Instructions for Managing Side Effects of Your High-Dose Cyclophosphamide Treatment

This information will help you manage some of the side effects of your high-dose cyclophosphamide treatment.

Cyclophosphamide can irritate the lining of your bladder. To protect your bladder, follow the instructions below. If your doctor or nurse gave you different instructions, follow the instructions they gave you.

Before Your Treatment

The day before your treatment, drink at least 8 to 10 (8-ounce) servings (at least 2 liters) of liquids.

  • Drink different types of liquids, such as juice, water, soup, and ice-pops.
  • Don’t drink more than 1 (8-ounce) serving of caffeinated liquids, such as coffee, tea, or cola.
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The Day of Your Treatment

The day of your treatment, drink at least 8 to 10 (8-ounce) servings (at least 2 liters) of liquids. Drink before, during, and after your treatment visit.

  • Drink different types of liquids, such as juice, water, soup, and ice-pops.
  • Don’t drink more than 1 (8-ounce) serving of caffeinated liquids, such as coffee, tea, or cola.

During your cyclophosphamide treatment, you will have an intravenous (IV) line. You will get fluids and a medication called mesna through your IV line. The fluids and mesna will help protect your bladder during your treatment. Try to urinate (pee) every 2 hours during your treatment.

After your treatment, try to urinate every 3 to 4 hours while you’re awake. Urinate before you go to bed. You don’t have to wake up at night to urinate.

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After Your Treatment

For about 24 hours after your treatment, urinate every 3 to 4 hours. You don’t have to wake up at night to urinate.

For 3 days after your treatment, drink 8 to 10 (8-ounce) servings (about 2 liters) of liquids every day.

  • Drink different types of liquids, such as juice, water, soup, and ice-pops.
  • Don’t drink more than 1 (8-ounce) serving of caffeinated liquids, such as coffee, tea, or cola each day.

To prevent nausea (feeling like you’re going to throw up) and vomiting (throwing up), 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, read our resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

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Call Your Doctor or Nurse if You:

  • Can’t drink liquids the day after your treatment because you have nausea, vomiting, or both
  • 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

Keep track of the liquids you drink to make sure you’re meeting your goals. Make a checkmark for each cup of liquid that you drink. One cup is equal to 8 ounces.

Remember that your goal is to drink 8 to 10 (8-ounce) servings (about 2 liters) the day before your treatment, the day of your treatment, and for 3 days after your treatment.

  1 2 3 4 5 6 7 8 9 10
Day before treatment                    
Day of treatment                    
Day 1 after treatment                    
Day 2 after treatment                    
Day 3 after treatment                    
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