What is a known side effect of Cycophosphamide concerning the urinary system?

Cycophosphamide is known to cause hemorrhagic cystitis, which is characterized by inflammation and bleeding in the bladder. This side effect is particularly concerning because it can lead to significant symptoms, such as hematuria (blood in urine), bladder irritation, and pain. The mechanism behind this side effect is primarily related to the drug’s metabolic byproducts, specifically acrolein, which is a toxic metabolite that can irritate the bladder lining.

Preventive strategies, such as adequate hydration and the use of mesna (a protective agent that binds to the toxic metabolites), are often employed to minimize the risk of developing hemorrhagic cystitis in patients receiving cyclophosphamide. Recognizing this specific side effect is crucial for healthcare providers, as it can significantly impact patients' quality of life and treatment adherence.