IFOSFAMIDE

Alkylating anticancer; related to cyclophosphamide

Dosage Forms

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Powder for injection

1 g

Uses

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  • Cancer

Dose and Duration

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Usually
  • 8−12 g/m² as single daily doses over 3-5 days every 2-4 weeks
  • OR 5−6 g/m² (maximum 10 g) given as a 24 hour infusion every 3-4 weeks
Dose frequency determined by degree of myelosuppression and recovery of bone marrow function

Contraindications

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  • Urinary tract obstruction
  • Acute infection
  • Urothelial damage
  • Severe renal impairment
  • Severe bone marrow function impairment
  • Severe hepatic impairment

Side Effects

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  • Infections
  • Myelosuppression
  • Decreased appetite
  • Hepatotoxicity
  • Alopecia
  • Haemorrhagic cystitis, haematuria
  • Renal damage
  • Phlebitis

Interactions

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  • ACE inhibitors e.g. captopril (can cause leucopoenia)
  • Carboplatin, cisplatin (increased haematotoxicity and immunosuppression)
  • Warfarin (increased anticoagulant effect)
  • Clozapine (increased risk of agranulocytosis)

Pregnancy

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  • Do not use

Breast-feeding

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  • Discontinue breastfeeding

⚠️ Caution

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  • Give adequate hydration before and after to minimise urothelial toxicity (haemorrhagic cystitis)
  • Use with mesna to reduce urothelial toxicity
  • Men and women taking ifosfamide should use adequate contraception during treatment
  • Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines