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Drug Formulary

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cyclophosphamide

( sigh-kloe-FOSS-fa-mide )

Other Name(s): Procytox®

Appearance: Injection- clear solution mixed into larger bags of fluids; Oral- tablets in various strengths

cyclophosphamide patient.pdf

cyclophosphamide pour le patient.pdf

Medication Information Sheet

cyclophosphamide Injection/Tablets (sigh-kloe-FOSS-fa-mide)

This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Procytox®

Appearance:

Injection- clear solution mixed into larger bags of fluids; Oral- tablets in various strengths

What is this medication for?

For treating breast cancer, lung cancer, lymphomas, multiple myeloma, leukemias and other types of cancer.

What should I do before I have this medication?

Tell your health care team if you have or had significant medical condition(s), such as:
- liver problems
- bladder, kidney or adrenal gland problems
- lung problems
- heart problems, including irregular heartbeat
- have had surgery in the past 10 days or have any upcoming surgery, including dental surgery
- or any allergies
This drug (tablets) contains a small amount of lactose. If you cannot tolerate lactose, talk to your doctor.

How will this medication affect sex, pregnancy and breastfeeding?

The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.
If there is ANY chance that you or your partner may become pregnant, you and your partner together must: ►Use 2 effective forms of birth control at the same time while taking this drug. Do not take birth control pills if you have breast cancer. Keep using birth control until at least 6 months (for male patients) and at least 12 months (for female patients) after the last dose. Discuss with your health care team.
Do not breastfeed while using this drug.

This medication may affect fertility (ability to get pregnant)

How is this medication given?

Talk to your health care team about your treatment schedule.

Injection:

This drug is given by injection into a vein.
If you missed your treatment appointment, talk to your health care team to find out what to do.

Tablets:

Take the dose at about the same time each morning.
Take it exactly as directed by your doctor. Make sure you understand the instructions.
Swallow whole with a glass of water, with meals; do not crush tablets.
If you miss a dose, do not take a double dose. Talk to your health care team about what to do.

What else do I need to know while on this medication?

Do not eat or drink any grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may make the drug not work as well.
This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.
Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

To prevent bladder or kidney problems, drink plenty of fluids. (Your health care team may ask you to drink at least 8 cups per day on treatment days and for 1-2 days after.) Discuss with your health care team. Empty your bladder (go pee) often.
Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

How should I safely store this medication?

Tablets:

Store in the original packaging at room temperature, away from heat, light or moisture. Keep out of reach of children and pets.
Do not throw out any unused drugs at home. Bring them to your pharmacy for safe disposal.

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.

Side effects and what to do	When to contact doctor?
More Common Side Effects (in 10 or more out of 100 people)

Hair thinning or loss

Use a gentle soft brush and avoid hair sprays, bleaches, dyes and perms.
In most cases, your hair will grow back after treatment, but the texture or colour may change.

Talk to your health care team if this bothers you

Nausea and vomiting

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens.

To help prevent nausea:

Take anti-nausea medication(s) as prescribed to you by your doctor.
Drink clear liquids and have small meals. Get fresh air and rest.
Do not eat spicy, fried foods or foods with a strong smell.
Limit caffeine (e.g. coffee, tea) and alcohol.

If you have nausea or vomiting:

Take anti-nausea medication(s) as prescribed to you by your doctor.
Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

Also see Nausea & Vomiting pamphlet for more information.

Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

Low platelets in the blood

Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

38.3°C (100.9°F) or higher at any time OR
38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
Do not eat or drink anything hot or cold right before taking your temperature.
Wash your hands often to prevent infection.
Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room.
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Side effects and what to do	When to contact doctor?
Less Common Side Effects (In 1 to 9 out of 100 people)

Liver problems (may be severe)

You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly.
Your doctor will monitor your liver regularly with a blood test.

Get emergency medical help right away

Irritation of the bladder wall

You may have blood in your pee, feel the need to pee urgently, have pain in your belly/lower belly area or pain when peeing.

To prevent bladder problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.

Talk to your health care team as soon as possible

Fatigue (tiredness)

Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
Pace yourself, do not rush. Put off less important activities. Rest when you need to.
Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information.

Contact your health care team if no improvement or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

irregular heartbeat, chest pain, fainting spells (passing out) or swelling in your legs, ankles and belly
feel confused and have a sudden loss of vision or trouble speaking or using your arms or legs
cough, shortness of breath, coughing up blood
pain, hardening, and swelling of a vein in your arms or legs
itchiness, rash, swollen lips, face or tongue, chest and throat tightness
redness or rash in areas where you previously received radiation
severe rash that causes your skin to blister or peel
wounds that do not heal well
unusual weight gain, have a tender (hurts to touch) right side of your belly or have eyes or skin that may look yellow
lower back pain, pee less than usual, body swelling
severe headache, confusion, muscle twitching, seizures
severe muscle pain or weakness, dark-coloured pee
have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving due to tingling/numb fingers and toes

Talk to your health care team about your risk of getting other cancers after this treatment.

Who do I contact if I have questions or need help?

My cancer health care provider is: ________________________________________________

During the day I should contact:__________________________________________________

Evenings, weekends and holidays:________________________________________________

Other Notes:

____________________________________________________________________________

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

cyclophosphamide

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Symptom Management

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