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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.

In some casesthe second malignancy developed several years after cyclophosphamide treatment had been discontinuedIn a single breast cancer trial utilizing two to four times the standard dose of cyclophosphamide in conjunction with doxorubicin a small number of cases of secondary acute myeloid leukemia occurred within two years of treatment initiationUrinary bladder malignancies generally have occurred in patients who previously had hemorrhagic cystitisIn patients treated with cyclophosphamide-containing regimens for a variety of solid tumorsisolated case reports of secondary malignancies have been publishedOne case of carcinoma of the renal pelvis was reported in a patient receiving long-term cyclophosphamide therapy for cerebral vasculitisThe possibility of cyclophosphamide-induced malignancy should be considered in any benefit-to-risk assessment for use of the drug.

As with any printed referencethe use of particular drugsregimens and drug dosages may become out-of-date over timesince new information may have been published and become generally accepted after the latest update to this printed informationPlease keep in mind that health care professionals are fully responsible for practicing within current standardsavoiding use of outdated regimensemploying good clinical judgment in selecting drugs and/or regimensin calculating doses for individual patientsand verifying all dosage calculations.

Do not increase your dose or take this medication more often without your doctor’s approvalYour condition will not improve any faster and the risk of serious side effects may be increased.

In some casesthe second malignancy developed several years after cyclophosphamide treatment had been discontinuedIn a single breast cancer trial utilizing two to four times the standard dose of cyclophosphamide in conjunction with doxorubicin a small number of cases of secondary acute myeloid leukemia occurred within two years of treatment initiationUrinary bladder malignancies generally have occurred in patients who previously had hemorrhagic cystitisIn patients treated with cyclophosphamide-containing regimens for a variety of solid tumorsisolated case reports of secondary malignancies have been publishedOne case of carcinoma of the renal pelvis was reported in a patient receiving long-term cyclophosphamide therapy for cerebral vasculitisThe possibility of cyclophosphamide-induced malignancy should be considered in any benefit-to-risk assessment for use of the drug.

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