Cytoxan

Cytoxan is a chemotherapy medication used for treating nephrotic syndrome in children and various types of cancer in adults. Leukemia, breast cancer, and multiple myeloma are among the types of cancer that the medication may be used to treat. Cytoxan, which is available by prescription, comes as an injection and in tablet form. Side effects can include loss of appetite, hair loss, mouth sores, and diarrhea.

What Is Cytoxan?

Cytoxan® (cyclophosphamide) is a prescription chemotherapy medication that is used to treat different types of cancer. It is also approved to treat certain kidney problems in children. Specifically, the drug is approved to treat the following cancers:
 
Cytoxan is approved to treat "minimal change" nephrotic syndrome in children (a kidney disorder) when other treatments have failed.
 
(Click Cytoxan Uses for more information, including possible off-label uses.)
 

Who Makes It?

Cytoxan is made by Bristol-Myers Squibb.
 

How Does Cytoxan Work?

Cytoxan is part of a group of medications called alkylating agents. The medication itself is not active against cancer, but it is metabolized by the liver into its active form. The active form causes "cross-linking" of DNA cells. When DNA is cross-linked, it can no longer function properly. Since DNA is essential for cells to grow and multiply, alkylating medications prevent cell growth and multiplication, and may cause cell death.
 
While Cytoxan can kill both healthy and cancerous cells, it has a greater effect on cells that are multiplying rapidly. Generally, cancer cells multiply more rapidly than healthy cells and are, therefore, more affected by the drug.
 
Cytoxan also suppresses the immune system, which is probably how it works to treat nephrotic syndrome.
 

When and How to Take It

Some general considerations for when and how to take Cytoxan include the following:
 
  • The medication comes in two forms: a tablet that is taken by mouth and an injection given through an IV. Some people take Cytoxan every day, while others take it intermittently.
     
  • Try to take the tablets on an empty stomach if possible. If the drug upsets your stomach too much, try taking it with food.
     
  • In general, it is best to take the tablets in the morning or afternoon. Taking them at night may increase your risk of bladder damage. Your healthcare provider may also recommend drinking large amounts of water to flush out and protect your bladder from damage.
     
  • For the injectable form, most people receive their injections at their healthcare provider's office, a hospital, or an "infusion center."
     
  • For the medication to work properly, it must be taken as prescribed. Cytoxan will not work as well if you stop taking it before your healthcare provider recommends.
     

Dosing Information

The dose of Cytoxan your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • Whether you are taking the tablets or injectable form of the medicine
  • The type of cancer being treated
  • Your height and weight
  • Other medications you may be taking
  • Other medical conditions you may have.
     
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
 
(Click Cytoxan Dosage for more information.)
 

Side Effects of Cytoxan

As with any medicine, side effects are possible with Cytoxan. However, not everyone who takes the drug will experience side effects. In fact, some people tolerate it quite well. If side effects do occur, in some cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
 
Side effects include but are not limited to:
 
(Click Cytoxan Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
 

Drug Interactions

Cytoxan can potentially interact with a few other medicines (see Cytoxan Drug Interactions).
 

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Cytoxan if you have:
 
  • A history of low levels of white blood cells in the blood (known medically as neutropenia) or low platelets (thrombocytopenia)
  • Undergone previous radiation treatment
  • Undergone previous chemotherapy treatment
  • A tumor that has spread to bone marrow
  • Any infection
  • Kidney disease, including kidney failure (renal failure)
  • Liver disease, including liver failure or cirrhosis
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
You should also make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Cytoxan Warnings and Precautions to learn more, including information on who should not take the drug.)
 

What If I Take an Overdose?

People who take too much Cytoxan may have overdose symptoms that could include:
 
  • Bone marrow depression (a decreased ability of the bone marrow to make blood cells)
  • Infections
  • Heart problems.
     
If you happen to take too much, seek immediate medical attention.
 
(Click Cytoxan Overdose for more information.)
 

What Should I Do If I Miss a Dose?

If you do not take your Cytoxan as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
 

Available Strengths

Cytoxan tablets are available in the following strengths:
 
  • Cytoxan 25 mg
  • Cytoxan 50 mg.
     
Injectable Cytoxan is available in various vial sizes.
 

Is There a Generic Version of Cytoxan?

Currently, both brand-name and generic versions of Cytoxan are licensed for sale (see Generic Cytoxan).
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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