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Updated October 2021
Cyclophosphamide (brand name: Cyclonex® Endoxan®) is a medicine used to treat severe inflammatory illnesses such as complicated systemic lupus erythematosus (SLE/lupus), myositis (muscle inflammation), scleroderma and vasculitis (inflamed blood vessels) like Granulomatosus with polyangiitis (Wegener’s granulomatosis).
Cyclophosphamide is also used in rheumatoid arthritis when there are serious complications involving organs other than the joints such as the lungs, eyes or skin. While cyclophosphamide can be very effective for rheumatoid arthritis, it is used infrequently because more effective and safer medicines have become available.
Cyclophosphamide is also used to treat some cancers.
Cyclophosphamide is an immunosuppressive medicine, which means that it works by reducing the activity of the immune system. In rheumatoid arthritis this action helps to reduce inflammation that can occur in the lungs, eyes or skin. In other diseases such as vasculitis or myositis, it reduces inflammation in other areas such as blood vessels and muscles.
When used to treat inflammatory illnesses, cyclophosphamide does not work straight away. It may take several weeks before there is some relief of symptoms.
It may take several months for the full effect to be seen.
Other medicines may be given to improve your symptoms while waiting for cyclophosphamide to work.
If you stop cyclophosphamide treatment for more than a few weeks there is a risk that your condition may worsen. Continue with your treatment unless advised by your doctor or unless side effects develop.
Cyclophosphamide can be taken by mouth as tablets or it can be given via a vein as an infusion. For long-term treatment it is normally taken in tablet form. There is only one strength of the tablet (50mg) available in Australia.
The dose depends on the disease being treated and on the person’s weight.
The oral (tablet form) dose is usually 75mg to 200mg per day. If you need to take a dose requiring half a tablet (e.g. 75mg), it is important not to break the tablets. An alternative way of taking your dose is to take 1 tablet one day and 2 tablets the next day and continue to alternate.
Cyclophosphamide can inflame the lining of the bladder so it is important to drink plenty of fluid to ‘flush out the bladder’. Eight to 10 glasses of water a day is recommended.
The tablets should be taken in the morning and should not be taken before going to bed.
Tablets should be taken whole – do not break, crush or chew the tablets.
Cyclophosphamide may be used with other arthritis medicines, including:
There are separate information sheets for the medicines mentioned above.
You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects.
A reduction in dose may minimise side effects so that you can continue to take this treatment. Your doctor will advise on any dose changes that are necessary.