Cyclophosphamide Side Effects

Medically reviewed by Drugs.com. Last updated on May 21, 2024.

Applies to cyclophosphamide: capsule, powder for solution, solution, tablet.

Serious side effects of cyclophosphamide

Along with its needed effects, cyclophosphamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking cyclophosphamide:

More common side effects

• cough or hoarseness
• fever or chills
• lower back or side pain
• missing menstrual periods
• painful or difficult urination

With high doses and/or long-term treatment

• blood in the urine
• dizziness, confusion, or agitation
• fast heartbeat
• joint pain
• shortness of breath
• swelling of the feet or lower legs
• unusual tiredness or weakness

Less common side effects

• black, tarry stools
• pinpoint red spots on the skin
• unusual bleeding or bruising

Rare side effects

• frequent urination
• redness, swelling, or pain at the injection site
• sores in the mouth and on the lips
• sudden shortness of breath
• unusual thirst
• yellow eyes or skin

Other side effects of cyclophosphamide

Some side effects of cyclophosphamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• darkening of the skin and fingernails
• loss of appetite
• nausea or vomiting

Less common side effects

• diarrhea
• flushing or redness of the face
• headache
• increased sweating
• skin rash, hives, or itching
• stomach pain
• swollen lips

For healthcare professionals

Applies to cyclophosphamide: intravenous powder for injection, intravenous solution, oral capsule, oral tablet.

Hematologic adverse events

• Very common (10% or more): Myelosuppression (e.g., bone marrow failure, pancytopenia, neutropenia, agranulocytosis, granulocytopenia, thrombocytopenia [complicated by bleeding], leukopenia, anemia)
• Common (1% to 10%): Febrile neutropenia
• Uncommon (0.1% to 1%): Thrombocytopenia, anemia
• Rare (0.01% to 0.1%): Hemorrhage
• Very rare (less than 0.01%): Disseminated intravascular coagulation, hemolytic uremic syndrome, thromboembolism
• Frequency not reported: Agranulocytosis, lymphopenia, hemoglobin decreased^[Ref]

Gastrointestinal

• Common (1% to 10%): Mucosal inflammation
• Very rare (less than 0.01%): Enterocolitis hemorrhagic, acute pancreatitis, ascites, stomatitis, diarrhea, vomiting, constipation, nausea
• Frequency not reported: Abdominal pain, parotid gland inflammation, GI hemorrhage, cecitis, colitis, enteritis^[Ref]

Dermatologic

• Very common (10% or more): Alopecia
• Rare (0.01% to 0.1%): Rash, dermatitis, nail discoloration, skin discoloration (palms and heels)
• Very rare (less than 0.01%): Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), radiation erythema, pruritus (including itching due to inflammation)
• Frequency not reported: Erythema multiforme, palmar-plantar erythrodysesthesia syndrome (hand-foot syndrome), urticaria, erythema, facial swelling, hyperhidrosis, scleroderma^[Ref]

Genitourinary

• Very common (10% or more): Cystitis, microhematuria
• Common (1% to 10%): Impairment of spermatogenesis
• Uncommon (0.1% to 1%): Ovulation disorder (rarely irreversible)
• Rare (0.01% to 0.1%): Amenorrhea, azoospermia/asperima, oligospermia, oligospermia, lower levels of female sex hormones, blood estrogen level decreased, blood gonadotropin level increased
• Very rare (less than 0.01%): Suburethral hemorrhage, bladder wall edema, bladder fibrosis and sclerosis, atypical urinary bladder epithelial cells
• Frequency not reported: Infertility, ovarian failure, oligomenorrhea, testicular atrophy^[Ref]

Respiratory

• Uncommon (0.1% to 1%): Pneumonia (sometimes fatal)
• Very rare (less than 0.01%): Acute respiratory distress syndrome (ARDS), chronic pulmonary interstitial fibrosis, pulmonary edema, bronchospasm, dyspnea, hypoxia, cough
• Frequency not reported: Nasal congestion, oropharyngeal pain, rhinorrhea, pulmonary venoocclusive disease, obliterative bronchiolitis, alveolitis allergic,^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Cardiomyopathy, myocarditis, heart failure (sometimes fatal), tachycardia, flushing, ECG changes, decreased LVEF
• Rare (0.01% to 0.1%): Ventricular arrhythmia, supraventricular arrhythmia, chest pain
• Very rare (less than 0.01%): Ventricular fibrillation, angina, myocardial infarction, pericarditis, atrial fibrillation, hypertension, hypotension
• Frequency not reported: Ventricular tachycardia, cardiogenic shock, pericardial effusion, bradycardia, palpitation, electrocardiogram QT prolonged, pulmonary embolism, venous thrombosis, vasculitis, peripheral ischemia^[Ref]

