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In patients with severe renal impairment, decreased renal excretion may result in increased plasma levels of cyclophosphamide and its metabolites. Oral cyclophosphamide dosing is usually in the range of 1 mg per kg per day to 5 mg per kg per day for both initial and maintenance dosing.

Animal data indicate that exposure of oocytes to cyclophosphamide during follicular development may result in a decreased rate of implantations and viable pregnancies, and in an increased risk of malformations.

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Female patients of reproductive potential should use highly effective contraception during and for up to 1 year after completion of treatment. Cyclophosphamide is teratogenic and embryo-fetal toxic in mice, rats, rabbits and monkeys. Advise female patients of reproductive potential to avoid becoming pregnant and to use highly effective contraception during treatment and for up to 1 year after completion of therapy [see Use in Specific Populations ]. Anorexia and, less frequently, abdominal discomfort or pain and diarrhea may occur.

After oral administration, peak concentrations of cyclophosphamide occurred at one hour. It may cause sterility in both sexes. Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

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If not used immediately, for microbiological integrity, cyclophosphamide solutions should be stored as described in Table At high doses, the fraction of parent compound cleared by 4-hydroxylation is reduced resulting in non-linear elimination of cyclophosphamide in patients.

Chemotherapy will kill all cells that are rapidly dividing. Cyclophosphamide Other Trade Name: Hyponatremia associated with increased total body water, acute water intoxicationand a syndrome resembling SIADH syndrome of inappropriate secretion of antidiuretic hormonewhich may be fatal, has been reported.

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Cyclophosphamide is an antineoplastic product. Musculoskeletal and Connective Tissue: In patients requiring dialysis, use of a consistent interval between cyclophosphamide administration and dialysis should be considered. During or immediately after the administration, adequate amounts of fluid should be ingested or infused to force diuresis in order to reduce the risk of urinary tract toxicity.

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In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac functioning, and of concomitant disease or other drug therapy.

Men treated with cyclophosphamide may develop oligospermia or azoospermia which are normally associated with increased gonadotropin but normal testosterone secretion. The following are less common side effects for patients receiving Cytoxan: Male mice and rats treated with cyclophosphamide show alterations in male reproductive organs e.

Urotoxicity can be fatal. The following adverse reactions have been identified from clinical trials or post-marketing surveillance. Different drugs may affect different parts of the body. Cyclophosphamide treatment may not be indicated, or should be interrupted, or the dose reduced, in patients who have or who develop a serious infection.