CYCLOPHOSPHAMIDE I.V.

Transcription

1 (sigh-clo-fos-fa-mide) Other names for this medication: Cytoxan, Procytox Appearance: (Brand Name) Injection: Clear solution for injection into the bloodstream. Why this medication is used: Cyclophosphamide is used to treat cancers of the breast, ovaries and lung, lymphomas and other types of cancer. How do you take this medication: Injection: Cyclophosphamide is injected into a vein by your chemotherapy nurse. It is important for you to take plenty of fluids before and to make sure that you pass lots of urine after Cyclophosphamide is given. Precautions for you: Due to increased risk of infection, check with your doctor before having any vaccinations. Before you have surgery, including dental surgery, be sure to tell your doctor or dentist that you are receiving Cyclophosphamide. What about other medications: Medication Info Sheet CYCLOPHOSPHAMIDE I.V. Ask your doctor or pharmacist before using any other medicine (such as Digoxin, Phenobarbital, Phenytoin, or Warfarin), including over-the-counter medicines, vitamins, minerals, and herbal products. If a doctor has advised you to take ASA (Aspirin) to prevent heart disease or stroke, tell your cancer doctor about this before you start cancer treatment. Otherwise, DO NOT take ASA for daily aches and pains during chemotherapy treatment; use Acetaminophen (Tylenol) products instead. (Check with your doctor or pharmacist if a product contains ASA or Acetaminophen.) It is important to tell your doctor if you have chickenpox (or have recently been exposed to someone who has had chickenpox), shingles, gout, kidney disease or liver disease. Any of these conditions could affect therapy with this medication. Revision Date: 10/14

2 Precautions for others: CYCLOPHOSPHAMIDE I.V. Cyclophosphamide is a chemotherapy drug that may be harmful to an unborn baby, or that could cause cancer in your partner or another person. Women who are pregnant or who think they might be pregnant should not handle this drug. Your family and friends must also avoid any exposure to the drug. The risk to others may persist for several days after each dose of Cyclophosphamide. Your nurse will tell you how to protect others in your home from drug exposure. Facts about sex and pregnancy: You and your partner should avoid a pregnancy while taking Cyclophosphamide. Birth control pills alone may not be effective for contraception for women taking Cyclophosphamide. It is usually recommended that you not become pregnant for at least a year after completing chemotherapy. It is important to discuss the most effective birth control with your doctor. Cyclophosphamide should not be used if you are pregnant or breast feeding. Men taking Cyclophosphamide should use condoms during sexual activities and neither men nor women should engage in unprotected sex with a woman who could be pregnant for as long as chemo precautions are in effect, at least 2-3 days after each dose of Cyclophosphamide. This drug alone, or in combination with other chemotherapy drugs, may cause fatigue, reduced sex drive, reduced sexual arousal or function, reduced sexual satisfaction and changes to any intimate relationships for both men and women. Cyclophosphamide may cause permanent changes in your ability to have children in the future (men or women) and to your menstrual cycle if you are a woman. Ask your doctor or nurse for more information. This information sheet does not contain all known information about this drug For more information on this medication, please call your doctor, pharmacist or nurse (Phone Number for your Doctor or Nurse) Or call the Canadian Cancer Society s Cancer Information Service at or at Systemic Therapy Program, Cancer Care Nova Scotia Approved by the Nova Scotia Cancer Patient Educ ation Committee Visit our Web site at: Crown copyright, Province of Nova Scotia, 2014 May be reprinted with permission from Cancer Care Nova Scotia ( ) 2 of 8

3 More Common: greater than 10 out of 100 people Signs of infection/ fever, chills, cough Low white blood cells Dizziness, confusion, agitation Missed menstrual period Tiredness or weakness Signs of anemia. Low hemoglobin levels Nausea and vomiting Hair loss (from head and body) Loss of appetite Keep a thermometer at home. Recognize the signs of infection. If your temperature is over 38 o C or 100 o F, go directly to the local Emergency Department. You may have an infection and need antibiotics. Contact your doctor as soon as possible. Contact your doctor or nurse as soon as possible if this bothers you. Otherwise, tell your doctor or nurse at your next visit. If vomiting is severe, contact your doctor or nurse right away. If you vomit within one hour of taking antivomiting tablets, you may take another dose of the antivomiting tablets. A wig, hat, cap, scarf or hair piece may be worn. Your hair will regrow, once all of your treatments are over. A high calorie meal plan is a good idea when you are not eating much. Consult with your dietitian for more information. Limit contact with people who are sick or have colds. Rest often. Wash your hands often. Rest when feeling tired or weak. Do not drive a motor vehicle or operate machinery. Eat well-balanced meals. Your doctor can order medicine for nausea and vomiting. Continue drinking clear fluids. Get fresh air and rest. Have several small meals a day. Eat slowly. Light exercise and fresh air may help. Drink plenty of fluids. Continued 3 of 8

4 Less Common: 1-10 out of 100 people Chest pain with shortness of breath Heart palpitations, rapid heart rate Swelling of feet or lower legs Heavy feeling in chest Slow or irregular heartbeats Blood clots Pain in lower legs or arms Sudden trouble breathing Reduced or lost eyesight Symptoms of disseminated intravascular coagulation (DIC) Excessive blood clots Contact your doctor or nurse immediately or go directly to the local Emergency Department. and contact your doctor or nurse, if you have any unusual pain or swelling in your arms or legs or difficulty breathing. and contact your doctor or nurse, if you have any unusual pain or symptoms of excess blood clotting or bleeding Bleeding from different areas of the body, blood in the urine Redness or red spots on the skin, skin breakdown Bladder pain Blood in urine Check with your doctor or nurse at your next appointment, or sooner if these symptoms bother you. Contact your doctor or nurse right away if you feel pain or discomfort while in the hospital or clinic. Your doctor will monitor your blood work and may order other tests to check for heart function Avoid tight clothing, don t sit with your legs crossed at the knees, maintain an active lifestyle, and drink lots of fluid. Your doctor will monitor blood clotting tests and other blood tests Drink plenty of fluids (at least eight cups daily on treatment days). Empty your bladder often. Continued 4 of 8

