Cyclophos Adverse Reactions

Haematologic: Prolonged use of high doses may induce myelosuppression especially leukopenia. Leukocyte count less than 2000 cells/mm³ develops commonly in patients treated with an initial loading dose of the drug and less frequently in patients maintained on small doses. Thrombocytopenia and anaemia develop occasionally in patients treated with Cyclophosphamide. These effects can be reversed by reducing the drug dose or by interrupting treatment. Recovery from leukopenia usually begins after 7-10 days of cessation of therapy.
Gastrointestinal: Nausea and vomiting commonly occur with Cyclophosphamide therapy. Anorexia and less frequently, abdominal discomfort or pain and diarrhea may occur. Antiemetic therapy should be initiated to reduce the incidence of nausea and vomiting.
Dermatologic: Alopecia occurs commonly in patients treated with Cyclophosphamide but it is reversible. Pigmentation of the skin and changes in nails can occur.
Urologic: Hemorrhagic cystitis may develop in patients treated with Cyclophosphamide. These adverse effects appear depending on the dose of Cyclophosphamide and the duration of therapy and is thought to be due to Cyclophosphamide metabolites excreted in urine. Ample fluid intake during or immediately after administration of Cyclophosphamide and increased diuresis help to prevent the development of hemorrhagic cystitis. Haematuria usually resolves in a few days after Cyclophosphamide treatment is stopped but may persist in a few cases. In patients receiving doses of 10 mg/kg body weight or more and in high risk patients, concomitant administration of Mesna for protection of urinary bladder, is advisable.
Interference with gonadal function: Cyclophosphamide interferes with oogenesis and spermatogenesis. It may cause sterility in both sexes. Development of sterility appears to depend on the dose of Cyclophosphamide, duration of therapy and state of gonadal function at the start of the treatment.
Infections: Treatment with Cyclophosphamide may cause significant suppression of immune responses. Serious, sometimes fatal infections may develop in severely immunosuppressed patients. Cyclophosphamide treatment may not be indicated or should be interrupted or the dose reduced in patients who have or who develop viral, bacterial, fungal, protozoal or helminthic infections.
Others: Rare instances of anaphylactic reactions have been reported but are not typical for Cyclophosphamide.