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 is it given?

Cyclophosphamide injection is given as an infusion into a vein.

What if you forget a dose?

Cyclophosphamide injection will be given to you by a health professional. If you miss an appointment, contact the health professional as soon as possible.

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 Effects	Recommended 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 Irritation or pain at injection site	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.