Prescribing Cyclophosphamide for Wegener's
Cyclophosphamide (Cytoxan®) is the most commonly used cytotoxic medication used as a Wegener's treatment. People with Wegener's granulomatosis take cyclophosphamide once a day by mouth and must take the drug all at once in the morning, followed by drinking a large amount of liquid. Although the first dose of cyclophosphamide is based on the person's weight and kidney function, the doctor may adjust the dosage based on blood counts, which are monitored closely to be sure that the white blood cell count is maintained at a safe level.
When Wegener's granulomatosis was first treated, cyclophosphamide was continued for a full year beyond that point at which the disease was in remission. The dose of cyclophosphamide was then decreased gradually and eventually stopped. In more recent Wegener's granulomatosis treatment approaches, however, cyclophosphamide is given until remission and then the patient is switched to another medicine, such as methotrexate or azathioprine.
Cyclophosphamide is a powerful Wegener's medication that keeps the immune system from working normally. Therefore, doctors must monitor their Wegener's patients carefully and perform frequent blood tests.
In people with Wegener's granulomatosis, cyclophosphamide can cause an increased risk of:
- Bone marrow suppression (lowering of blood counts)
- Hemorrhagic cystitis (bleeding from the bladder)
- Bladder cancer
- Other serious side effects.