NZ Formulary

Cyclophosphamide (tablet for inflammatory conditions)


What does it do?

Cyclophosphamide is an immunosuppressant medicine used to treat inflammatory conditions such as rheumatoid arthritis and systemic lupus erythematosus (lupus/SLE). It is sometimes used for other conditions.

How should you take it?

Take cyclophosphamide regularly as directed, usually in the morning. Take with food and a glass of water. Swallow the tablets whole – do not break, crush or chew.

What if you forget a dose?

Take the missed dose as soon as possible. If it is close to the time for your next dose, skip the missed dose and carry on as normal. Do not take two doses at the same time.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort, echinacea) or recreational drugs.

What side effects might you notice?

Side EffectsRecommended action

Symptoms of allergy including: skin rash, itching, swelling, trouble breathing

Increased risk of infection - symptoms may include: fever, chills, sore throat, aches and pains, tiredness, pain when peeing, mouth ulcers

Easy/unusual bruising or bleeding

Symptoms of liver problems including: yellow skin or eyes, itching, dark urine, pale bowel motions, abdominal pain

Swollen feet or legs, fast or irregular heartbeat

Short of breath, persistent dry cough

Tell your doctor immediately

Hair loss or thinning, darkening of skin or fingernails

Changes in periods

Nausea, vomiting, loss of appetite, diarrhoea

Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

  • Tell your doctor if you have kidney, liver, bladder, blood or heart problems, or diabetes.
  • Tell your doctor if you have a long-term infection e.g. tuberculosis, HIV or hepatitis B or C.
  • Both men and women should use reliable contraception while taking cyclophosphamide, and for 3 months after stopping. If you or your partner are planning to become pregnant, or find you are pregnant, discuss this with your doctor. Tell your doctor if you are breastfeeding.
  • Cyclophosphamide can affect fertility in both men and women – discuss with your doctor.
  • Cyclophosphamide can sometimes cause bladder damage. Drinking plenty of fluids may help prevent this – discuss with your doctor.
  • You will need regular blood and urine tests while taking cyclophosphamide to monitor its effects on your kidneys, bladder and blood.
  • Protect yourself from too much sunlight while taking immunosuppressant medicines (they may increase your risk of skin cancer). Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF30) when outside. Do not use sunbeds.
  • You have an increased risk of getting an infection while taking cyclophosphamide. Discuss with your doctor.
  • Cyclophosphamide affects your immune system. Before you start and while you are using it, check with your doctor what vaccines you might need. You should not have a live vaccine while using it.
  • You may not notice the effects of cyclophosphamide straight away – it can take several weeks before you start to feel better.
  • It is important to tell anyone who gives you medical or dental treatment that you are taking cyclophosphamide.