This information leaflet is to help you

Rheumatology Day Unit

Answerphone 24hrs

Dr V Saravanan         

Dr K Laverick 

Dr M Khan      

Dr O Jones     

CYCLOPHOSPHAMIDE is a powerful and effective treatment for Rheumatoid Arthritis, Lupus and Vasculitis, and can be lifesaving drug in severe cases. The use of this drug allows the dose of steroids to be reduced. It is used to bring about a remission of the disease but can take around 6 weeks or more to work.

How to take it

It is given intermittently in hospital as an intravenous infusion with treatment being given at intervals varying from 1 to 8 weeks. The course of treatment will usually 3 – 6 months but may be longer depending on your exact circumstances; this will be discussed with you. Sometimes, it is given by tablet. Regular blood and urine tests are required. Your Rheumatologist will advise how often these are required.

You will normally be given steroids by infusion or by mouth prior to Cyclophosphamide.

Possible side effects

If side effects occur contact your GP or the Rheumatology Helpline number (listed above) for advice. Calls to the helpline will be answered within 1 working day.

Bladder problems can occur rarely. You will usually be given another drug, called Mesna, which will help to prevent any side effects of Cyclophosphamide on the bladder. If you notice blood in the urine, please contact the rheumatology helpline (or your GP out of hours) immediately and stop taking your Cyclophosphamide if you are taking it in tablet form.

Nausea (feeling sick) is a common side effect but can be managed with anti-sickness tablets.

Hair loss may occur but usually grows back after the course of treatment (see above).

Fertility, pregnancy and breast feeding: Cyclophosphamide may impair fertility in both men and women. This will be discussed in detail before embarking on Cyclophosphamide treatment. Women may experience irregular menstruation. You should not receive Cyclophosphamide if you are pregnant or breast feeding. Contraception, in both sexes, is advised during and for at least three months after therapy has stopped. Please contact your rheumatologist should you (or your partner) become pregnant whilst on this treatment or within 3 months of completing it.

Infection:  Cyclophosphamide can make it harder for the body to fight infection. Contact your GP or the hospital immediately if any symptoms develop to suggest an infection. Cyclophosphamide will be temporarily withdrawn if antibiotics are required. Your rheumatologist may prescribe a tablet called Co-trimoxazole during your treatment to decrease the risk of certain types of infection. Contact your GP or the day unit helpline if you come in contact with anyone who is infected with chicken pox.

Vaccination: Live vaccines should be avoided. Flu vaccine and COVID vaccines should be given prior to treatment and pneumococcal vaccine should be considered

Malignancy: Cyclophosphamide may increase the risk of certain kinds of treatable cancer. Your rheumatologist feels that the benefits of Cyclophosphamide outweigh the risks and this will be discussed with you in detail before starting treatment.

Special precautions

This drug does interact with Allopurinol which is prescribed for people with Gout. Remind your doctor if you are taking this drug. It can make some anti-diabetic drugs taken by mouth more effective. In this case the dosage will be adjusted. Alcohol can be taken in moderation.

Choosing the right drug to treat your condition is complex. Your doctor or rheumatology nurse will discuss the risks and benefits of the treatments available in clinic and a decision will be reached with you on the most appropriate treatment. If you have any further questions or concerns and wish to discuss alternative drugs, please speak to the rheumatology nurse when you are seen for education.

For additional information please refer to the patient information leaflet supplied with your medicine or refer to for the full summary of the product characteristics.