Reported Reactions

Drugs › Alkylating drug

Generic name

Cyclophosphamide: adverse event reports filed with FDA

141,099 reports list it as a suspect or interacting product, 2004–2026. Class: Alkylating drug. Also reported as Cyclophosphamide For Injection Usp, Cyclophosphamide Tablets Usp, Cyclophosphamide Injection 1g.

141,099
reports as suspect product
0.7% of all reports · about 6,273 a year
12,360
reports, 12 months to June 2026
13,414 in the 12 months before
97.8%
marked serious by the reporter
93.5% across the class
20.5%
record death among outcomes, as reported
28,981 reports · not verified by FDA

Between January 2004 and June 2026, 141,099 adverse event reports received by FDA list cyclophosphamide, a generic name as a suspect or interacting product. Reports that mention it only as a concomitant medication (39,413) are left out of every figure here.

In the 12 months to June 2026, 12,360 reports listed it, close to the 13,414 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 6,273 reports a year and 0.7% of the 20,646,523 reports in the database, and 55.7% of the reports for the alkylating drug class. How many people take it is not in the data, so a count is not a rate of occurrence.

The reactions recorded most often are febrile neutropenia (9.2%), off label use (9%) and neutropenia (6.3%). A report can list several reactions, so shares add to more than 100%; 5,398 different terms appear across these reports. Febrile neutropenia is recorded in 9.2% of these reports, a larger share than in the median alkylating drug drug (4.9%).

97.8% of the reports are marked serious by the reporter (93.5% across the class); 20.5% record death among the outcomes and 36.6% record hospitalisation, as reported. 44.8% of the reports came from other health professionals, and the largest patient age group is 45 to 64 (24.8%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

08051,609Jul 2021: 737Aug 2021: 673Sep 2021: 885Oct 2021: 1,162Nov 2021: 904Dec 2021: 1,1012022Jan 2022: 937Feb 2022: 945Mar 2022: 1,133Apr 2022: 1,128May 2022: 965Jun 2022: 1,016Jul 2022: 1,066Aug 2022: 1,108Sep 2022: 1,054Oct 2022: 1,108Nov 2022: 1,115Dec 2022: 1,5642023Jan 2023: 1,155Feb 2023: 1,266Mar 2023: 1,137Apr 2023: 1,278May 2023: 1,313Jun 2023: 1,373Jul 2023: 1,315Aug 2023: 1,194Sep 2023: 989Oct 2023: 1,097Nov 2023: 1,160Dec 2023: 1,2032024Jan 2024: 1,039Feb 2024: 1,036Mar 2024: 1,090Apr 2024: 1,089May 2024: 1,038Jun 2024: 899Jul 2024: 1,304Aug 2024: 1,213Sep 2024: 1,086Oct 2024: 1,609Nov 2024: 1,009Dec 2024: 1,2262025Jan 2025: 976Feb 2025: 937Mar 2025: 1,008Apr 2025: 977May 2025: 941Jun 2025: 1,128Jul 2025: 1,502Aug 2025: 980Sep 2025: 1,195Oct 2025: 980Nov 2025: 952Dec 2025: 1,0442026Jan 2026: 852Feb 2026: 869Mar 2026: 955Apr 2026: 1,056May 2026: 892Jun 2026: 1,083

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

07,24014,4802004: 90320042005: 1,2022006: 1,1632007: 1,41220072008: 1,8702009: 2,2022010: 2,45920102011: 4,3822012: 4,0752013: 3,57120132014: 3,9072015: 5,0592016: 4,96720162017: 5,9282018: 9,1442019: 9,33520192020: 9,8742021: 10,0592022: 13,13920222023: 14,4802024: 13,6382025: 12,62020252026: 5,707

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Cyclophosphamide reports recording the termmedian drug in alkylating drug

  1. Febrile neutropeniafever with low white blood cells9.2%12,947
  2. Off label useused for a purpose or in a way not on the label9%12,764
  3. Neutropenialow neutrophils, a type of white blood cell6.3%8,854
  4. Drug ineffectivethe medicine did not work as expected5.9%8,320
  5. Disease progressionthe disease advanced5.2%7,284
  6. Pyrexiafever5%7,047
  7. Product use in unapproved indicationused for a purpose not on the label3.9%5,516
  8. Thrombocytopenialow platelets3.9%5,491
  9. Pneumonialung infection3.8%5,394
  10. Anaemialow red blood cells3.7%5,171
  11. Nauseafeeling sick3.6%5,047
  12. Sepsisa severe body-wide response to infection3.5%4,880
  13. Diarrhoealoose or frequent stools2.9%4,142
  14. Deaththe patient died; cause not stated by this term2.9%4,104
  15. Vomitingbeing sick2.9%4,035
  16. Infectionan infection, type not specified2.7%3,859
  17. Pancytopenialow counts of all blood cells2.6%3,704
  18. White blood cell count decreasedlow white cell count2.3%3,307
  19. Fatiguetiredness2.2%3,125
  20. Neuropathy peripheralnerve damage in hands or feet2%2,787
  21. Dyspnoeashortness of breath1.9%2,731
  22. Leukopenialow white blood cells1.9%2,666
  23. Septic shockshock arising from infection1.8%2,591
  24. Astheniaweakness or lack of energy1.8%2,472
  25. Respiratory failurethe lungs could not supply enough oxygen1.7%2,428

