Drug Formulary information is intended for use by healthcare professionals. It is not intended to be medical advice. Some of the information, including information about funding for cancer drugs, does not apply to all patients. Cancer treatment plans are unique to each patient. If you are a patient, please speak with your healthcare team to understand how this information applies to you.

drug-infosheet

cyclophosphamide

Cancer Type
Breast, Sarcoma, Ewing's, Soft Tissue, Gynecologic, Gestational Trophoblastic Disease, Hematologic, Leukemia - Chronic Lymphocytic (CLL), Lung, Thymoma, Lymphoma - Non-Hodgkin's Low Grade, Lymphoma - Non-Hodgkin's High Grade, Lymphoma - Non-Hodgkin's Intermediate Grade, Multiple Myeloma, Lymphoma - Hodgkin, Small Cell, Gastrointestinal, Colorectal, Cervix, Endometrial, Ovary, Gastric Stomach, Esophagus, Hepatobiliary Liver Bile Duct, Pancreas, Genitourinary, Prostate, Bladder Urothelial, Endocrine, Adrenal, Lymphoma - T-cell, Head and Neck, Leukemia - Acute Lymphoblastic (ALL), Wilm's Tumour, Neuroendocrine (GI), Rare Diseases, Amyloidosis
Other Names

Procytox®
Appearance

Injection- clear solution mixed into larger bags of fluids; Oral- tablets in various strengths

cyclophosphamide

Injection/Tablets

Pronunciation:

sigh-kloe-FOSS-fa-mide

Other Name(s):

Procytox®

Appearance:

Injection- clear solution mixed into larger bags of fluids; Oral- tablets in various strengths

This handout gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on medication

People Talking

This handout was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

 

Who do I contact if I have questions or need help?

 

My cancer health care provider is: _____________________________________________

During the day I should contact: _______________________________________________

Evenings, weekends and holidays: _____________________________________________

 

This page gives general information about this cancer medication.

You will learn:

  • who to contact for help

  • what the medication is

  • how it is given

  • what to expect while on this medication

People Talking

This information was created by Ontario Health (Cancer Care Ontario) together with patients and their caregivers who have also gone through cancer treatment. It is meant to help support you through your cancer treatment and answer some of your questions.

This information does not replace the advice of your health care team. Always talk to your health care team about your treatment.

What is this treatment for?

For treating breast cancer, lung cancer, lymphomas, multiple myeloma, leukemias and other types of cancer. 

What should I do before I start this treatment?

Tell your health care team if you have or had significant medical condition(s), especially if you have / had: 

  • liver problems,

  • bladder, kidney or adrenal gland problems,

  • lung problems,

  • heart problems, including irregular heartbeat, or

  • any allergies.

Tell your health care team if have had surgery in the past 10 days or have any upcoming surgery, including dental surgery

Cyclophosphamide tablets contain a small amount of lactose. Tell your health care team if you cannot have lactose.

 

Important Icon

Remember To:

 

  • Tell your health care team about all of the other medications you are taking.

  • Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

You will have a blood test to check for hepatitis B before starting treatment. See the Hepatitis B and Cancer Medications pamphlet for more information.

How is this treatment given?

Talk to your health care team about your treatment schedule.


Injection:

  • This drug is given by injection into a vein.
     
  • If you missed your treatment appointment, talk to your health care team to find out what to do.


Tablets:

  • Take the dose at about the same time each morning.
     
  • Take it exactly as directed by your doctor. Make sure you understand the instructions.
     
  • Swallow whole with a glass of water, with meals; do not crush tablets. 
     
  • If you miss a dose, do not take a double dose. Talk to your health care team about what to do.

 

Warning: If you take too much of this medication by accident, or if you think a child or a pet may have swallowed your medication, you must call the Ontario Poison Control Center right away at: 1-800-268-9017.

 

DO this while on treatment DO NOT do this while on treatment

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  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO talk to your health care team about your risk of getting other cancers during and after this treatment.

  • DO drink plenty of fluids (unless told differently) and pee often for 2 or 3 days after your cyclophosphamide treatment to prevent bladder irritation.

