Cyclophosphamide, also called Cytoxan, is classified as a “cytotoxic agent” because it has a toxic effect on many types of cells (“good” cells as well as “bad”). Cytoxan was first used as a chemotherapy drug for the treatment of cancer.
Researchers trying to find a cure for certain types of vasculitis discovered that cytoxan was able to suppress the immune system. This medication became the first effective treatment to suppress immunologically–mediated diseases and some forms of vasculitis such as Wegener’s Granulomatosis (WG).
For vasculitis diseases, lower doses of cytoxan treatments than are used to treat cancer. However, the doses of cytoxan to treat vasculitis are still high enough to cause a significant number of side–effects. This drug must be used with great caution.
Side-effects include the following:
1. Serious bladder inflammation and bleeding from the bladder wall.
2. Anemia (low red-blood count), which causes fatigue.
3. Low platelets, which leads to a risk of bleeding
4. Risk of infection if the WBC (white blood count) becomes low (warts, shingles, and other types of infection)
5. Infertility (in men and women)
6. Premature menopause in women
7. Higher risk of developing certain types of cancer (leukemia, lumphoma, myelodysplastic anemia, skin cancer, and bladder cancer).
Prevention of possible side-effects include the following:
1. Get blood and urine tests every 2 weeks
2. Drink at least 8 eight-ounce glasses of water a day (mostly in the morning after taking the medication)
3. Take the antibiotic every day
4. Follow up with your rheumatologist as instructed
5. Keep in touch with your primary care physician
My Analysis: Cytoxan is usually taken with prednisone. There are at least two ways to take cytoxan–I.V. and orally. I took cytoxan for 11 months (every four weeks) through an I.V. My symptoms included nausea, thinning hair, low WBC, and problems with cognitive function.
I had cytoxan the second time orally for six months. I had the same symptoms. I learned to drink lots and lots of water. (I was only allowed 2 liters because I also had kidney problems).
Because of my severe vasculitis problems (almost died the first time), cytoxan was the hammer that suppressed my WG. But I had some toxic problems with it. I hope that my maintenance drug (imuran) will keep my WG in remission.
For more information about cytoxan and side-effects go here.