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Cyclophosphamide-induced symptomatic hyponatremia, a rare but severe side effect: a case report

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      Cyclophosphamide is commonly used in the treatment of malignant diseases. Symptomatic severe hyponatremia induced by low-dose cyclophosphamide is very uncommon worldwide. We report a case of severe symptomatic hyponatremia that developed in a female breast cancer patient following the first cycle of chemotherapy containing low-dose cyclophosphamide. Her laboratory test showed serum Na of 112 mmol/L. Her hyponatremia was initially treated with sodium bicarbonate. She completely recovered without neurological deficits after slow correction of the serum Na concentration. Although hyponatremia is a rare toxicity it should always be considered during the usage of cyclophosphamide, even if the dosage is low, especially with concurrent use of other medications that impair water excretion, like chlorthalidone. This report describes the first reported case of cyclophosphamide-induced hyponatremia in Qatar.

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          Life-threatening acute hyponatraemia induced by low dose cyclophosphamide and indomethacin.

          We report the case of a patient with multiple myeloma who developed acute life-threatening water intoxication following treatment with oral indomethacin and low dose intravenous cyclophosphamide. We describe a possible drug interaction between these two drugs and recommend that they should only be used together with caution.

            Author and article information

            [1 ]Pharmacy Department, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
            [2 ]Oncology Hematology Department, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
            Author notes
            Correspondence: Shereen Elazzazy, P.O. Box 3050, Pharmacy Department, National Center for Cancer Care and Research NCCCR, Hamad Medical Corporation, Doha, Qatar, Phone +974 55 009 621, Email shereen_amin@
            Onco Targets Ther
            Onco Targets Ther
            OncoTargets and Therapy
            OncoTargets and therapy
            Dove Medical Press
            30 September 2014
            : 7
            : 1641-1645
            © 2014 Elazzazy et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

            The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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