  • DO tell your health care team if you plan to have any surgery (including dental surgery). Wounds may take longer to heal than normal or may not fully heal while using cyclophosphamide.  

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  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may make the drug not work as well.
DO this while on treatment

Check Mark Icon

  • DO check with your health care team before getting any vaccinations, surgery, dental work or other medical procedures.  

  • DO talk to your health care team about your risk of getting other cancers during and after this treatment.

  • DO drink plenty of fluids (unless told differently) and pee often for 2 or 3 days after your cyclophosphamide treatment to prevent bladder irritation.

  • DO tell your health care team if you plan to have any surgery (including dental surgery). Wounds may take longer to heal than normal or may not fully heal while using cyclophosphamide.  

DO NOT do this while on treatment

Stop Icon

  • DO NOT take any other medications, such as vitamins, over-the-counter (non-prescription) drugs or substances, or natural health products without checking with your health care team.

  • DO NOT start any complementary or alternative therapies, such as acupuncture or homeopathic products, without checking with your health care team.

  • DO NOT use tobacco products (such as smoking cigarettes or vaping) or drink alcohol while on treatment without talking to your health care team first. Smoking and drinking can make side effects worse and make your treatment not work as well.

  • DO NOT eat or drink grapefruit, starfruit, Seville oranges or their juices (or products that contain these) while on this treatment. They may make the drug not work as well.

Will this treatment interact with other medications or natural health products?

Yes, this medication can interact with other medications, vitamins, foods, traditional medicines and natural health products. Interactions can make this medication not work as well or cause severe side effects.

Tell your health care team about all of your:

  • prescription and over-the-counter (non-prescription) medications
  • other drugs and substances, such as cannabis/marijuana (medical or recreational)
  • natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements, or traditional medicines

Check with your health care team before starting or stopping any of them.

 

Medication Icon
Talk to your health care team BEFORE taking or using these :
  • Anti-inflammatory medications such as ibuprofen (Advil® or Motrin®), naproxen (Aleve®) or Aspirin®.
  • Over-the-counter products such as dimenhydrinate (Gravol®) 
  • Natural health products such as St. John’s Wort
  • Traditional medicines
  • Supplements such as vitamin C
  • Grapefruit juice
  • Alcoholic drinks 
  • Tobacco 
  • All other drugs or substances, such as marijuana or cannabis (medical or recreational)
What to do if you feel unwell, have pain, a headache or a fever

  • Always check your temperature to see if you have a fever before taking any medications for fever or pain (such as acetaminophen (Tylenol®) or ibuprofen (Advil®)).

    • Fever can be a sign of infection that may need treatment right away.

    • If you take these medications before you check for fever, they may lower your temperature and you may not know you have an infection.

How to check for fever:

Keep a digital (electronic) thermometer at home and take your temperature if you feel hot or unwell (for example, chills, headache, mild pain). 

  • You have a fever if your temperature taken in your mouth (oral temperature) is:

    • 38.3°C (100.9°F) or higher at any time

  •       OR

    • 38.0°C (100.4°F) or higher for at least one hour.

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If you do have a fever: 

  • Try to contact your health care team.  If you are not able to talk to them for advice, you MUST get emergency medical help right away.

  • Ask your health care team for the Fever pamphlet for more information.

 

 

 

 

 

If you do not have a fever but have mild symptoms such as headache or mild pain:

  • Ask your health care team about the right medication for you. Acetaminophen (Tylenol®) is a safe choice for most people.
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Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment.

Important Icon

Talk to your health care team if you already take low dose aspirin for a medical condition (such as a heart problem). It may still be safe to take.

How will this treatment affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

  • How this treatment may affect your sexual health

  • How this treatment may affect your ability to have a baby, if this applies to you


This treatment may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

  • If there is any chance you may become pregnant, you and your partner together must use 2 effective forms of birth control at the same time until at least 12 months after your last dose. Talk to your health care team about which birth control options are best for you. 
     

  • If you are a patient that can get somebody pregnant, you and your partner together must use 2 effective forms of birth control at the same time until at least 6 months after your last dose. Talk to your health care team about which birth control options are best for you.
     

