Ifosfamide

Brands

DEA Class; Rx

Common Brand Names; Ifex

  • Antineoplastics, Alkylating

Alkylating agent; synthetic analog of cyclophosphamide
Used for the treatment of advanced testicular cancer, along with several off-label uses
Black box warnings for myelosuppression, neurotoxicity, nephrotoxicity, and hemorrhagic cystitis

Indicated in combination with other antineoplastic agents for third-line germ cell testicular cancer

For the treatment of non-Hodgkin’s lymphoma (NHL).
For the treatment soft-tissue sarcoma.
For the treatment of unresectable or metastatic osteogenic sarcoma, in combination with mesna, dacarbazine, and doxorubicin.

Hypersensitivity

Severe myelosuppression

  • Alopecia (83%)
  • Nausea (58%)
  • Vomiting (58%)
  • Leukopenia (50%)
  • Hematuria (46%)
  • Metabolic acidosis (31%)
  • Thrombocytopenia (20%)
  • CNS toxicity (12%)
  • Neurotoxicity (10-20%)
  • Infection (8%)
  • Nephrotoxicity (6%)

Avoid pregnancy

May interfere with wound healing

Use caution in renal impairment

Heart Failure risk

  • Acute heart failure, often occurring within 1 to 10 days of treatment, has been reported with induction therapy at doses greater than 12.5 mg/m2
  • The onset of HF can be reversible, usually resolving over 3 to 4 weeks

Pregnancy Category: D

Lactation: excreted in breast milk, do not nurse

The suggested maximum tolerated dose (MTD) for ifosfamide is dependent on performance status, other chemotherapy agents or radiation given in combination, and disease state. Therefore, dosing may vary from protocol to protocol. If questions arise, clinicians should consult the appropriate references to verify the dose.

Adults

FDA approved: 1,200 mg/m2 IV on days 1 through 5, every 21 days.
Off-label: Single doses up to 5,000 mg/m2 IV (see regimen for specific information).

Geriatric

FDA approved: 1,200 mg/m2 IV on days 1 through 5, every 21 days.
Off-label: Single doses up to 5,000 mg/m2 IV (see regimen for specific information).

Adolescents

FDA labeling: Safety and efficacy have not been established.
Off-label: Single doses up to 3,000 mg/m2 IV (see regimen for specific information).

Children

FDA labeling: Safety and efficacy have not been established.
Off-label: Single doses up to 3,000 mg/m2 IV (see regimen for specific information).

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Ifosfamide

kit: powder with mesna solution

  • 1g/vial
  • 3g/vial

solution

  • 1g/20mL
  • 3g/60mL
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