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DATE 11 MAY 2016




Version: 01

Artworker: Caroline Berghmans

Date: 11 MAY 2016

Errors: Yes / No PR1:

Errors: Yes / No PR2:





Draft: 2nd



Cyclophosphamide Injection 500 mg and 1 g
Cyclophosphamide monohydrate

Read all of this leaflet carefully before you
are given this medicine because it contains
important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or
• This medicine has been prescribed for you only. Do not
pass it on to others. It may harm them, even if their signs
of illness are the same as yours.
• If you get any side effects, talk to your doctor, nurse or
pharmacist. This includes any possible side effects not
listed in this leaflet. See section 4.
Throughout this leaflet, Cyclophosphamide Injection will be
called Cyclophosphamide.

Important things to know about
Your doctor has prescribed Cyclophosphamide because
you have cancer that can be treated.
Cyclophosphamide is a medicine that kills cancer cells
but, as a result, also attacks normal cells. It can therefore
have a number of side effects. Your doctor will not give
you Cyclophosphamide unless he or she thinks that your
cancer is more of a risk to you than any possible side
effects. Your doctor will check you regularly and treat any
side effects where possible.
• will reduce your blood cell count, which may make you
feel tired and be more likely to get infections.
• can affect your kidneys and bladder. You may be given
another medicine called Mesna to help prevent any
damage. If you notice blood in your urine, tell your
doctor immediately.
• like most anti-cancer or chemotherapy medicines, you
may lose your hair (anything from thinning to total loss),
although it should start to grow back once your treatment
has finished. It may also make you feel sick or be sick.
Your doctor can give you advice or medicines to help.
• Men or women should not have a child during treatment
with Cyclophosphamide or for at least 6 months after
treatment. You should use an effective contraceptive.
Ask your doctor for advice.
Now read the rest of this leaflet. It includes other
important information on the use of Cyclophosphamide
that might be especially important for you.

In this leaflet:
1. What Cyclophosphamide is and what it is used for
2. What you need to know before you are given
3. How Cyclophosphamide is given
4. Possible side effects
5. How to store Cyclophosphamide
6. Contents of the pack and other information

1 What Cyclophosphamide is and what it is
used for
Cyclophosphamide is a cytotoxic drug or anti-cancer drug.
It works by killing cancer cells, this is sometimes called
It is used to treat lots of different cancers. Cyclophosphamide
is often used together with other anti-cancer drugs or
radiotherapy. Occasionally, some doctors may prescribe
Cyclophosphamide for other conditions not related to cancer,
your doctor will tell you if this applies to you.

2 What you need to know before you are given
You will not be given Cyclophosphamide if:
• you have ever had an allergic reaction to
Cyclophosphamide. An allergic reaction can include
shortness of breath, wheezing, rash, itching or swelling of
the face and lips
• your bone marrow is not working properly (especially if you
have previously had chemotherapy or radiotherapy).
You will have blood tests to check how well your bone
marrow is working
• you have a urinary tract infection, which can be recognised
as pain when passing urine (cystitis)
• you currently have any infections
• you have ever had kidney or bladder problems as a result
of previous chemotherapy or radiotherapy
• you have a condition which decreases your ability to
urinate (Urinary outflow obstruction).

Tell your doctor if:
• you are already having, or have recently had, radiotherapy
or chemotherapy
• you have diabetes
• you have liver or kidney problems. Your doctor will check
how well your liver and kidneys are working by doing a
blood test
• you have had your adrenal glands removed
• you have heart problems or have had radiotherapy in the
area of your heart
• you have poor general health or are frail
• you are elderly.

