Ifosfamide
Cytostatic · Alkylating agent
Indications
Bronchogenic carcinoma (including non-oat cell type), testicular tumours of all histological types, soft tissue sarcomas, leiomyosarcoma, mammary carcinoma, ovarian carcinoma, endometrial carcinoma, hypernephroid carcinoma of the kidney, pancreatic carcinoma, malignant lymphoma.
Dosage
Germ Cell Testicular Cancer: Adults: 1.2 gm/m²/day IV for 5 days. Repeat every 3 wk.
Administration
IV: Administer slow IVP, IVP Bolus over 30 min to several hours or continuous IV infusion over 5 days. Reconstitution: Dilute powder with SWFI or NS to a conc of 50 mg/mL. Further dilution in 50-100 mL D5W or NS is recommended for IV Infusion. Compatibility: Stable in D5LR, D5NS, D5W, LR, ½NS, NS; incompatible with bacteriostatic SWI or bacteriostatic NS. Stability: Store at 20°C-25°C (68°F-77°F). Protect from temperatures above 30°C (86°F). Constituted solution or constituted and further diluted solutions of ifosfamide should be refrigerated and used within 24 hours. Solutions reconstituted with bacteriostatic WFI are stable for 1 week at room temperature or 3 weeks under refrigeration and diluted solutions are chemically stable for up to 1 week at room temperature and for up to 6 weeks under refrigeration in glass containers or plastic bags. Preservative-free solutions should be used…
Adverse Effects
Haemorrhagic cystitis (use mesna), myelo suppression, leucopenia, somnolence, hallucination, alopecia, metabolic acidosis, hematuria. Urothelial and renal effects, myelosuppression, CNS effects, GI upset, stomatitis, dermatitis, impaired gonadal function, polyneuropathy, pneumonitis, impaired vision.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Severe bone marrow suppression. Myelosuppression (e.g., leucocytes <4000/ mm3 or platelets <100000/mm3), urinary tract obstruction, acute infection, acute urothelial toxicity, renal impairment (serum creatinine >120 micromoles/I), hepatic impairment (bilirubin >17 micromoles/I), serum transaminases or alkaline phosphatase > 2.5 x ULN. Precautions: Impaired renal function, compromised bone marrow function. Advise patients to report symptoms of cystitis. Risk of infertility. Reduced plasma albumin levels, previous nephrectomy. Correct electrolyte imbalances before starting. Maintain adequate hydration. Monitor for proteinuria or haematuria before and regularly during treatment. Diabetes, elderly or debilitated patients.
Interactions
Phenobarbital, carbamazepine, phenytoin, anticoagulants, antidiabetic agents, allopurinol, platinum compounds, other nephrotoxic agents.
Advice to Patient
This medication is administered by infusion. Report immediately if there is redness/swelling/pain or burning at infusion site. Contact prescriber if there is unusual rash, fever, chills, easy bruising or bleeding, constant nausea, vomiting, difficulty in breathing, unusual fatigue, swelling of extremities, difficulty or pain with urination, chest pain, palpitations, fast heartbeat, confusion, hallucinations, sleep walking occur. Consult prescriber for antiemetic and analgesic if there is severe vomiting and headache. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Using soft toothbrush, cotton swabs, regular mouth care may help to prevent mouth sores.
Pharmacokinetics
Pharmacokinetics are dose dependent. Metabolism: Hepatic to active metabolites isofosforamide mustard, 4-hydroxy-ifosfamide, acrolein, and inactive, dichloroethylated and carboxy metabolites; acrolein is the agent implicated in development of hemorrhagic cystitis. Half-life elimination: (increased in the elderly): High dose (3,800 to 5,000 mg/m²); approx. 15 hours. Lower dose (1,600 to 2,400 mg/m²): approx. 7 hours. Excretion: High dose (5,000 mg/m²): Urine (70% to 86%; 61% as unchanged drug). Lower dose (1,600 to 2,400 mg/m²): Urine (12% to 18% as unchanged drug).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.