Which side effect is associated with cyclophosphamide?

Cyclophosphamide is known for its potential to cause hemorrhagic cystitis, which is characterized by bleeding in the bladder due to irritative effects on the bladder lining. This side effect occurs because cyclophosphamide is metabolized in the liver to form toxic metabolites, including acrolein. Acrolein can accumulate in the bladder, leading to inflammation and bleeding.

The risk of hemorrhagic cystitis is particularly heightened when cyclophosphamide is administered in high doses or when adequate hydration is not maintained. As a result, clinicians often recommend increased fluid intake or co-administration of mesna, a protective agent that helps to neutralize these toxic metabolites, to minimize the incidence of this side effect.

Understanding this complication is crucial for monitoring patients receiving cyclophosphamide and implementing preventive strategies to reduce the risks associated with its use.