Just as with other cytostatics, bone marrow depression and gastrointestinal toxicity are the most important adverse reactions. Nausea and vomiting are often immediately related to the treatment; the leukocytes and the thrombocytes reach their nadir 1 to 2 weeks into the treatment. At least half of the treated subjects develop (often complete), occasionally reversible, alopecia. Cyclophosphamide sometimes causes a (sterile) hemorrhagic cystitis (ensure ample fluid supply!).

There is frequent development of sometimes irreversible amenorrhea and azoospermia. Hepatic function disorders, hyperpigmentation, pulmonary fibrosis (mostly lethal), heart failure, pericardial effusion do not occur frequently. Delayed consequences: acute leukemia, bladder cancer.

Cyclophosphamide: Interactions

In combination with other cytostatics: increased myelotoxicity! Together with doxorubicin there is an increased risk of cardiotoxic effects. Allopurinol reinforces the effects of cyclophosphamide. The effect of suxamethonium is increased by cyclophosphamide.

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