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Cytoxan (cyclophosphamide) Disease Interactions

There are 6 disease interactions with Cytoxan (cyclophosphamide):

Major

Cyclophosphamide (Includes Cytoxan) ↔ myelosuppression

Severe Potential Hazard, High plausibility. Applies to: Fever, Bleeding, Bone Marrow Depression/Low Blood Counts, Infection - Bacterial/Fungal/Protozoal/Viral

The use of cyclophosphamide can cause myelosuppression (leukopenia, neutropenia, thrombocytopenia and anemia), bone marrow failure, and severe immunosuppression which may lead to serious and sometimes fatal infections, including sepsis and septic shock. Close monitoring of complete blood counts is essential during cyclophosphamide treatment so that the dose can be adjusted, if needed. Cyclophosphamide should not be administered to patients with neutrophils <1,500/mm3 and platelets < 50,000/mm3. Cyclophosphamide treatment may not be indicated, or should be interrupted, or the dose reduced, in patients who have or who develop a serious infection. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding.

References

  1. "Product Information. Cytoxan (cyclophosphamide)." Bristol-Myers Squibb, Princeton, NJ.
Major

Cyclophosphamide (Includes Cytoxan) ↔ urinary tract obstruction

Severe Potential Hazard, Moderate plausibility. Applies to: Urinary Tract Obstruction, Urinary Tract Infection, Cystitis

The use of cyclophosphamide is contraindicated in patients with any urinary outflow obstruction. Before treatment initiation, urinary obstruction should be excluded or corrected. Hemorrhagic cystitis, pyelitis, and hematuria have been reported during cyclophosphamide therapy. Adequate hydration and use of a prophylactic agent such as mesna prior to each course of cyclophosphamide therapy reduces bladder irritation and hematuria. Therapy with cyclophosphamide should be administered cautiously in patients with or predisposed to cystitis, including patients with active urinary infections. Treatment should be discontinued if there is sign of urotoxicity as hemorrhagic cystitis, bladder ulceration, necrosis, fibrosis, contractures, etc. Urinary sediment should be checked regularly for presence or erythrocytes and other signs of toxicity.

References

  1. "Product Information. Cytoxan (cyclophosphamide)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Cyclophosphamide (Includes Cytoxan) ↔ cardiac disease/cardiotoxicity

Moderate Potential Hazard, Moderate plausibility. Applies to: Heart Disease

Myocarditis, myopericarditis, pericardial effusion including cardiac tamponade, and congestive heart failure, which may be fatal, have been reported with cyclophosphamide therapy. Supraventricular arrhythmias and ventricular arrhythmias (including severe QT prolongation associated with ventricular tachyarrhythmia) have been reported after treatment with regimens that included cyclophosphamide. The risk of cardiotoxicity may be increased with high doses of cyclophosphamide, in patients with advanced age, and in patients with previous radiation treatment to the cardiac region and/or previous or concomitant treatment with other cardiotoxic agents.
Particular caution is necessary in patients with risk factors for cardiotoxicity and in patients with preexisting cardiac disease. These patients should be closely monitored.

References

  1. "Product Information. Cytoxan (cyclophosphamide)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Cyclophosphamide (Includes Cytoxan) ↔ hepatic dysfunction

Moderate Potential Hazard, Low plausibility. Applies to: Liver Disease

Cyclophosphamide is metabolized by the liver to a biologically active form. Metabolic activation and therapeutic activity may be altered in patients with hepatic impairment. Additionally, Veno-occlusive liver disease (VOD) sometimes with fatal outcome has been reported in patients receiving cyclophosphamide- containing regimens. VOD has also been reported to develop gradually in patients receiving long-term low-dose immunosuppressive doses of cyclophosphamide. Preexisting disturbances of hepatic function seems to also be a risk factor. Therapy with cyclophosphamide should be administered cautiously in patients with compromised hepatic function.

References

  1. "Product Information. Cytoxan (cyclophosphamide)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Cyclophosphamide (Includes Cytoxan) ↔ pulmonary impairment

Moderate Potential Hazard, Moderate plausibility. Applies to: Pulmonary Impairment

Pneumonitis, pulmonary fibrosis, pulmonary veno-occlusive disease and other forms of pulmonary toxicity leading to respiratory failure have been reported during and following treatment with cyclophosphamide. Pneumonitis may develop years after treatment with cyclophosphamide. Patients should be monitored for signs and symptoms of pulmonary toxicity. Caution is advised in patients with preexisting pulmonary impairment.

Moderate

Cyclophosphamide (Includes Cytoxan) ↔ renal dysfunction

Moderate Potential Hazard, Low plausibility. Applies to: Renal Dysfunction

In patients with severe renal impairment, decreased renal excretion may result in increased plasma levels of cyclophosphamide and its metabolites, which may result in increased toxicity. Monitor patients with severe renal impairment (CrCl =10 mL/min to 24 mL/min) for signs and symptoms of toxicity. Therapy with cyclophosphamide should be administered cautiously in patients with a history of or predisposition to renal dysfunction. Clinical monitoring of renal function is recommended.

References

  1. "Product Information. Cytoxan (cyclophosphamide)." Bristol-Myers Squibb, Princeton, NJ.

Cytoxan (cyclophosphamide) drug interactions

There are 347 drug interactions with Cytoxan (cyclophosphamide)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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