Take special care with Cyclophosphamide
• Cyclophosphamide can have effects on your blood and
immune system.
• Blood cells are made in your bone marrow. Three different
types of blood cell are made:
– red blood cells, which carry oxygen around your body
– white blood cells, which fight infection, and
– platelets, which help your blood to clot.
• After taking Cyclophosphamide, your blood count of the three
types of cells will drop. This is an unavoidable side effect of
Cyclophosphamide. Your blood count will reach its lowest level
about 5 to 10 days after you start taking Cyclophosphamide
and will stay low until a few days after you finish the course.
Most people recover to a normal blood count within 21 to
28 days. If you have had a lot of chemotherapy in the past, it
may take a little longer to return to normal.
• You may be more likely to get infections when your blood
count drops. Try to avoid close contact with people who
have coughs, colds and other infections. Your doctor will
treat you with appropriate medicine if they think you have,
or are at risk, of an infection.
• Your doctor will check that the number of red blood cells,
white blood cells and platelets is high enough before and
during your treatment with Cyclophosphamide. They may need
to reduce the amount you are given or delay your next dose.
• Cyclophosphamide can affect wound healing. Keep any
cuts clean and dry, and check they are healing normally.
• It is important to keep your gums healthy, as mouth ulcers
and infections can occur. Ask your doctor about this if you
are unsure.
• Cyclophosphamide can damage the lining of your bladder,
causing bleeding into your urine and pain on urination. Your
doctor knows this can happen and, if necessary, he or she
will give you a medicine called Mesna which will protect
your bladder.
• Mesna can either be given to you as a short injection, or
mixed into the drip solution with your Cyclophosphamide,
or as tablets.
• More information on Mesna can be found in the Patient
Information Leaflet for Mesna Injection and Mesna tablets.
• Most people having Cyclophosphamide with Mesna do not
develop any problems with their bladder, but your doctor
may want to test your urine for the presence of blood using
a ‘dipstick’ or microscope.
• If you notice that you have blood in the urine, you must tell
your doctor straight away as they may need to stop giving
you Cyclophosphamide.
• Cancer medicines and radiation therapy can increase
the risk of you developing other cancers; this can be
a number of years after your treatment has stopped.
Cyclophosphamide has an increased risk of causing cancer
in the area of your bladder.
• Cyclophosphamide can cause damage to your heart or affect
the rhythm of it beating. This increases with higher doses of
Cyclophosphamide, if you are being treated with radiation
or other chemotherapy medicines or if you are elderly. Your
doctor will monitor your heart closely during treatment.
• Cyclophosphamide can cause inflammation or scarring in
your lungs. This can occur more than six months after your
treatment. If you start having difficulty breathing tell your
doctor straight away.
• Cyclophosphamide can have life threatening effects on
your liver.
If you have sudden weight gain, liver pain and jaundice tell
your doctor straight away.
• Hair thinning or baldness can occur. Your hair should grow
back normally though it may be different in texture or colour.


C 267

• Cyclophosphamide can make you feel sick or be sick. This
can last for about 24 hours after taking Cyclophosphamide.
You may need to be given medicines to stop feeling or
being sick. Ask your doctor about this.

Using other medicines and treatments
Tell your doctor or nurse if you are taking or have recently
taken any other medicines, including medicines you have
bought yourself. In particular, tell them about the following
medicines or treatments as they may not work well with
The following medicines can reduce how effective
Cyclophosphamide is:
• aprepitant (used to prevent being sick)
• bupropion (an anti-depressant)
• busulfan, thiotepa (used to treat cancer)
• ciprofloxacin, chloramphenicol (used to treat bacterial
• fluconazole, itraconazole (used to treat fungal infections)
• Prasugrel (used to thin the blood)
• Sulfonamides, such as sulfadiazine, sulfasalazine,
sulfamethoxazole (used to treat bacterial infections).
The following medicines can increase the toxicity of
• allopurinol (used to treat gout)
• azathioprine (used to reduce the activity of the immune
• chloral hydrate (used to treat insomnia)
• cimetidine (used to reduce stomach acid)
• disulfiram (used to treat alcoholism)
• glyceraldehyde (used to treat warts)
• protease inhibitors (used to treat viruses)
• ondansetron (used to prevent being sick)
• medicines that increase liver enzymes such as:
– rifampicin (used to treat bacterial infections)
– carbamazepine, phenobarbital, phenytoin (used to treat
– St. John’s wort (a herbal remedy for mild depression)
– Corticosteroids (used to treat inflammation)
• medicines that can increase the toxic effects on your blood
cells and immunity
– ACE inhibitors (used to treat high blood pressure).
– natalizumab (used to treat multiple sclerosis)
– paclitaxel (used to treat cancer)
– thiazide diuretics such as hydrochlorothiazide or
chlortalidone (used to treat high blood pressure or water
– zidovudine (used to treat viruses)
– Clozapine (used to treat symptoms of some psychiatric
• medicines that can increase the toxic effects on your heart
– anthracyclines such as bleomycin, doxorubicin,
epirubicin, mitomycin (used to treat cancer)
– cytarabine, pentostatin, trastuzumab (used to treat
– radiation in the area of your heart
• medicines that can increase the toxic effects on your lungs
– amiodarone (used to treat irregular heart beat)
– G-CSF, GM-CSF hormones (used to increase white blood
cell numbers after chemotherapy)
• medicines that can increase the toxic effects on your
– amphotericin B (used to treat fungal infections)
– Indomethacin (used to treat pain and inflammation).
Other medicines that can affect or be affected by
Cyclophosphamide include:
• etanercept (used to treat rheumatoid arthritis)
• metronidazole (used to treat bacterial or protozoal
• tamoxifen (used to treat breast cancer)
• bupropion (used to help stop smoking)
• coumarins such as warfarin (used to thin the blood)
• cyclosporine (used to reduce the activity of the immune
• succinylcholine (used to relax muscles during medical
• digoxin, ß-acetyldigoxin (used to treat heart conditions)
• vaccines
• verapamil (used to treat high blood pressure, angina or
irregular heart beat).

