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rkm001
04-30-2009, 04:43 AM
Mother just yesterday was taken off the Cytoxan due to her white cell blood count being extremely low. She is still on 50 mg of prednisone. Does any one know about the side effects from the Cytoxan, could this be causing her extreme weakness and lack of appetite?

JennyT
04-30-2009, 05:15 AM
i've been taking off cytocan for a while because off white cell count. Then when it went up i am back on it but a lower dose.
For myself i can't say the weakness or appetite part. My weakness had a lot to do with hemoglobin as well. did they check her kidney functions. Had a couple of dialisys and plasma's done and then it went better.

good luck
Jenny T

rkm001
04-30-2009, 05:25 AM
Mother has been on dialysis since diagnosis in March of this year. She goes 3 days a week.

andrew
04-30-2009, 05:39 AM
A low white cell count could cause weakness. Not sure about the lack of appetite though, never had that problem :eek: Common thing to come off th cytoxan while the count comes back up then go on again perhaps at a lower dose as Jenny mentioned.

rkm001
05-01-2009, 10:57 AM
Are there any other websites, that talk specifically about the symtoms after diagnosis and treatment?

Jack
05-01-2009, 04:16 PM
A lot of your mother's problems could be due to the dialysis. I know that I did not tolerate it very well at all and felt permanently ill. :(

andrew
05-01-2009, 08:34 PM
Are there any other websites, that talk specifically about the symtoms after diagnosis and treatment?

Try this one: Johns Hopkins Vasculitis Center Discusses Wegener's Granulomatosus Types of Vasculitis (http://vasculitis.med.jhu.edu/typesof/wegeners.html)

And this one: Wegeners Granulomatosis (http://my.clevelandclinic.org/disorders/Wegener_Granulomatosis/hic_Wegeners_Granulomatosis.aspx)

Both are good.

Doug
05-02-2009, 02:51 AM
Here's more than you ever wanted to know about the drug Cytoxan. The site is more for medical professionals, but, I hope you can read through this and find out what you want to know about the drug. Again, if you have guardianship or authority to talk with your mother's doctor about your concerns, please do. While we weggies can discuss our reactions to various situations, I still feel patients (or their families, where possible) need to question, question, question their doctors. Let them know you intend to know as much about the disease and treatment processes as possible, up to and not excluding involving other specialists. I find most doctors are willing to answer your questions, even deal with your fears. :confused:

Cytoxan

Side Effects & Drug Interactions


CYTOXANŽ
(cyclophosphamide) for Injection, USP
CYTOXANŽ Tablets
(cyclophosphamide) Tablets, USP
DRUG DESCRIPTION

CYTOXANŽ (cyclophosphamide for injection, USP) is a sterile white powder containing cyclophosphamide monohydrate. CYTOXAN Tablets (cyclophosphamide tablets, USP) are for oral use and contain 25 mg or 50 mg cyclophosphamide (anhydrous). Inactive ingredients in CYTOXAN Tablets are: acacia, FD&C Blue No. 1, D&C Yellow No. 10 Aluminum Lake, lactose, magnesium stearate, starch, stearic acid, and talc. Cyclophosphamide is a synthetic antineoplastic drug chemically related to the nitrogen (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=32780) mustards. Cyclophosphamide is a white crystalline powder with the molecular formula C7H15Cl2N2O2P•H2O and a molecular weight of 279.1. The chemical name for cyclophosphamide is 2-tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate. Cyclophosphamide is soluble in water, saline (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=16206), or ethanol and has the following structural formula:

http://images.rxlist.com/images/rxlist/cyclophosphamide1.gif
Last updated on RxList: 4/23/2008

[B]INDICATIONS

Nonmalignant Disease

Biopsy Proven "Minimal Change" Nephrotic Syndrome in Children

CYTOXAN is useful in carefully selected cases of biopsy proven "minimal change" nephrotic syndrome in children but should not be used as primary therapy (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=10897). In children whose disease fails to respond adequately to appropriate adrenocorticosteroid therapy or in whom the adrenocorticosteroid therapy produces or threatens to produce intolerable side effects, CYTOXAN may induce a remission. CYTOXAN is not indicated for the nephrotic syndrome in adults or for any other renal (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=5298) disease.


