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|Cytoxan Tablets

Cytoxan

Cytoxan is used for:

Treating certain types of the following cancers: lymphoma, multiple myeloma, leukemia, mycosis fungoides, neuroblastoma, ovarian cancer, eye cancer, and breast cancer. It is usually used in combination with other medicines. It may also be used to treat certain kidney problems (nephrotic syndrome) in children or for other conditions as determined by your doctor.

Cytoxan is an antineoplastic. It works by stopping or slowing the growth or spread of certain cancer cells.

Do NOT use Cytoxan if:

• you are allergic to any ingredient in Cytoxan or to other similar medicines
• you have severely suppressed bone marrow function
• you are in the first 3 months of pregnancy or you are breast-feeding
• you are taking tumor necrosis factor (TNF)-blocking medicines (eg, etanercept)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Cytoxan:

Some medical conditions may interact with Cytoxan. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are planning to become pregnant
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have an infection, chickenpox, a suppressed immune system, bone marrow suppression or other bone marrow problems, low levels of white blood cells or platelets, or liver or kidney problems
• if you are receiving or have received cytotoxic therapy or x-ray or radiation therapy
• if you have had an adrenal gland removed (adrenalectomy)
• if you are receiving or have received chemotherapy or radiation therapy

Some MEDICINES MAY INTERACT with Cytoxan. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Ondansetron because the effectiveness of Cytoxan may be decreased
• Imidazoles (eg, ketoconazole) or phenobarbital because the risk of side effects of Cytoxan may be increased
• Doxorubicin or trastuzumab because the risk of heart-related side effects and toxicity may be increased
• TNF-blocking medicines (eg, etanercept) because the risk of certain types of cancer may be increased
• Indomethacin because the risk of side effects may be increased
• Succinylcholine because actions and side effects may be increased by Cytoxan
• Digoxin because effectiveness may be decreased by Cytoxan

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cytoxan may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Cytoxan:

Use Cytoxan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Cytoxan may be taken with or without food.
• If you experience nausea, vomiting, diarrhea, or loss of appetite, contact your doctor to discuss ways to reduce these side effects.
• Drinking extra fluids and emptying your bladder regularly while you are taking Cytoxan is recommended. Check with your doctor for instructions.
• If you miss a dose of Cytoxan, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Cytoxan.

Important safety information:

• Cytoxan may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor.
• Cytoxan may lower your body"s ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rashes, or chills.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Cytoxan. If possible, inform the doctor or dentist at least 10 days before the procedure.
• Cytoxan may decrease your body"s ability to heal wounds. Discuss any questions or concerns with your doctor.
• Cytoxan may increase your chance of developing a second cancer, sometimes even years after stopping treatment with Cytoxan. Discuss any questions or concerns with your doctor.
• Cytoxan may cause infertility that is sometimes permanent. Discuss any questions or concerns with your doctor.
• Check with your doctor before receiving any vaccinations while you are using Cytoxan.
• The use of birth control is recommended while using Cytoxan.
• LAB TESTS, including complete blood cell counts, platelet counts, and urine tests, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
• Use Cytoxan with caution in the ELDERLY because they may be more sensitive to its effects.
• PREGNANCY and BREAST-FEEDING: Cytoxan has been shown to cause harm to the fetus. Avoid becoming pregnant while you are using Cytoxan. If you think you may be pregnant, discuss with your doctor the benefits and risks of using Cytoxan during pregnancy. Cytoxan is excreted in breast milk. Do not breast feed while taking Cytoxan.

Possible side effects of Cytoxan:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Appetite loss; absence of menstrual periods;color change in skin; diarrhea; general unwell feeling; hair loss; nausea; skin rash; stomach discomfort or pain; texture change in nails; vomiting; weakness.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in urine; bloody or black tarry stools; chest pain; chills; fever; hallucinations; increased or decreased urination; infection; lower back or abdominal pain; painful urination; persistent cough; pneumonia; red, swollen, or blistered skin; seizures; severe stomach pain; shortness of breath; sore throat; sores in the mouth; swelling of the hands or feet; unusual bruising or bleeding; unusual or severe tiredness or weakness; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm ), or emergency room immediately. Symptoms may include back or stomach pain; fast heartbeat; red or bloody urine; weakness.

Store Cytoxan at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Keep Cytoxan out of the reach of children and away from pets.

General information:

• If you have any questions about Cytoxan, please talk with your doctor, pharmacist, or other health care provider.
• Cytoxan is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Cytoxan. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.