Cyclophosphamide with food and drink
Drinking alcohol can increase the nausea and vomiting
caused by Cyclophosphamide.

Pregnancy, breast-feeding and fertility
Do not become pregnant while taking Cyclophosphamide. This
is because it can cause miscarriage or damage your unborn
baby. Tell your doctor if you are pregnant, think you might be
pregnant or are trying to become pregnant.
• Men or women should not try to have a child during or for
at least 6 to 12 months after treatment. You should use an
effective contraceptive. Ask your doctor for advice.
• Cyclophosphamide can affect your ability to have children
in the future. Talk to your doctor about freezing sperm
samples or eggs before your treatment starts.
Do not breast-feed while being treated with
Cyclophosphamide. Ask your doctor for advice.

Driving or using machines
Some of the side effects of treatment with Cyclophosphamide
might affect your ability to drive and use machines safely.
Your doctor will decide if it is safe for you to do so.

What to do if you see a different doctor, or have
to go to hospital
If you see any other doctor or have to go to hospital for any
reason, tell them what medicines you are taking. Do not take
any other medicines unless your doctor knows you are taking

3 How Cyclophosphamide is given
Cyclophosphamide will be given to you by a doctor or nurse.
• It can be given as an injection or by mouth.
• When Cyclophosphamide is given as an injection, it will
normally be added to a large bag of fluid and will be slowly
injected (infused) directly into your vein. The vein can be in
your arm, the back of your hand or a large vein under your
collar bone. Depending on your dose, it will usually take
between a few minutes to an hour to be given.
• When Cyclophosphamide is given by mouth, it will usually
be made in to a solution with some flavourings (called an
‘elixir’) which will make it taste pleasant and easier to
• Cyclophosphamide is often given with other anti-cancer
drugs or radiotherapy.
The usual dose
• Your doctor will decide how much of the medicine you
need and when you should be given it.
• The amount of Cyclophosphamide you will be given
depends on:
– the type of illness you have
– how big you are (a combination of your height and weight)
– your general health
– whether you are being given other anti-cancer drugs or
having radiotherapy.
Cyclophosphamide is usually given as a series of courses of
treatment. After each course there is a break (a period when
no Cyclophosphamide is given) before the next course.
Your doctor may need to change the amount of medicine you
are given and monitor you more closely if you:
• have problems with your liver or kidneys
• you are elderly.

If you take too much Cyclophosphamide
In the event of an overdose, or if a child swallows any of
your tablets, talk to your doctor or local hospital emergency
department immediately. Hospital admission for special
treatment may be needed.

4 Possible side effects
Like all medicines, Cyclophosphamide can cause side
effects, although not everybody gets them. Side effects can
sometimes occur after ending the treatment. The following
side effects may happen with this medicine.

Tell your doctor straight away, if you notice any
of the following serious side effects:
• allergic reactions, signs of this would be shortness of
breath, wheezing, rash, itching or swelling of the face and
• getting bruises without knocking yourself, or bleeding from
your gums. This may be a sign that the platelet levels in
your blood are getting too low
• a lowering of your white blood cell count, your doctor
will check this during your treatment. It will not cause
any signs, but you will be more likely to get infections.
If you think you have an infection (a high temperature,
feeling cold and shivery, or hot and sweaty, or any signs
of infection such as a cough, or stinging on passing water)
you may need antibiotics to fight infections because your
blood count is lower than usual


DATE 11 MAY 2016



Version: 00




• very pale, lethargic and tired. This may be a sign of low red
blood cells (anaemia). Usually, no treatment is required,
your body will eventually replace the red blood cells. If you
are very anaemic, you may need a blood transfusion
• blood in your urine, pain while passing urine, or less urine
being passed.