SIDE EFFECTS

Information on adverse reactions associated with the use of CYTOXAN (cyclophosphamide) is arranged according to body system affected or type of reaction. The adverse reactions are listed in order of decreasing incidence (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=11516). The most serious adverse reactions are described in the WARNINGS (http://www.wegeners-granulomatosis.com/forum/#) section.
Reproductive System

See WARNINGS (http://www.wegeners-granulomatosis.com/forum/#) for information on impairment of fertility (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=3412).
Digestive System

Nausea (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4510) and vomiting commonly occur with cyclophosphamide therapy (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=10897). Anorexia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2268) and, less frequently, abdominal (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=19269) discomfort or pain (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4723) and diarrhea (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2985) may occur. There are isolated reports of hemorrhagic (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=3701) colitis (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2780), oral mucosal ulceration (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=11848) and jaundice (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4070) occurring during therapy. These adverse drug effects generally remit when cyclophosphamide treatment is stopped.
Skin and Its Structures

Alopecia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2206) occurs commonly in patients treated with cyclophosphamide. The hair can be expected to grow back after treatment with the drug or even during continued drug treatment, though it may be different in texture or color. Skin rash (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=5209) occurs occasionally in patients receiving the drug. Pigmentation (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=9681) of the skin and changes in nails can occur. Very rare reports of Stevens-Johnson syndrome (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=14086) and toxic epidermal (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=32397) necrolysis have been received during postmarketing surveillance; due to the nature (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=13707) of spontaneous adverse event (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2159) reporting, a definitive causal relationship to cyclophosphamide has not been established.
Hematopoietic System

Leukopenia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4149) occurs in patients treated with cyclophosphamide, is related to the dose of drug, and can be used as a dosage guide. Leukopenia of less than 2000 cells/mm3 develops commonly in patients treated with an initial loading dose of the drug, and less frequently in patients maintained on smaller doses. The degree of neutropenia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4560) is particularly important because it correlates with a reduction in resistance (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=11958) to infections. Fever (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=3425) without documented infection (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=12923) has been reported in neutropenic patients.
Thrombocytopenia or anemia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=15491) develop occasionally in patients treated with CYTOXAN. These hematologic effects usually can be reversed by reducing the drug dose or by interrupting treatment. Recovery from leukopenia usually begins in 7 to 10 days after cessation of therapy.
Urinary System

See WARNINGS (http://www.wegeners-granulomatosis.com/forum/#) for information on cystitis (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2900) and urinary bladder (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2472) fibrosis.
Hemorrhagic ureteritis and renal (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=5298) tubular necrosis (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4514) have been reported to occur in patients treated with cyclophosphamide. Such lesions usually resolve following cessation of therapy.
Infections

See WARNINGS (http://www.wegeners-granulomatosis.com/forum/#) for information on reduced host resistance to infections.
Carcinogenesis

See WARNINGS (http://www.wegeners-granulomatosis.com/forum/#) for information on carcinogenesis.
Respiratory System

Interstitial (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=9587) pneumonitis has been reported as part of the postmarketing experience. Interstitial pulmonary fibrosis (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=10871) has been reported in patients receiving high doses of cyclophosphamide over a prolonged period.
Other

Anaphylactic reactions have been reported; death has also been reported in association with this event. Possible cross-sensitivity with other alkylating agents has been reported. SIADH (syndrome (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=5613) of inappropriate ADH secretion (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=7209)) has been reported with the use of cyclophosphamide. Malaise (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4253) and asthenia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=32122) have been reported as part of the postmarketing experience.


DRUG INTERACTIONS

The rate of metabolism (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=4359) and the leukopenic activity of cyclophosphamide reportedly are increased by chronic (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2728) administration of high doses of phenobarbital.
The physician should be alert for possible combined drug actions, desirable or undesirable, involving cyclophosphamide even though cyclophosphamide has been used successfully concurrently with other drugs, including other cytotoxic (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=19883) drugs.
Cyclophosphamide treatment, which causes a marked and persistent inhibition of cholinesterase activity, potentiates the effect of succinylcholine chloride (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=9940).
If a patient has been treated with cyclophosphamide within 10 days of general anesthesia (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=2246), the anesthesiologist (http://www.wegeners-granulomatosis.com/script/main/art.asp?articlekey=9445) should be alerted.
Adrenalectomy

Since cyclophosphamide has been reported to be more toxic in adrenalectomized dogs, adjustment of the doses of both replacement steroids and cyclophosphamide may be necessary for the adrenalectomized patient.
Wound Healing

Cyclophosphamide may interfere with normal wound healing.
Last updated on RxList: 4/23/2008