Regular complete blood counts (CBCs) with differential are crucial; monitor neutrophils, platelets, and hemoglobin levels closely. Expect initial drops in these counts within 1-2 weeks of starting Cytoxan. Adjust dosage based on these results, following established guidelines.
Assess renal function via serum creatinine and creatinine clearance tests before each cycle and as needed. Cytoxan is nephrotoxic; promptly address any signs of renal impairment. Hydration is key to mitigating this risk.
Monitor liver function tests (LFTs) including ALT, AST, and bilirubin regularly. Hepatotoxicity is a potential adverse effect; promptly report abnormal results. Dosage adjustments may be necessary.
Evaluate for bladder toxicity through frequent urinalysis, including microscopic examination for hematuria. Encourage patients to maintain adequate hydration and consider cystitis prophylaxis (e. g., Mesna) as per established protocols.
Closely observe patients for signs of infection due to myelosuppression. Promptly address any symptoms, providing appropriate antimicrobial therapy when indicated. Consider prophylactic antibiotics in high-risk patients.
Regularly assess for signs of secondary malignancies, especially in long-term survivors. Follow-up imaging and tumor marker monitoring might be appropriate, depending on individual patient history and risk factors.
Patient education is paramount. Provide patients with clear instructions on reporting any unusual symptoms or side effects without delay. Open communication fosters adherence and early detection of potential complications.
