For the latest COVID information Click Here.
Updated February 2023
Cyclophosphamide is a medication used to treat severe inflammatory diseases (diseases which may affect kidneys, blood vessels, joints, muscles, skin, gut or eyes). This can include complicated lupus (also known as SLE), vasculitis, uveitis and scleroderma. It is also used to treat certain cancers.
Cyclophosphamide is a medication that works by suppressing your immune system. It reduces the damage done by inflammation, rather than just reducing pain.
Cyclophosphamide is a medication that works slowly. You can expect your child to gradually start feeling better, but it might take weeks to months.
Cyclophosphamide is given via a vein as an infusion, or as an oral tablet.
Tablets: Daily Infusion: Approximately once a month for up to six months.
This depends on the weight of your child. When the disease is under control, other medications may be started. The dose of cyclophosphamide may then be reduced or stopped.
People may stay on cyclophosphamide for long periods (several years) to help keep their disease under control. The dose is usually reduced after the first six months.
Cyclophosphamide is usually very effective in improving your child’s condition, but as with all medications side effects can occur. Some are common, and some are rare. Most people don’t have any problems when they take cyclophosphamide. You must have regular blood tests while you are on cyclophosphamide.
Most common side effects
Treatment
Nausea (feeling sick) vomiting, loss of appetite & diarrhoea
Hair loss
Mouth ulcers Sore gums Sore throat
Disturbance in the blood counts (change in blood tests results)
Rare side effects
Upset liver function
Cystitis (inflammation of the lining of the bladder)
Heart failure
What to do if your child is sick Don’t give cyclophosphamide if your child:
If you’re not sure, talk to your doctor, and get your child checked if necessary before giving the cyclophosphamide.
Interactions Cyclophosphamide can interact with many other medications. Talk to your doctor before your child takes any prescription medications, natural medications and medications that you can buy over the counter.
Immunisations Most immunisations are safe to have (flu vaccine, cervical cancer vaccine, killed polio vaccine (IPV) etc) when taking this medication. Live virus vaccines (such as mumps, measles, rubella (MMR), polio (OPV)), varicella (chicken pox) and some travel vaccines should not be used when taking cyclophosphamide.
Infections Patients on cyclophosphamide are at increased risk of infection, because of immune suppression. Cyclophosphamide can make chickenpox infections more serious. A blood test can be done to see if your child is already immune to the virus. If your child is in contact with chickenpox or shingles, call your doctor.
Alcohol Cyclophosphamide and alcohol are both broken down by the liver. Drinking alcohol while you are on this medication can put extra strain on the liver. It is not known how much is safe, so it is suggested that anyone on cyclophosphamide should avoid drinking alcohol.
Cancer There is an increased risk of developing different types of cancer with cyclophosphamide even many years later.
Sexual health and pregnancy Being pregnant while you are taking cyclophosphamide, it can be very bad for the baby. Patients who are sexually active, should use effective contraception to avoid getting pregnant. Women on cyclophosphamide may stop getting their periods but they usually return after the drug is stopped. Having been on cyclophosphamide may affect fertility for the future. Your doctor will discuss this before the medication is started.
Myths and misconceptions You may hear a lot of different information about cyclophosphamide from friends, pharmacists or people that you know. If you are worried about anything, please talk to your child’s doctor or nurse. If your child is taking cyclophosphamide they should see their paediatric rheumatologist regularly to make sure the treatment is working and to minimise any possible side effects.