Other possible side effects may be:
Immune system and Infections
• allergic reactions, signs of this would be shortness of
breath, wheezing, rash, itching or swelling of the face and
lips (hypersensitivity). Severe allergic reactions could lead
to difficulty in breathing or shock, with a possible fatal
outcome (anaphylactic shock, anaphylactic/anaphylactoid
• reduction in the effectiveness of your immune system
• increased risk and severity of bacterial, fungal, viral,
protozoal or parasitic infections due to the effect of
cyclophosphamide on your immune system
• reactivation of infections you have had before (latent
• severe infection spreading through the blood which may
lead to a dangerous drop in blood pressure with a possible
fatal outcome (sepsis, shock).
• cancer of your blood (leukaemia)
• cancer of the bone marrow (myelodysplastic syndrome)
• cancer of the lymphatic system (Non-Hodgkin’s lymphoma)
• secondary tumours in various parts of the body, often in
the area of the bladder
• changes to your metabolism caused by the breakdown of
the dying cancer cells (Tumour lysis syndrome).
Blood and Lymphatic System
• decrease in the activity of your bone marrow
(myelosuppression). This can cause a decrease in the
number of cells in your blood:
– white cells – which fight infection (leucopenia,
agranulocytosis, granulocytopenia, lymphopenia,
neutropenia). This may be associated with fever (febrile
– platelets – which help your blood clot
– red cells – which carry oxygen around the body
(anaemia). This may be associated with a decrease in
their ability to carry oxygen (decreased haemoglobin)
– red cells, white cells and platelets at the same time
• formation of small blood clots in your blood vessels
disrupting the normal blood flow around your body
(disseminated intravascular coagulation)
• haemolytic uremic syndrome – a condition causing
abnormal break down of the red blood cells, decreased
numbers of platelets in the blood and kidney failure.
Endocrine System
• swelling of the brain due to too much water in your
blood (water intoxication). Signs of this can be headache,
changes in personality or behaviour, confusion, drowsiness
• increase in the release of antidiuretic hormone from the
pituitary gland. This affects the kidneys causing the low
levels of sodium in your blood (hypernatremia) and water
Metabolism and Nutrition
• low blood levels of sodium which can cause tiredness and
confusion, muscle twitching, fits and coma (hyponatremia)
• accumulation of fluid in the body (water retention), which
may been seen as fluid beneath the skin or swelling in you
• high blood sugar levels which can cause thirst, tiredness
and irritability (hyperglycaemia)
• low blood sugar levels which can cause confusion and
sweating (hypoglycaemia)
• loss of appetite (anorexia)
• dehydration.
Digestive system
• feeling sick and being sick (nausea, vomiting).
• inflammation of your intestines or bowel which may
resulting in bleeding (enteritis, cecitis, hemorrhagic
• bleeding in your stomach or intestines (gastrointestinal
• tummy discomfort or severe tummy and back pain, this
may be caused by inflammation of the pancreas (acute
• Inflammation which causes abdominal pain or diarrhoea
• constipation or diarrhoea
• ulcers in the lining of your digestive system (mucosal
• inflammation of the lining of your mouth including ulcers
• swelling of the glands in your neck (parotid gland
Psychiatric Disorders
• Confusion
Nervous System
• effects on the brain (encephalopathy), signs of this can be
