The drug should be administered with caution in the following patients: Patients with leukopenia; thrombocytopenia; tumor cell infiltration of bone marrow; previously under X-ray therapy; previously treated with other cytotoxic agents; impaired hepatic function; impaired renal function.
Cyclophosphamide may suppress active mechanism of immune system. Therefore, the dose-controlling or discontinuance of administration in the patients with microbiosis, fungal infection or viral infection should be considered. The administration of cyclophosphamide to the patients who were recently treated with steroidal drugs, the patients with concomitant administration with steroidal drugs, and especially, the patients with zoster herpes infection may be fatal, and should be cautioned.
The drug may interfere with normal wound healing.
Since cyclophosphamide has been reported to be more toxic in adrenalectomized dogs, adjustment of the doses of both replacement steroids and cyclophosphamide may be necessary for the adrenalectomized patient.
Use in Pregnancy & Lactation: Cyclophosphamide crosses the placenta and may cause teratogenesis. In the initial pregnancy, the drug should be used only when the expected benefits clearly outweigh the potential risks. Use in patients of child-bearing potential should be cautioned.
Cyclophosphamide is excreted in breast milk. Breast feeding should be discontinued prior to the drug therapy.