Cytoxan (cyclophosphamide) interacts significantly with several medications. Concurrent use with live attenuated vaccines should be avoided due to the risk of severe infections. Avoid concurrent administration with allopurinol, as it may increase the risk of neutropenia.
Concurrent use with other bone marrow suppressive agents, such as methotrexate or radiation therapy, increases the risk of myelosuppression. Monitor blood counts closely.
Drugs metabolized by the liver (e. g., some anticoagulants) may experience altered metabolism with Cytoxan, requiring careful dose adjustments. Monitor patients for bleeding or clotting irregularities.
Patients with pre-existing kidney or liver impairment require careful dose adjustment and frequent monitoring of organ function. Cytoxan is contraindicated in patients with significant hepatic or renal dysfunction.
Pregnancy and breastfeeding are absolute contraindications due to the known teratogenic effects and potential harm to the infant. Effective contraception is mandatory.
Patients with a history of hemorrhagic cystitis should use caution. Adequate hydration and mesna should be considered to prevent this complication.
Inform patients about the increased risk of infections and the importance of prompt medical attention for any signs of infection. Always review the complete medication list of the patient to identify potential drug interactions before starting Cytoxan therapy.