problems in thinking or concentrating, reduced alertness,
changes in personality, tiredness, fits, muscle twitching,
and shaking
• fits (convulsions)
• dizziness
• a syndrome called Reversible posterior
leukoencephalopathy syndrome, which can cause swelling
of the brain, headache, confusion, fits and loss of sight
• effects on the spinal cord (Myelopathy), which can cause
numbness, weakness and tingling in the hands, loss of
motor skills
• a disorder of the nerves which can cause weakness,
tingling or numbness (peripheral neuropathy). This could
be in more than one set of nerves (polyneuropathy)
• pain from your nerves, which can also feel like an aching
or burning sensation (neuralgia)
• tingling or numbness, often in the hands or feet
• shaking (tremor)
• changes in your sense of touch (dysesthesia) or loss of
sensation (hypoesthesia)
• changes in your sense of taste (dysgeusia) or loss of taste
• changes in your sense of smell (parosmia).
Eyes and Ears
• blurring, reduction or loss of sight
• inflammation of the eye (conjunctivitis)
• increased tear formation (lacrimation).
• deafness or hearing impairment
• ringing in the ears (tinnitus).
Heart and Circulation
• heart attack (myocardial infarction)
• changes in your heart rhythm (arrhythmia) which may be
noticeable (palpitations):
– irregular heart beat (fibrillation)
– faster heart beat (tachycardia), which may be life
threatening (ventricular tachycardia)
– slower heart beat (bradycardia)
• decrease in your hearts ability to pump enough blood
around your body which may be life threatening
(cardiogenic shock, heart failure or cardiac arrest)
• disease of the heart muscle (cardiomyopathy)
• inflammation of the tissues in or around your heart
(myocarditis, pericarditis)
• build up of fluid in the sac around your heart (pericardial
effusion). Increased pressure from this fluid can stop the
heart filling properly (cardiac tamponade)
• abnormal ECG heart tracing (Electrocardiogram QT
• blood clot in the lungs which causes chest pain and
breathlessness (pulmonary embolism)
• blood clot, usually in a leg, which causes pain swelling or
redness (venous thrombosis)
• inflammation of the blood vessels (vasculitis)
• reduced blood supply to your hands and feet (peripheral
ischemia ). This may cause pain, weakness, numbness,
ulcers, changes in skin colour or temperature
• low or high blood pressure (hypotension, hypertension)
• reddening of the skin (flushing) which may be
accompanied by feeling hot or sweating (hot flushing).
• life-threatening decrease of your lungs ability to transfer
oxygen in to your blood (respiratory failure)
• blood clot in the lungs which causes chest pain and
breathlessness (pulmonary veno-occlusive disease)
• scarring of the lungs which causes shortness of breath
(pulmonary fibrosis)
• conditions causing inflammation of the lungs which can
cause breathlessness, cough and raised temperature
or scarring of the lungs (pneumonitis, acute respiratory
distress syndrome, obliterative bronchiolitis, organizing
pneumonia, alveolitis allergic)
• fluid in or around the lungs (pulmonary oedema, pleural
• increased blood pressure in the lungs which can cause
shortness of breath, fatigue, cough, angina, fainting,
peripheral oedema (pulmonary hypertension)
• difficulty in breathing or wheezing (bronchospasm)
• shortness of breath (dyspnea)
• decrease levels of oxygen in your body (hypoxia)
• cough
• blocked or runny nose
• pain at the back of your throat.


