What is a common side effect of cyclophosphamide and ifosfamide?

Cyclophosphamide and ifosfamide are both alkylating agents used in chemotherapy that can lead to a specific side effect known as hemorrhagic cystitis. This condition arises due to the metabolism of these drugs, which produces toxic metabolites that can irritate the bladder. The most notable metabolite associated with this effect is acrolein, which is responsible for causing bladder irritation and hemorrhage.

Patients taking these medications may experience symptoms such as hematuria (blood in the urine), dysuria (painful urination), and increased urinary frequency. Hemorrhagic cystitis can be particularly severe, necessitating close monitoring and preventive measures, such as the co-administration of mesna, which helps to neutralize the toxic metabolites and protect the bladder.

While peripheral neuropathy is associated with some chemotherapeutic agents, it is not a common or primary side effect of cyclophosphamide and ifosfamide. Weight gain and hypotension are not directly linked to these medications either. Therefore, recognizing hemorrhagic cystitis as a notable complication is essential for safe management and patient education during treatment with these drugs.