Cyclophosphamide, a chemotherapy drug, was first developed in the 1950s by scientists at the pharmaceutical company Boehringer Ingelheim. It was introduced for clinical use in 1959, and since then, it has become an essential treatment for various cancers and autoimmune conditions. Cyclophosphamide’s approval by regulatory bodies, including the U.S. Food and Drug Administration (FDA), marked a significant breakthrough in cancer treatment. It is now widely used in oncology and rheumatology for its ability to target rapidly dividing cells.

In clinical trials, cyclophosphamide demonstrated its ability to inhibit the growth of various cancer types, including breast cancer, lymphoma, leukaemia, and multiple myeloma. Its effectiveness in autoimmune diseases, such as lupus and rheumatoid arthritis, has also been a major area of research. Ongoing clinical trials continue to explore new indications, dosages, and combination therapies to improve patient outcomes.

• Cancer Treatment (breast cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, leukaemia, ovarian cancer)
• Autoimmune Disorders (lupus nephritis, rheumatoid arthritis, systemic vasculitis)
• Bone Marrow Transplantation (pre-chemotherapy)
• Immunosuppressive Therapy (for certain autoimmune conditions)

Cyclophosphamide is available in the form of a tablet and injections. The recommended Cyclophosphamide dose for tablets is 50mg and injection is 1gm, 200mg, 500mg, 1000mg . Depending on your age, weight, and disease condition, your doctor will determine your appropriate dose and duration. Do not stop using this medicine unless your doctor instructs you. 

Common side effects include:

• Nausea and vomiting
• Hair loss (alopecia)
• Fatigue
• Loss of appetite
• Increased susceptibility to infections
• Bladder irritation and blood in urine (especially with high doses)

Less common but serious side effects include liver toxicity, cardiomyopathy, and lung fibrosis. Immediate medical attention is required if any unusual symptoms or severe side effects occur.

• Cyclophosphamide may cause severe bone marrow suppression, leading to neutropenia and thrombocytopenia. Monitoring blood counts during treatment is essential.
• The drug is teratogenic, meaning it can cause birth defects or miscarriage, and should not be used during pregnancy unless absolutely necessary.
• Increased risk of infections: Since cyclophosphamide weakens the immune system, it may increase susceptibility to infections, particularly bacterial, fungal, or viral.
• Risk of secondary malignancies: Long-term use of cyclophosphamide has been associated with an increased risk of secondary cancers, such as leukaemia and bladder cancer.

Treatment with this medicine may lead to immune suppression, bone marrow failure, cardiotoxicity, renal toxicity, pulmonary toxicity, and secondary malignancies. Inform your doctor if you have pre-existing kidney disease, immune conditions, cardiac disorders, or liver diseases. Hydration is critical when receiving cyclophosphamide intravenously to reduce the risk of hemorrhagic cystitis, a condition that can damage the bladder.

Inform the doctor if the patient has any kidney, liver, heart problems and medication taken for different medical conditions. It causes immune suppression and hence inform the doctor if there are any immunity related problems. This medication should be avoided in pregnant women and breast feeding mothers. The patient undergoing treatment with this medicine may have dizziness, blurred vision. Consult your doctor before driving and handling heavy machines.

1. Baxter, Electronic medicines compendium (emc), [ Revised on June 2016] [ Accessed on 8th April 2021], https://www.medicines.org.uk/emc/product/1815/smpc 
2. Baxter, US Food and Drug Administration, [ Revised on May 2013] [ Accessed on 7th April 2021], https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/012141s090,012142s112lbl.pdf
3. KD Tripathi, Essentials of Medical Pharmacology, Anticancer drugs, 7th edition, 2013, 860.

The drug information on this page is not a substitute for medical advice; it is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you are eligible to receive this treatment.