C 267

• increased liver size (hepatomegaly)
• yellowing of the skin or whites of the eyes (jaundice)
• blockage of the small veins in your liver (veno-occlusive
liver disease) which can cause weight gain, increased liver
size, pain and jaundice
• conditions causing inflammation of the liver which can
cause jaundice, weight loss and malaise (hepatitis),
• disruption of the formation of bile by the liver which can
cause itchiness, jaundice, pale coloured stools, dark urine
• a build up of toxins in the body due to liver failure
(hepatotoxicity). This may affect the brain causing
confusion, reduced consciousness or coma (hepatic
• a build up of fluid in the abdomen causing swelling of the
tummy and shortness of breath (ascites)
• increased levels of certain proteins produced by your liver
called enzymes. Your doctor will do blood tests to test for
Skin and Subcutaneous Tissue
• life threatening conditions which cause rash, ulcers, sore
throat, fever, conjunctivitis, separation of skin layers (toxic
epidermal necrolysis, Stevens-Johnson syndrome)
• swelling, numbness, red lumps and peeling of skin on the
hands and feet (Palmar-plantar erythrodysesthesia syndrome)
• dark red raised itchy rash (urticaria)
• inflammation of this skin which may cause rash, blisters,
itching, sores, oozing and scarring (dermatitis)
• redness and blistering of the skin appearing months or
years after treatment (Radiation recall dermatitis)
• itchy, red rash which can develop in to sores (erythema
• changes in colour of your fingernails and skin.
• separation of the nail bed which can cause nails to fall off
• dehydration
• excessive sweating (hyperhidrosis)
• swelling of the face
• hair loss (alopecia).
Musculoskeletal and Connective Tissue
• abnormal muscle breakdown which can lead to kidney
problems (rhabdomyolysis)
• serious illness which causes thickening of the skin and the
connective tissue in your internal organs (scleroderma)
• muscle spasms
• muscle pain (myalgia) or joint pain (arthralgia).
Renal and Urinary
• life threatening decrease in the abilities of your kidney to
adequately remove toxins and waste products from the
blood (kidney failure)
• changes to the tissues within your kidneys which prevent
them from working correctly (renal tubular necrosis, renal
tubular disorder)
• damage to the kidneys by toxins in the blood (toxic
• pain and difficultly passing urine (cystitis)
• blood in the urine (haematuria)
• glucose in the urine (nephrogenic diabetes insipidus)
• inflammation of the bladder lining which causes
pain, bleeding, blood in the urine, reduced urine flow
(haemorrhagic cystitis)
• inflammation of the urethra which causes pain and
bleeding. (haemorrhagic ureteritis)
• death of the cells and tissues (necrosis), ulceration or
scaring (fibrosis) of the bladder
• decrease in the size of the bladder (bladder contracture)
• changes to the cells in the lining of your bladder
• increase in the levels of creatinine or urea nitrogen in your
blood. Your doctor will do blood tests to test for these.
Pregnancy and Fertility
• premature labour.
• infertility. Sperm production in men and egg production in
women may be reduced or stop. In some cases this can be
• absence of menstrual periods (amenorrhea) or reduced
frequency (oligomenorrhea)
• decrease in testicle size (testicular atrophy)
• decrease in the hormone oestrogen in the blood
• increase in the hormone gonadotrophin in the blood.
• use in young patients may result in some impairments of
future fertility.
Congenital, Familial and Genetic Disorders
• reduction in growth, deformity or death of a foetus while in
the womb
• toxic effects on the foetus such as myelosuppression and
General Disorders and Administrative Site Conditions
• life threatening failure of multiple organs
• general physical deterioration
• flu-like symptoms such as headache, fever, chills, joint and
muscle pain, weakness, tiredness
• chest pain
• swelling
• Injection/infusion site reactions such as swelling, redness,
pain, inflammation, tissue damage, tissue death, clot formation
• inflammation of the linings of your body cavities (mucosal

Reporting of side effects
If you get any side effects, talk to your doctor, nurse or
pharmacist. This includes any possible side effects not listed
in this leaflet. You can also report side effects directly (see
details below). By reporting side effects you can help provide
more information on the safety of this medicine.
ADR Reporting
Yellow Card Scheme

5 How to store Cyclophosphamide
Because Cyclophosphamide is usually given in hospital it will
be stored safely and correctly by the hospital staff. If you do
need the storage conditions they are given below:
• Keep this medicine out of the sight and reach of children.
• Do not use Cyclophosphamide after the expiry date which
is stated on the label after EXP. The expiry date refers to
the last day of that month.
• Do not store above 25ºC. Store in the original container.

6 Contents of the pack and other information
What Cyclophosphamide contains
The active substance is Cyclophosphamide and each vial
contains 500 mg or 1 g.
There are no other ingredients.

What Cyclophosphamide looks like and contents
of the pack
Cyclophosphamide is a dry, white powder supplied in clear
glass vials. Each carton contains one vial.

Nature and contents of container
Vials are packed with or without a protective plastic
overwrap. Protective plastic overwrap does not come into
contact with the medicinal product and provides additional
transport protection, which increases the safety for the
medical and pharmaceutical personnel.

Marketing Authorisation Holder and
The Marketing Authorisation holder is:
Baxter Healthcare Ltd
Caxton Way, Thetford, Norfolk, IP24 3SE
United Kingdom
Send all enquiries to this address.
Cyclophosphamide is manufactured by:
Baxter Oncology GmbH
Kantstrasse 2, 33790 Halle/Westfalen

This leaflet was last revised in 04/2016.

For information about
Cyclophosphamide or to request this
leaflet in formats such as audio or large
print please contact the Marketing
Authorisation Holder:
Tel: +44 (0)1635 206345.
Baxter is a trademark of Baxter International Inc.


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