Endocrine

• Rare (0.01% to 0.1%): Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
• Frequency not reported: Water intoxication^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Hypersensitivity reaction, anaphylactic/anaphylactoid reaction
• Very rare (less than 0.01%): Anaphylactic shock^[Ref]

Oncologic

• Rare (0.01% to 0.1%): Acute leukemia (e.g., acute myeloid leukemia, acute promyelocytic leukemia), myelodysplastic syndrome, secondary malignancies, bladder cancer, ureteric cancer
• Very rare (less than 0.01%): Tumor lysis syndrome
• Frequency not reported: Non-Hodgkin's lymphoma, sarcoma, renal cell carcinoma, renal pelvis cancer, thyroid cancer^[Ref]

Nervous system

• Rare (0.01% to 0.1%): Convulsion, dizziness
• Very rare (less than 0.01%): Dysgeusia, hypogeusia, paresthesia
• Frequency not reported: Neurotoxicity (e.g., myelopathy, peripheral neuropathy, polyneuropathy, neuralgia, dysesthesia, hypoesthesia, paresthesia, tremor, hypogeusia, parosmia), reversible posterior leukoencephalopathy syndrome (e.g., headache, altered mental functioning, seizures, abnormal vision from blurriness to vision loss), encephalopathy^[Ref]

Musculoskeletal

• Very rare (less than 0.01%): Rhabdomyolysis, cramps
• Frequency not reported: Muscle spasms, myalgia, arthralgia^[Ref]

Local

• Very rare (less than 0.01%): Injection site reactions (e.g., thrombosis, necrosis, phlebitis, inflammation, pain, swelling, erythema)

Ocular

• Rare (0.01% to 0.1%): Blurred vision, visual impairment
• Very rare (less than 0.01%): Conjunctivitis, eye edema (usually from hypersensitivity), lacrimation increased
• Frequency not reported: Blurred vision, vision loss^[Ref]

Metabolic

• Uncommon (0.1% to 1%): Anorexia, blood lactate dehydrogenase increased, C-reactive protein increased
• Rare (0.01% to 0.1%): Dehydration
• Very rare (less than 0.01%): Hyponatremia, weight gain
• Frequency not reported: Hyperglycemia, hypoglycemia^[Ref]

Psychiatric

• Common (1% to 10%): Chills, asthenia, malaise
• Very rare (less than 0.01%): Confusion^[Ref]

Hepatic

• Common (1% to 10%): Hepatic function abnormal
• Rare (0.01% to 0.1%): Hepatitis
• Very rare (less than 0.01%): Venoocclusive liver disease, hepatomegaly, jaundice
• Frequency not reported: Cholestatic hepatitis, hepatotoxicity (e.g., hepatic failure, hepatic encephalopathy, ascites, hepatomegaly, jaundice, blood bilirubin increased, hepatic enzymes increased [e.g., ASAT, ALAT, ALP, gamma-GT])^[Ref]

Other

• Very common (10% or more): Fever
• Uncommon (0.1% to 1%): Deafness
• Very rare (less than 0.01%): Multiorgan failure
• Frequency not reported: Tinnitus, premature labor, intrauterine death, fetal malformation, fetal growth retardation, fetal damage, carcinogenic effect on offspring^[Ref]

Renal

• Very rare (less than 0.01%): Renal impairment, blood creatinine increased, renal tubular necrosis
• Frequency not reported: Renal tubular disorder, toxic nephropathy, hemorrhagic urethritis, bladder contracture, nephrogenic diabetes insipidus, blood urea nitrogen increased^[Ref]

Frequently asked questions

• How does AC (Adriamycin and Cytoxan [cyclophosphamide]) work for Breast Cancer?

Further information

Cyclophosphamide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer