Men treated with cyclophosphamide may develop oligospermia or azoospermia associated with increased gonadotropin but normal testosterone secretion. Sexual potency and libido are unimpaired in these patients. Boys treated with cyclophosphamide during prepubescence develop secondary sexual characteristics normally, but may have oligospermia or azoospermia and increased gonadotropin secretion. Some degree of testicular atrophy may occur. Cyclophosphamide-induced azoospermia is reversible in some patients, though the reversibility may not occur for several years after cessation of therapy. Men temporarily rendered sterile by cyclophosphamide have subsequently fathered normal children.
The rules and regulations for handling cytostatics in general must be observed when reconstituting or handling Cyclophosphamide. Reconstitution must, to the extent possible, be performed in a laminar air flow safety cabinet. The person handling the product must wear a protective mask and protective gloves . In case of spills, the area must be thoroughly rinsed with water. If Cyclophosphamide, Powder for Solution for Injection or Infusion is stored (. during transport) at the temperature exceeding the maximum temperature, cyclophosphamide may melt. Vials for injections containing melted cyclophosphamide can be visually recognised. Cyclophosphamide is a white powder. M elted cyclophosphamide is a clear or yellowish viscous liquid (usually found as droplets in the affected vials.). Vials for injections containing melted cyclophosphamide may no longer be used.
In treatment of cancer, the initial course of Cytoxan is usually of 40 to 50 mg/kg given intravenously (IV) in divided doses over a period of 2 to 5 days. Other intravenous regimens include 10 to 15 mg/kg given every 7 to 10 days or 3 to 5 mg/kg twice weekly. Oral Cytoxan dosing is usually in the range of 1 to 5 mg/kg/day for both initial and maintenance dosing. For non-malignant disease an oral dose of to 3 mg/kg daily for a period of 60 to 90 days is recommended. Cytoxan may interact with phenobarbital, allopurinol, digoxin, warfarin, thiazide diuretics (water pills), other chemotherapy medicines, or "live" vaccines. Tell your doctor all medications you use. Cytoxan is not recommended for use during pregnancy. It may cause harm to a fetus. Women of childbearing age and men should use birth control during treatment and for some period afterwards. This drug passes into breast milk. Because of the potential risk to the infant, breastfeeding while using this drug is not recommended.