Top 30 of 5,398 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 23 drugs in the alkylating drug class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death20.5%28,981
Life-threatening8%11,255
Hospitalisation (initial or prolonged)36.6%51,662
Disability1.4%1,933
Congenital anomaly0.3%408
Other serious67.2%94,860
Not serious2.2%3,155

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 253,205 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 21.4%1,926
2 to 115.9%8,297
12 to 173.6%5,034
18 to 4413.6%19,251
45 to 6424.8%34,924
65 to 7413.2%18,680
75 and over6.4%8,967
Age not given31.2%44,020

Patient sex

Female42.6%60,092
Male36.1%50,922
Not given21.3%30,085

Who reported

Physician42.8%60,419
Pharmacist3.1%4,392
Other health professional44.8%63,241
Lawyer0.1%154
Consumer or non-health professional4.8%6,716
Not given4.4%6,177

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 24.2% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Diffuse large b-cell lymphoma16,91312%
Breast cancer9,2926.6%
Plasma cell myeloma8,1455.8%
Acute lymphocytic leukaemia4,7203.3%
B-cell lymphoma3,8552.7%
Bone marrow conditioning regimen2,8152%

The indication field is filled in by the reporter and is often blank; shares are of all 141,099 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Cyclophosphamide reports
Rituximab44,60231.6%
Vincristine42,93030.4%
Doxorubicin37,45126.5%
Prednisone36,08025.6%
Dexamethasone29,36720.8%
Etoposide25,89318.4%
Doxorubicin hydrochloride22,15315.7%
Methotrexate21,46615.2%
Cytarabine19,63313.9%
Prednisolone18,45013.1%

Other products listed in reports where Cyclophosphamide is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureCyclophosphamideAlkylating drugAll reports
Reports as suspect product141,099253,20520,646,523
Share of that pool—55.7%0.7%
Reports, latest 12 months12,360—1,332,454
Marked serious97.8%93.5%57.4%
Death recorded among outcomes, per 1,000 reports20520891
Hospitalisation recorded, per 1,000 reports366333213
Consumer-filed share4.8%6.3%45.8%
Top term, share of reportsFebrile neutropenia 9.2%median 4.9%0.3%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the alkylating drug class

DrugName typeReportsLatest 12 monthsMarked serious
Ifosfamidegeneric18,6581,32598.2%
Melphalangeneric17,19095698.5%
Temozolomidegeneric15,3241,05582.3%
Busulfangeneric11,8251,09594.9%
Thiotepageneric7,8531,03598.8%
Bendamustine hydrochloridegeneric6,94125396%
Dacarbazinegeneric6,43151196.3%
Temodarbrand4,6522456.1%
Matulanebrand3,84528415.9%
Carmustinegeneric3,37818099%
Treandabrand3,330366.5%
Chlorambucilgeneric2,4867598.5%
Valchlorbrand2,1141628.4%
Mitomycingeneric2,04111792.4%
Lomustinegeneric1,1009294.8%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Cyclophosphamide reports

How many adverse event reports has FDA received for Cyclophosphamide?

141,099 reports list Cyclophosphamide as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 12,360 of them arrived in the latest 12 months. Another 39,413 list it only as a concomitant medication.

What reactions are recorded in Cyclophosphamide reports?

febrile neutropenia (9.2%), off label use (9%), neutropenia (6.3%), drug ineffective (5.9%) and disease progression (5.2%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Cyclophosphamide was responsible.

How serious are the reports?

97.8% are marked serious by the reporter. Among the outcomes recorded, 20.5% of reports include death and 36.6% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (44.8%), physician (42.8%) and consumer or non-health professional (4.8%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Cyclophosphamide rising?

12,360 reports in the 12 months to June 2026, close to the 13,414 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Cyclophosphamide was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Cyclophosphamide?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Cyclophosphamide as a suspect or interacting product; reports listing it only as a concomitant medication (39,413) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.