Cyclophosphamide

Cyclophosphamide is type of drug known as a疾病改良的抗风湿药（DMARD）。

When people have an autoimmune condition, the body’s immune system can mistakenly cause harm to healthy tissues. Cyclophosphamide can stop this happening by reducing the effects of the overactive immune system.

It can be prescribed for more serious forms of the following conditions:

• lupus（厕所）
• 血管炎（vask-you-lie-tus）
• myositis(my-o-sy-tus)
• systemic sclerosis（SIS-TEM-IC Skle-ro-SIS）
• Sjögren’s syndrome(show-grin’s sin-drome)
• 非常稀有，类风湿关节炎(roo-ma-toy-d arth-ri-tus).

环磷酰胺对许多人来说是一种非常有效的药物。但是并不是每个人都可以接受。

You will need to have tried other drugs to treat your condition before you can be prescribed cyclophosphamide.

在开始环磷酰胺之前，您的医生需要检查您是否曾经暴露于结核病（TB），以及B和丙型肝炎。这是因为环磷酰胺可以增加这些疾病的风险。如果测试是肯定的，则可能需要治疗方案才能首先解决这些问题。

Your doctor will also arrange a series of urine and blood tests before and during treatment to check this drug is right for you. You may be asked to keep a record of your test results in a booklet, and you should bring this with you when you visit your GP or the hospital.

可以采取环磷酰胺：

• through a drip into a vein. This process is known as an intravenous infusion and is carried out in a hospital or a special clinic.
• 作为低剂量片剂。这些通常每天服用一次。您可以将它们带走或不用食物，但要确保用大量水吞下它们。

您的医生将与您讨论这些选择。

您处方的剂量将取决于您的体重，并且可能会根据您对药物的反应方式而改变。

Cyclophosphamide doesn’t work straight away. It may take several weeks before you notice an improvement. It’s important to attend your planned infusions or take the cyclophosphamide tablets as directed, even if it doesn’t seem to be working at first.

当您的症状改善并开始感觉更好，以控制状况时，您还应该继续按照规定的方式进行服用。

If you forget to take a dose, contact the healthcare professionals in charge of your care. They can advise on whether you should take the missed dose straight away or just skip it.

As with all drugs, cyclophosphamide can sometimes cause side effects. If you have severe side effects or are concerned about any of your symptoms, contact one of the healthcare professionals in charge of your care.

环磷酰胺的常见副作用是感觉或生病。您的医生可能会开具反挑食药物来控制这一点。

由于其对免疫系统的影响，环磷酰胺可以使您更有可能患上感冒症状或吸收感染。如果您在开始环磷酰胺后出现以下任何症状，则应立即告诉医生或风湿病护士：

• 喉咙痛或咳嗽
• 高温或发烧
• 皮疹。

你的风湿病学团队如果chickenp联系ox or shingles, or if you come into contact with someone who has them and you have never had chickenpox before. These illnesses can be worse than usual if you’re taking cyclophosphamide. You may need treatment for them and your cyclophosphamide may need to be stopped until you’re better.

如果您注意到尿液中的血液，请尽快去看医生。这可能是膀胱炎（SIS-TYE-TIS）的迹象，这是膀胱壁发炎引起的。

为了减少这种情况的风险，可能会要求您每天喝8-10杯（2-3升）的液体。您可能会开处方一种称为Mesna的药物，以降低膀胱炎的风险。

环磷酰胺有时会导致您的血液计数，肝脏问题，脱发和口腔溃疡的减少。

There’s also a slightly increased risk of certain types of cancer, particularly bladder cancer, but cyclophosphamide will not be recommended for you unless the benefits of treatment are thought to be much greater than the risks. You should discuss this with your doctor or nurse specialist.

减少感染风险的提示

• 尽量避免与您认识的感染者密切接触。
• 定期洗手，携带一小瓶抗菌手凝胶。
• Keep your mouth clean by brushing your teeth regularly.
• Stop smoking if you’re a smoker.
• Make sure your food is stored and prepared properly.
• 尝试保持房屋清洁和卫生，尤其是厨房，浴室和厕所。

Cyclophosphamide may be prescribed alongside other drugs to treat your condition, or examplesteroid tabletsor类固醇注射。

Some drugs can interact with cyclophosphamide, so speak to your doctor before starting any new medications.

请记住，如果您受到平时以外的任何人的治疗，请提及您使用环磷酰胺rheumatology team，因为它不会从GP中出现在您的重复处方列表中。

你可以继续非甾体类抗炎药（NSAIDS）orpainkillersif needed, unless your doctor advises otherwise.

Don’t take over-the-counter preparations or herbal remedies without talking to your healthcare team or pharmacist first, as some of them may react badly with cyclophosphamide.

疫苗接种

It’s usually recommended that people on cyclophosphamide avoid live vaccines such as measles, mumps and rubella (MMR), chickenpox and yellow fever. But sometimes a live vaccine may be necessary, so you should discuss this with your rheumatology team.

If you’ve never had chickenpox, it’s good to get a vaccination against it before starting cyclophosphamide. But discuss this with your rheumatology team first. 

It’s also a good idea to get any family or household members vaccinated against chickenpox before you start taking cyclophosphamide. 

The Zostavax shingles vaccine is a live vaccine and isn’t recommended for people who are on cyclophosphamide. However, a non-live shingles vaccine (Shingrix) is available so you may be able to have this instead. 

建议您进行针对Covid-19的疫苗接种。建议您在服用环磷酰胺时接受肺炎疫苗和年度流感疫苗的注射。这些疫苗不是活的，因此可以安全地使用它们。

If you’re unsure about whether you should be having a vaccine, make sure to have a chat with your rheumatology team.

有操作

If you are due to have surgery talk this over with your specialists. You may be advised to stop cyclophosphamide for a few weeks before and after your surgery.

对于大多数服用环磷酰胺的人来说，喝酒不会引起任何问题。有些人发现酒精和环磷酰胺的结合会导致他们感到或生病。

尝试遵守政府指南，该准则说，男人和女人每周的酒精应不超过14单位。这相当于大约六杯酒或六品脱啤酒。最好不要保存您的14个单元并立即将它们全部保存，并尝试每周至少有两天的无酒精饮料。

You can find out more about units of alcohol atwww.drinkaware.co.uk。

Cyclophosphamide can affect your fertility. This is your ability to become pregnant or father a child. If this is an issue for you, speak to your doctor before you start treatment.

如果怀孕或试图怀孕，您不应服用环磷酰胺。服用环磷酰胺的男女应使用避孕。建议妇女应在治疗结束后一年继续使用避孕药，并应这样做六个月。

If you’re planning a family or you become pregnant while taking cyclophosphamide, talk to your doctor as soon as possible.

如果您使用环磷酰胺，则不应母乳喂养，因为它可能会进入母乳。