5 Less Common: 1-10 out of 100 people Continued Symptoms of Neuropathy Contact your doctor or nurse as soon as Dizziness possible if these symptoms bother you. Weakness on one or both sides, changes in senses, numbness, tingling or nerve pain Diarrhea, stomach pain If symptoms are severe, call your doctor or nurse right away. For less severe diarrhea, contact your doctor or nurse if it lasts longer than 24 to 48 hours, or if you feel weak. Be Reactions during or shortly after infusion of drug: Burning feeling in the face, stuffy nose Redness or pain at injection site Skin itchiness (pruritis); usually due to dry skin Skin rash or redness Decreased activity of immune system. May lead to: 5 of 8 sure to drink plenty of fluids. If you experience any of these effects, tell your chemotherapy nurse as soon as possible (while you are in the chemotherapy room). Tell your nurse if this bothers you. Increase chance for an infection Increase chance for another cancer to develop For more severe dry skin, apply more lotion than usual, use lotions that contain aloe vera or dimethicone Speak with your doctor or nurse about the chance of reduced immune function and what you need to look for. Avoid high fibre foods, such as bran, nuts, fruits & vegetables Your chemotherapy nurse will check for these symptoms during the injection. These effects are temporary, and will not last after the injection is finished. Use mild, fragrance-free soaps or liquid shower gels Apply lotions or bland emollients often. Use antidandruff shampoo and conditioner Continued

6 Less Common: 1-10 out of 100 people Continued Menstrual periods or sperm production stop Inability to conceive a baby Pain in joints, bones, muscles, or back Headache Hearing loss Earache, buzzing or feeling of fullness in the ear(s) Blurred vision, full or partial loss of vision Change of taste sensation, or loss of taste Certain foods taste unpleasant or metallic Rare: less than 1 out of 100 people Flushing, feeling of warmth Sneezing, hiccups Dizziness, sleepiness Chills Bleeding in the stomach, black, tarry stools 6 of 8 Contact your doctor or nurse to discuss hese issues and your options. If the pain or headache still bothers you after two to four days, contact your doctor or nurse. Tell your doctor or nurse at your next visit. Contact your doctor or nurse if you notice any loss of sight. Avoid eating favorite foods when taste changes Choose bland, less flavorful, less odorful foods. Eat smaller meals more frequently If you experience any of these effects, tell your chemotherapy nurse as soon as possible (while you are in the chemotherapy room). and contact your doctor or nurse as soon as possible. Your nurse or doctor may speak with you about sperm or egg banking if you are at risk of permanent fertility loss and still hope to start a family in future. Take Acetaminophen (Tylenol) one or two tablets every four hours, as needed Take note if you or your family notice you are having trouble hearing, needing things to be repeated often Consider zinc supplementation For dry mouth, consider artificial saliva products Consider the natural health product alpha lipoic acid (ALA) Your chemotherapy nurse will check for these symptoms during the injection. These effects are will not last after the injection is finished.

7 Rare: less than 1 out of 100 people Jaundice Yellow eyes or skin, itchy feeling Unusual thirst Sores in the mouth or the lips Bleeding in the stomach, black, tarry stools Symptoms of Pancreatitis Nausea and vomiting that gets worse after eating Contact your doctor or nurse at your next appointment, or sooner if these symptoms bother you. Contact your doctor or nurse as soon as you notice sores on mouth or lips. CYCLOPHOSPHAMIDE I.V Your doctor will monitor blood tests for the liver functions. Continued Maintain good mouth hygiene. Use a soft toothbrush and floss regularly Rinse your mouth at least 4 times daily with a bland mouth rinse (1 tsp salt & 1 tsp baking soda in 1 litre/4 cups of water- prepare daily). Avoid hot, spicy or acidic foods. and contact your doctor or nurse as soon as possible. Contact your doctor or nurse as soon as possible or go directly to the local Emergency Department for sudden onset symptoms Burning pain in the stomach area that spreads to the middle back Possible increase in blood pressure, heart or breathing rates Skin hives, itching; Contact your doctor or nurse if these bother severe skin reaction you. where you have had radiation Cough, shortness of breath Trouble breathing Contact your doctor or nurse right away. If symptoms are serious, go directly to the nearest local Emergency Department. Your doctor may take X-rays and check your lungs at regular clinic visits. Continued 7 of 8

8 Rare: less than 1 out of 100 people Continued Symptoms of rhabdomyolysis: Muscle pains with vomiting and confusion Brown coloured urine Symptoms of toxic Contact your doctor or nurse right away. If symptoms are serious, go directly to the nearest local Emergency Department. epidermal necrolysis: Red or darkened skin, outer skin loose or peeling from rest of body, blisters Flu-like symptoms, Sudden headache, seizures, confusion, loss of energy, loss of sight Usually more than one symptom at the same time Symptoms of a kidney problem called syndrome of inappropriate secretion of ADH: Contact your doctor or nurse IMMEDIATELY. If symptoms are serious, go directly to the nearest Emergency Department. Loss of appetite, nausea, muscle aches and weakness, muscle jerking, shaking, trouble walking straight, confusion, seizures, changes in breathing pattern Increased chance of a new cancer Your doctor will monitor your bloodwork and watch for any changes in the sodium levels and other markers at regular clinic visits. Report any unusual symptoms to your doctor 8 of 8