• If you are allergic to anything, including medicines, dyes, additives, or foods.

• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. Also, be sure your doctor knows if you have had your adrenal glands removed. These conditions may require that your medicine dose, regimen, or timing be changed.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug may cause birth defects if either the male or female is taking it at the time of conception or during pregnancy. Men and women who are taking this drug need to use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.

• If you are breast-feeding. The drug passes into breast milk and may harm the baby.

• If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.

• If you have been treated previously with radiation or chemotherapy. Your doctor will want to monitor you more closely as you receive cyclophosphamide.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.

Tell your doctor or nurse right away if you develop signs of an allergic reaction such as rash, hives (itchy welts), fever and chills, or red blotches on your skin. If you have trouble breathing, if you have swelling or itching in your throat, lips, or mouth, or if you have other serious symptoms, get emergency help.

Cyclophosphamide can cause bleeding in your bladder. You can help prevent this by drinking extra liquids during treatment with this medicine. Your nurse or doctor can give you instructions. Let your doctor know right away if you see blood in your urine or if you have pain when you urinate.

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. This can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

This drug may cause hair loss. You may want to talk to your doctor or nurse about getting a wig before starting treatment. If your insurance does not cover it, there may be other resources to help you. Hair loss is usually temporary, and your hair will likely grow back during or after treatment.

If you need surgery of any kind, and you have had a dose of cyclophosphamide within the last 10 days, be sure that the doctor or dentist knows that you are taking this drug.

Because of the way this drug acts on cells in the body, it may increase your long-term risk of getting a second type of cancer, such as leukemia. This is rare, but if it does occur it would probably be years after the drug is used. If you are getting this drug, your doctor feels this risk is outweighed by the risk of what might happen if you do not get this drug. You may want to discuss these risks with your doctor.

• decreased white blood cell count with increased risk of infection*
• hair loss*
• nausea
• vomiting
• loss of appetite
• sores in mouth or on lips
• diarrhea
• stopping of menstrual periods in women
• decreased sperm production in men

• decreased platelet count (mild) with increased risk of bleeding*
• bleeding from bladder, with blood in urine*
• darkening of nail beds
• acne
• tiredness
• fetal changes if you become pregnant while taking cyclophosphamide

• heart problems with high doses, with chest pain, shortness of breath, or swollen feet
• severe allergic reactions*
• scarring of bladder
• scarring of lung tissue, with cough and shortness of breath
• second cancer, which can happen years after taking this drug*

*See "Precautions" section for more detailed information.