Instructions for After Your High-Dose Cyclophosphamide Treatment

This information will help you manage some of the side effects of your high-dose cyclophosphamide treatment while you’re at home.

Managing Side Effects

  • Cyclophosphamide can irritate the lining of your bladder. To protect your bladder, follow the instructions below:
    • The day before your treatment, drink at least 2 liters (8 to 10 cups) of liquids. Drink a variety of liquids, such as juice, water, soup, and ice-pops. Drink only 1 cup of caffeinated drinks (such as coffee or tea) per day. Continue drinking 2 liters of these liquids every day for 3 days after your treatment. Use the log on the next page to keep track of how much you drink.
    • While you are awake, try to urinate every 3 to 4 hours for 24 hours after your treatment. Urinate before you go to bed. You do not have to wake up at night to urinate.
    • You will be given an intravenous (IV) medication called mesna while you receive cyclophosphamide.
  • To prevent nausea and vomiting, take your antinausea medications as instructed.
  • Ask your doctor before taking aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), or vitamin E. These medications can cause bleeding. For more information, please review the information in the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).
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Call Your Doctor or Nurse if You:

  • Are unable to drink liquids the day after your treatment due to nausea and/or vomiting
  • Have vomiting lasting more than 24 hours
  • Have pain while you urinate or blood in your urine
  • Have a fever of 100.4° F (38° C) or higher or chills
  • Have any unexpected or unexplained problems
  • Have any questions or concerns


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Daily Liquid Log

Week: Place a check mark for each cup of liquid you drink. (1 cup = 8 ounces)
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