Dangerous Drug: Ifosfamide(eye foss’ fa mide)
Ifex
PREGNANCY CATEGORY D
Drug Classes
Alkylating drug
Antineoplastic
Nitrogen mustard
Therapeutic Actions
Cytotoxic: Exact mechanism of action is not known, although metabolite of ifosfamide alkylates DNA and interferes with the replication of susceptible cells; immunosuppressive: Lymphocytes are especially sensitive to drug effects.
Indications
In combination with other approved neoplastic drugs for third-line chemotherapy of germ cell testicular cancer; prophylactically with mesna to prevent hemorrhagic cystitis
Orphan drug uses: Third-line chemotherapy in the treatment of bone sarcomas, soft-tissue sarcomas
Unlabeled uses: Possible effectiveness in the treatment of lung, breast, ovarian, pancreatic, and gastric cancers; sarcomas; acute leukemias; malignant lymphomas; bladder and cervical cancer
Contraindications and Cautions
Contraindicated with allergy to ifosfamide, hematopoietic depression, pregnancy, lactation.
Use cautiously with impaired hepatic or renal function.
Available Forms
Powder for injection—1, 3 g; solution for injection—50 mg/mL
Dosages
Adults
Administer IV at a dose of 1.2 g/m2/day over at least 30 min for 5 consecutive days. Treatment is repeated every 3 wk or after recovery from hematologic toxicity. For prevention of bladder toxicity, give more than 2 L of fluid per day IV or PO. Also use mesna IV to prevent hemorrhagic cystitis.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
Data not available on appropriate dosage. Reduced dosage is advisable; use caution.
Pharmacokinetics
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