Home > Cyclophosphamide for Rheumatoid Arthritis
Cyclophosphamide is an immunosuppressive
medicine, which means that it decreases the effects of your body's
immune system. By interrupting the immune process,
cyclophosphamide reduces inflammation and slows joint damage caused by
rheumatoid arthritis. Cyclophosphamide is a
disease-modifying antirheumatic drug (DMARD), which means it controls the
progression of the disease. DMARDs are also called slow-acting antirheumatic
Cyclophosphamide is used for severe
rheumatoid arthritis that has not responded to other treatments, especially
when there are also complications such as inflammation of blood vessels (vasculitis).
Cyclophosphamide has been found to be
effective in treating serious complications of rheumatoid arthritis such as
vasculitis. Because of its serious side effects, cyclophosphamide is most often
reserved for use in people with severe rheumatoid arthritis that has not
responded to other treatments.1
Side effects of cyclophosphamide are
common and can include:
Severe reactions can include:
Because cyclophosphamide decreases the activity of your
body's natural immune system, fever and chills are considered serious side
effects that should be reported to your doctor immediately.
Cyclophosphamide increases the risk of infections such as herpes zoster
(shingles). Prolonged use of cyclophosphamide is
associated with an increased risk for some cancers, including bladder
If you take cyclophosphamide, you may have a slightly
greater chance of getting cancer. This risk is small. But your
doctor may check for cancer more often than if you did not take
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
Cyclophosphamide should not be used
by women who are pregnant or trying to become pregnant. If you are a woman of
childbearing age and are going to take cyclophosphamide, use some form of
reliable birth control.
If you are taking cyclophosphamide, it is
very important to drink plenty of fluids (around 3 quarts) each day to avoid
Your doctor will schedule you for regular
blood counts during treatment with cyclophosphamide.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Lipsky PE (2008). Rheumatoid arthritis. In AS Fauci et
al., eds., Harrison's Principles of Internal Medicine,
17th ed., vol. 2, pp. 2083–2092. New York: McGraw-Hill.
June 5, 2012
Anne C. Poinier, MD - Internal Medicine & Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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