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Cyclophosphamide interferes with oogenesis and spermatogenesisIt may cause sterility in both sexesDevelopment of sterility appears to depend on the dose of cyclophosphamideduration of therapyand the state of gonadal function at the time of treatmentCyclophosphamide-induced sterility may be irreversible in some patients.

Hemorrhagic cystitis may develop in patients treated with cyclophosphamideRarelythis condition can be severe and even fatalFibrosis of the urinary bladdersometimes extensivealso may develop with or without accompanying cystitisAtypical urinary bladder epithelial cells may appear in the urineThese adverse effects appear to depend on the dose of cyclophosphamide and the duration of therapySuch bladder injury is thought to be due to cyclophosphamide metabolites excreted in the urineForced fluid intake helps to assure an ample output of urinenecessitates frequent voidingand reduces the time the drug remains in the bladderThis helps to prevent cystitisHematuria usually resolves in a few days after cyclophosphamide treatment is stoppedbut it may persistMedical and/or surgical supportive treatment may be requiredrarelyto treat protracted cases of severe hemorrhagic cystitisIt is usually necessary to discontinue cyclophosphamide therapy in instances of severe hemorrhagic cystitis.

Handle and dispose of cyclophosphamide in a manner consistent with other cytotoxic drugs1 Caution should be exercised when handling and preparing Cyclophosphamide for InjectionUSPlyophilized powderor bottles containing cyclophosphamide tabletsTo minimize the risk of dermal exposurealways wear gloves when handling vials containing Cyclophosphamide for InjectionUSPlyophilized powderor bottles containing cyclophosphamide tabletsThe coating of the cyclophosphamide tablets prevents direct contact of persons handling the tablets with the active substanceHoweverto prevent inadvertent exposure to the active substancethe cyclophosphamide tablets should not be cutchewedor crushedPersonnel should avoid exposure to broken tabletsIf contact with broken tablets occurswash hands immediately and thoroughly.

Continued use of cyclophosphamide is contraindicated in patients with severely depressed bone marrow functionCyclophosphamide is contraindicated in patients who have demonstrated a previous hypersensitivity to itSee WARNINGS and PRECAUTIONS

CUse with caution if benefits outweigh risksAnimal studies show risk and human studies not available or neither animal nor human studies done.

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