When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you have had an allergic reaction to cyclophosphamide, or if you are pregnant or breastfeeding.

How to Use This Medicine:
Injectable

• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine. It may also be given by a home health caregiver.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• Tell your caregiver right away if any of the medicine gets on your skin.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.
• Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how cyclophosphamide works. Tell your doctor if you are also using cyclosporine, etanercept, pentostatin, a protease inhibitor, tamoxifen, a thiazide diuretic (water pill), trastuzumab, or warfarin.
• Talk to your doctor before you get any vaccines, such as a flu shot.

Warnings While Using This Medicine:

• This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant. Women should avoid pregnancy for 1 year after treatment ends. Men should use birth control for 4 months after treatment ends so their partner does not become pregnant.
• Make sure your doctor knows if you have kidney disease, liver disease, heart disease, or lung disease.
• This medicine may cause the following problems:
  
  • Infertility
  • Liver disease
  • Kidney and urinary tract problems
  • Heart and lung problems
  • Slow or delayed healing
  • Secondary cancers
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Blood in your urine or stools, painful urination
• Chest pain, trouble breathing
• Dark urine or pale stools, yellow skin or eyes
• Fast, pounding, or uneven heartbeat
• Fever, chills, cough, sore throat
• Rapid weight gain, swelling in your hands, ankles, or feet
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Changes in your menstrual periods
• Hair loss, changes in skin or nail color
• Nausea, vomiting, loss of appetite
• Pain, swelling, itching, or irritation where the IV needle is placed
• Sores or white patches in your mouth or throat

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088