"CMF"
Cyclophosphamide (Cytoxan®)
Methotrexate (MTX)
Fluorouracil (5-FU)

How do these drugs work?

These are "chemotherapy" drugs that destroy cancer cells and may also kill normal cells which grow fast such as blood cells, hair, cells that line the mouth, stomach, and intestines.

Common side effects

• Lower numbers of white blood cells (which fight against infection), red blood cells (which carry oxygen), platelets (which helps blood clot). A low number of these cells may lead to infection and bleeding

• Nausea, vomiting, and diarrhea

• Hair thinning and hair loss

• Mouth & throat irritation and sores

• Irritation of the eyes

• Metallic taste and taste changes in general

• Skin reactions: rash, itchy skin, discoloration

• Fingernail splitting or darkening

• Watery or dry eyes, eye discomfort

• Menopause symptoms - hot flashes, dry vaginal mucosa

• Fatigue

Less common side effects with your type of chemotherapy:

CYCLOPHOSPHAMIDE

• Bladder bleeding and irritation

• Nasal stuffiness, sneezing, watery eyes (when Cytoxan® is given)

• Dizziness, confusion, agitation

• Yellowing of skin and/or eyes

• Sensitivity to light

• Difficulty breathing

• Swelling of legs and feet

• Yellowing of skin and/or eyes

• Liver irritation and elevated liver function tests

• Sensitivity to light

• Mild depression

• Difficulty with balance and walking

• Rare blood clots causing chest pain, heart attack, or stroke

As with any drug, other side effects that were not mentioned may occur

General concerns

• Report vomiting or nausea that is not relieved with anti-nausea medication.

• Immediately report any fevers of 101ƒ or higher, with or without chills.

• Report nose bleeds, gum bleeding, or any unusual bruising.

• Report more than 5 watery stools a day.

• Avoid direct sunlight. Wear sunscreen and sunglasses for protection.

• Ask your nurse about special mouth rinses to prevent mouth sores.

• Ask your doctor about a birth control method for you.

• Report any symptoms which are unusual for you.

Other concerns with your CMF chemotherapy

CYCLOPHOSPHAMIDE

• Should be taken on an empty stomach.

• Drink 8-10 glasses of fluid each day for two days after your treatment. If you are taking Cytoxan® by mouth, take the pill in the morning and continue drinking fluids for as long as you are taking the drug. Urinate often (about every 2 hours while awake). Drinking fluids and urinating often will help prevent any bladder damage.

• Report nasal stuffiness while getting the drug.

• Immediately report blood in urine or painful urination.

• Do not take aspirin-containing products, NSAIDs (Advil, Motrin), sulfa drugs, or alcohol while getting MTX.

• Report to your nurse, doctor, or pharmacist if you are taking anticoagulants or blood-thinners.

• Report pain or difficulty with urination.

• Report any dry cough, shortness of breath, or chest pain.

• Report any balance or movement difficulty.

• Report any chest pain, dizziness, or changes in vision to your physician or nurse.