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Although cyclophosphamide is used to treat cancerin some patients it may increase the risk of developing another form of cancersometimes months to years after treatmentConsult your doctor for more detailsIt is important to be closely monitored by your doctor during treatmentYou should also see your doctor regularly after treatment is finishedTell your doctor right away if you developunusual growths or lumpsswollen glandsunexplained or sudden weight lossnight sweatspain in the pelvispainful or frequent urination.

Hemorrhagic cystitis may develop in patients treated with cyclophosphamideRarelythis condition can be severe and even fatalFibrosis of the urinary bladdersometimes extensivealso may develop with or without accompanying cystitisAtypical urinary bladder epithelial cells may appear in the urineThese adverse effects appear to depend on the dose of cyclophosphamide and the duration of therapySuch bladder injury is thought to be due to cyclophosphamide metabolites excreted in the urineForced fluid intake helps to assure an ample output of urinenecessitates frequent voidingand reduces the time the drug remains in the bladderThis helps to prevent cystitisHematuria usually resolves in a few days after cyclophosphamide treatment is stoppedbut it may persistMedical and/or surgical supportive treatment may be requiredrarelyto treat protracted cases of severe hemorrhagic cystitisIt is usually necessary to discontinue cyclophosphamide therapy in instances of severe hemorrhagic cystitis.

In some casesthe second malignancy developed several years after cyclophosphamide treatment had been discontinuedIn a single breast cancer trial utilizing two to four times the standard dose of cyclophosphamide in conjunction with doxorubicin a small number of cases of secondary acute myeloid leukemia occurred within two years of treatment initiationUrinary bladder malignancies generally have occurred in patients who previously had hemorrhagic cystitisIn patients treated with cyclophosphamide-containing regimens for a variety of solid tumorsisolated case reports of secondary malignancies have been publishedOne case of carcinoma of the renal pelvis was reported in a patient receiving long-term cyclophosphamide therapy for cerebral vasculitisThe possibility of cyclophosphamide-induced malignancy should be considered in any benefit-to-risk assessment for use of the drug.

Cyclophosphamide does not contain any antimicrobial preservative and thus care must be taken to assure the sterility of prepared solutionsUse aseptic technique.

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