  • Do not breastfeed while on this treatment.

How to safely store and handle this medication

This section applies to cyclophosphamide tablets:

  • Keep cyclophosphamide tablets in the original packaging at room temperature in a dry place, away from heat and light.

  • Keep out of sight and reach of children and pets.

  • Do not throw out any unused cyclophosphamide tablets at home. Bring them to your pharmacy to be thrown away safely.
     

How to safely touch oral anti-cancer medication


This section applies to cyclophosphamide tablets:

If you are a patient:

  • Wash your hands before and after touching your oral anti-cancer medication.

  • Swallow each pill whole. Do not crush or chew your pills.

If you are a caregiver:

  • Wear nitrile or latex gloves when touching tablets, capsules or liquids.
     

  • Wash your hands before putting on your gloves and after taking them off, even if your skin did not touch the oral anti-cancer medication.
     

  • Throw out your gloves after each use. Do not re-use gloves. 
     

  • Do not touch oral anti-cancer medications if you are pregnant or breastfeeding.
     

What to do if anti-cancer medication gets on your skin or in your eyes 

This section applies to cyclophosphamide tablets:

If medication gets on your skin:

  • Wash your skin with a lot of soap and water.

  • If your skin gets red or irritated, talk to your health care team.

If medication gets in your eyes:

  • Rinse your eyes with running water right away. Keep water flowing over your open eyes for at least 15 minutes.

What are the side effects of this treatment?

You may not have all of the side effects below. You may have side effects that are not listed.


Side effects and what to do When to contact doctor?
More Common Side Effects (in 10 or more out of 100 people)

Hair thinning or loss 

  • Use a gentle soft brush and avoid hair sprays, bleaches, dyes and perms.
  • In most cases, your hair will grow back after treatment, but the texture or colour may change. 
 Talk to your health care team if this bothers you

Nausea and vomiting

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens. 

To help prevent nausea:

  • Take anti-nausea medication(s) as prescribed to you by your doctor.
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

 Contact your healthcare team if nausea lasts more than 48 hours or vomiting lasts more than 24 hours

Low platelets in the blood

  • Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
  • Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often to prevent infection.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.


If you have a fever, talk to your health care team or go to the closest emergency room. 

See our Neutropenia (Low white blood cell count) pamphlet for more information.

 Get emergency medical help right away

 

 
Side effects and what to do When to contact doctor?
Less Common Side Effects (In 1 to 9 out of 100 people)

Liver problems (may be severe)

  • You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly.
  • Your doctor will monitor your liver regularly with a blood test.
 Get emergency medical help right away

Irritation of the bladder wall

You may have blood in your pee, feel the need to pee urgently, have pain in your belly/lower belly area or pain when peeing.

  • To prevent bladder problems, drink lots of water or other liquids. Your doctor may ask you to drink at least 6 to 8 cups (2 L) per day on treatment days, unless you have been told otherwise.
 Talk to your health care team as soon as possible

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

 Contact your health care team if no improvement or if severe
 

Other rare, but serious side effects are possible with this treatment.

If you have any of the following, talk to your cancer health care team or get emergency medical help right away:

  • irregular heartbeat, chest pain, fainting spells (passing out) or swelling in your legs, ankles and belly

  • feel confused and have a sudden loss of vision or trouble speaking or using your arms or legs

  • cough, shortness of breath, coughing up blood

  • pain, hardening, and swelling of a vein in your arms or legs

  • itchiness, rash, swollen lips, face or tongue, chest and throat tightness

  • redness or rash in areas where you previously received radiation

  • severe rash that causes your skin to blister or peel

  • wounds that do not heal well

  • unusual weight gain, have a tender (hurts to touch) right side of your belly or have eyes or skin that may look yellow

  • lower back pain, pee less than usual, body swelling

  • severe headache, confusion, muscle twitching, seizures

  • severe muscle pain or weakness, dark-coloured pee

  • have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving due to tingling/numb fingers and toes

     

For more information on how to manage your symptoms ask your health care provider, or visit: https://www.cancercareontario.ca/symptoms.

Notes

July 2026 MIS eng-0708

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Last Updated: July 27, 2026

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