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ifosfamide ifosfamide

 
  Trade/other name(s)
Ifex, Isophosphamide 		 
  Pronunciation: eye-foss-fuh-mide  
  Why would this drug be used?
Ifosfamide is used to treat lymphoma, leukemia, testicular, and bladder cancers. 		 
  How does this drug work?
Ifosfamide is a member of a general group of chemotherapy drugs known as alkylating agents. It stops or slows the growth of cancer cells. 		 
  Before taking this medicine

Tell your doctor: 		 
 
  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, diabetes, gout, or infections. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. If either the male or female is taking it at the time of conception or during pregnancy, there's a chance it may cause birth defects. If you are sexually active while taking this drug, you should use some kind of birth control. It is important to check with your doctor about what kinds of birth control can be used with this medicine.
  • If you are breast-feeding. The drug may pass into breast milk and harm the baby.
  • If you think you might want to have children in the future. Some drugs can cause sterility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • If you have previously been treated for cancer with radiation or chemotherapy. Your doctor may watch you more closely for certain side effects.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs.
 
  Interactions with other drugs
No serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine. 		 
  Interactions with foods
No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem. 		 
 
Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

  
  How is this drug taken or given?
Ifosfamide is injected in a vein over a period of time from 1 hour to 24 hours for a few days. Because ifosfamide can hurt your bladder, you will likely be given fluids in the vein to help flush out the drug. You should also be given mesna, a drug that helps protect the bladder. If you take mesna by mouth, make sure you take it exactly as prescribed by your doctor. You should avoid alcohol and drink plenty of fluids: 3 or more quarts of fluid a day, or at least 12 8-oz glasses of juice, water, or sports drink (like Gaterorade) during the first 24 hours after treatment. This will flush your kidneys, and make you pass your urine frequently, which will help protect your bladder. The dose of ifosfamide depends on several factors: your size, how well your kidneys are working, your blood counts, and the type of cancer being treated. 		 
  Precautions
Ifosfamide can cause serious bleeding in the bladder, so it should ALWAYS be given with fluids in the vein and mesna, a drug that helps to protect the bladder wall. Your doctor should tell you how to best get all the fluids you will need. While taking this drug, it's extremely important to drink plenty of fluids and empty your bladder often. Call your doctor if your urine has blood in it, or if it becomes painful to urinate.

You may have nausea and vomiting on the day you receive this drug or in the first few days afterward. Your doctor may give you medicine before your treatment to help prevent nausea and vomiting. You will likely also get a prescription for an anti-nausea medicine that you can take at home. It is important to have these medicines on hand and to take them as prescribed by your doctor.

Do not get any immunizations (vaccinations), either during or after treatment with this drug, without your doctor's OK. This drug may affect your immune system, which could make vaccinations ineffective, or could even lead to serious infections. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

Your doctor will likely test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can lower your white blood cell count, especially in the weeks after the drug is given. A low white blood cell count increases your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

This drug may lower your platelet count in the weeks after it is given, which can increase your risk of bleeding. Speak with your doctor before taking any drugs or supplements that might affect your body's ability to stop bleeding, such as aspirin or aspirin-containing medicines, warfarin (Coumadin), or vitamin E. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

This drug may cause hair loss. You may want to talk to your doctor or nurse about getting a wig before starting treatment. If your insurance does not cover the cost of a wig, there may be other resources to help you. Hair loss is usually temporary, and your hair will likely grow back during or after treatment.

 
 
Possible side effects
  
  Common
  • nausea*
  • vomiting*
  • hair loss*
  • bladder irritation, blood in the urine*
  • frequent or painful urination*
  • kidney function abnormalities
  • poor appetite
  • diarrhea
  • fetal abnormalities if pregnancy occurs while taking ifosfamide
  • decreased white blood cell count with increased risk of infection*
 
  Less common
  • pain at place of injection
  • decreased platelet count with increased risk of bleeding*
  • agitation
  • dizziness
 
  Rare
  • tiredness (fatigue)
  • confusion
  • sleepiness
  • seizures
  • allergic reaction

*See "Precautions" section for more detailed information.

 
 
There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.
  
 
 
  FDA approval
Yes - first approved in 1988. 		 
 
 
  Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.  


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