomatosis With Polyangiitis (GPA)
- Breast Cancer FAQs
- Rheumatoid Arthritis FAQs
- Systemic Lupus Erythematosus FAQs
- Ovarian Cancer FAQs
- Cancer FAQs
- Rheumatoid Arthritis (RA): 17 Warning Signs of Serious Complications
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Drugs: Buying Prescription Drugs Online Safely
- Lupus Nephritis Treatment
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
- Drug Duo May Be an Advance Against a Common Leukemia
- Cost of Breast Cancer Chemo Varies Widely in U.S.
- Steep Rise in Price of Older Cancer Drugs
- Study Suggests Causes for Lupus' Impact on Immune System
- Drug Combo Helps Lupus-Related Kidney Condition
- Experimental Vaccines May Extend Life in Pancreatic Cancer
- Experimental Vaccines May Extend Life With Pancreatic Cancer
- 2 Pre-Surgery Drug Treatments Show Promise Against Aggressive Breast Cancer
- Many Lupus Patients Forgo Needed Medication, Study Finds
- New Strategy Helps Young Lymphoma Patients Avoid Radiation Treatment
- No Evidence That Lupus Drugs Lead to Cancer, Says Study
- Shortage of Drug for Children's Cancer May Have Upped Relapse Rates
- 'Rediscovered' Lymphoma Drug Helps Double Survival: Study
- Many Primary Care Docs Don't Know Long-Term Effects of Chemo: Survey
- 'Chemo Brain' May Linger 20 Years After Breast Cancer Treatment
- Avastin May Help Fight Early Breast Cancer
- Birth Defects Seem Rare in Kids of Childhood Cancer Survivors
- More Aggressive Chemo May Help Younger Lymphoma Patients: Study
- Two-Drug Combo May Help Hard-to-Treat Leukemia
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.