Many people taking cyclophosphamide do have serious side effects. Adverse drug reactions include chemotherapy-induced nausea and vomiting, bone marrow suppression, stomachache, diarrhea, darkening of the skin/nails, alopecia (hair loss) or thinning of hair, changes in color and texture of the hair, and lethargy.
Hemorrhagic cystitis is a frequent complication, but this is prevented by adequate fluid intake and mesna (sodium 2-mercaptoethane sulfonate), a sulfhydryl donor which binds acrolein.
In the case of preventing hemorrhagic cystitis from cyclophosphamide, the use of aggressive hydration and the use of mesna, which neutralizes the toxicity of the cyclophosphamide-metabolite acrolein, may reduce the likelihood of developing hemorrhagic cystitis. Unfortunately mesna is ineffective as a treatment once hemorrhagic cystitis has developed. Although rare, once a case of radiation-induced hemorrhagic cystitis is diagnosed there is no empirically-proven treatments to heal this type of condition, which can severely degrade a patient's quality of life and might possibly lead to renal failure with risk of death.