Cellcept; Patients receiving immunosuppressive regimens involving combinations of drugs, including CellCept, as part of an immunosuppressive regimen are at increased risk of developing lymphomas and other malignancies, particularly of the skin. However, this risk is directly related to the the dosage and duration of immunosuppression, rather than to the use of any specific drug. As usual for Lupus patients, exposure to sunlight and UV light should be limited by wearing protective clothing and using a sunscreen with a high protection factor. I've never heard of any precautions about being in the pool. The most common side effects are (and they all do not happen to everyone): diarrhea, constipation, nausea, indigestion, headache, cough, acne, hair loss, itchy skin, dizziness, shaking, inability to sleep, anxiety or depression. Serious: signs of infection (fever, inflammation, sweating, chills or flu-like symptoms), signs of anaemia (excessive tiredness, dizziness or pale), swelling in legs, arms or face, bleeding, urinary infection, blood in urine, irregular heartbeat, chest pain, cold sores, vomiting, stomach, back muscle or other pain, skin changes, especially in moles or freckles.
Cytoxin (Cyclophosphamide) is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Cytoxan is classified as an "alkylating agent." Cytotoxic drugs, such as methotrexate, Cytoxan, and Imuran are used to treat Lupus, rheumatoid arthritis and some other rheumatic diseases. It is in the class of medications referred to as immunosuppressants – medicines that can decrease the immune response in diseases such as Lupus.
Cytoxan may cause bladder damage, probably from toxic byproducts of the drug that are excreted in the urine. Potential problems include bladder infection with bleeding and fibrosis of the bladder. If you choose Cytoxan, try to drink 3 or 4 liters of fluid a day to help prevent bladder problems. The extra fluid will dilute your urine and make you urinate frequently, thus minimizing the Cytoxan byproducts' contact with your bladder. Cytoxan may cause many side effects, but it is well tolerated by most patients. It may cause an upset stomach and its use may cause the cell count to decrease. You may have an increased risk of developing malignancies including leukemia, bladder cancer and other tumors. Cytoxan may also cause temporary or permanent sterility in both women and men, preventing them from having children. It may also cause damage to a developing fetus if a woman gets pregnant unintentionally while being treated with the drug. Cytoxan also predisposes a patient to develop shingles, which is a painful, blistering skin condition. It can cause hair loss. Cytoxan may predispose you to develop unusual infections, particularly when it is used in combination with high doses of steroids.
Immunosuppressive and cytotoxic drugs are used for two major reasons. First, they are potent drugs that help to reduce disease activity in skin or internal organs. Second, they may reduce or sometimes eliminate the need for steroids (such as prednisone). Steroids used alone to treat major involvement must sometimes be given in high doses. This increases the risk of both short-term and long-term side effects, which may sometimes be worse than the disease itself. Immunosuppressive drugs can be used either in addition to, or instead of, steroids to lower the amount of steroid needed and often spare you many of the undesirable side effects of steroid therapy.
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