What is cyclophosphamide?
Cyclophosphamide, also called Cytoxan, is used to treat autoimmune diseases, including multiple sclerosis. It is also used to treat cancers.
Why use cyclophosphamide in MS?
Cyclophosphamide is used in MS to slow down the overactive immune system. This overactive immune system is believed to responsible for an MS patient’s worsening condition.
In which MS patients is cyclophosphamide used?
Cyclophosphamide is used in patients who have very frequent relapses or who quickly become disabled despite treatment with the Interferons or Copaxone®.
How is cyclophosphamide given?
Cyclophosphamide is given as a monthly IV infusion. Patients receive cyclophosphamide at an outpatient infusion center and do not need to be admitted into the hospital. Each treatment takes five-six hours to administer. Other medications, including IV steroids and anti-nausea medications, are also given during the infusion.
What effect does cyclophosphamide have on pregnancy and fertility?
Cyclophosphamide can interfere with the normal menstrual period in women and temporarily stop sperm production in men. Rarely, cyclophosphamide can make one sterile. This does not mean that a patient or partner cannot become pregnant while on this treatment. Because cyclophosphamide can harm a fetus, it is important to use a reliable birth control method during this treatment.
Is it safe to breastfeed while taking cyclophosphamide?
No. Cyclophosphamide enters breast milk so a patient should not plan on breastfeeding during treatment or for several months afterwards.
What are the common side effects associated with cyclophosphamide?
Common side effects include temporarily thinned or brittle hair, darkened skin, and loss of appetite or weight. Cyclophosphamide can irritate the kidney and bladder so it is important to drink plenty of fluids before and after each infusion. Cyclophosphamide will temporarily weaken the immune system. Patients should try to avoid people with infections and should not receive live vaccines. Cyclophosphamide can interfere with fertility as described above.
What are less common side effects?
Less common side effects include painful urination or red urine, black tarry stools, unusual bruising or bleeding or rash, cough, sore throat, shortness of breath, fever, chills, swelling of the feet and ankles, and nausea.
What tests are required while I receive monthly cyclophosphamide treatments?
You must receive periodic blood tests to check your blood cells, liver and kidney function. This is so important that if you are unable or unwilling to get these lab tests, we will not feel safe giving you cyclophosphamide.