Ifosfamide

Ifosfamide is a prescription medication used to treat cancer of the testicles that has not improved or that has worsened after previous treatment. Ifosfamide belongs to a class of drugs called alkylating agents. It works by slowing or stopping the growth of cancer cells in your body.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

Common side effects of ifosfamide include nausea, vomiting, loss of appetite, and sores in the mouth or throat.

Ifosfamide is a prescription medication to treat cancer of the testicles that has not improved or that has worsened after prior treatment. It is used in combination with other medications.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Ifosfamide may be found in some form under the following brand names:

• Ifex

Common side effects of ifosfamide include:

• nausea
• vomiting
• loss of appetite
• diarrhea
• sores in the mouth and throat
• hair loss
• a general feeling of pain and tiredness

This is not a complete list of ifosfamide side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that block a protein in the body (CYPA4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone (Serzone)
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's Wort, and nimodipine (Nimotop)

This is not a complete list of ifosfamide drug interactions. Ask your doctor or pharmacist for more information.

Treatment with ifosfamide increase the risk of certain serious side effects including the following:

• Lowered blood count. The number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious or life-threatening infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, chills, sore throat, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; bloody vomit; or vomiting blood or brown material that resembles coffee grounds.
• Severe or life-threatening damage to the nervous system. If you experience any of the following symptoms, call your doctor immediately: confusion; drowsiness; blurred vision; seeing things or hearing voices that do not exist (hallucinating); or pain, burning, numbness, tingling in the hands or feet; seizures; or coma (loss of consciousness for a period of time).
• Severe or life-threatening kidney problems. Kidney problems may occur during therapy or months or years after you stop receiving treatment. Tell your doctor if you have or have ever had kidney disease. If you experience any of the following symptoms, call your doctor immediately: decreased urination; swelling of the face, arms, hands, feet, ankles, or lower legs; or unusual tiredness or weakness.
• Toxicity to the heart which could lead to fatal outcome. Patients should report preexisting cardiac disease.
• Toxicity to the lung leading to respiratory failure with fatal outcome.
• The development of other cancers.
• Liver disease
• Harm to an unborn baby if a patient becomes pregnant or fathers a child during therapy and for up to 6 months after therapy. Effective methods of contraception should be used during therapy and for up to 6 months after therapy.
• Harm to a nursing infant if breastfeeding.
• Amenorrhea (absence of a menstrual cycle), premature menopause, and sterility.
• Hair loss, wound healing, and other serious skin and tissue disorders.
• Stomach and intestinal disorders
• Alcohol may increase nausea and vomiting.
• Inflammation of the mouth; it is important to conduct proper oral hygiene.
• Eye disorders such as visual impairment, blurred vision, and eye irritation.
• Hearing disorders such as deafness, vertigo, and tinnitus
• Decreased ability to heal wounds

Do not take ifosfamide if you:

• are allergic to ifosfamide or to any of its ingredients
• have urinary outflow obstruction (not able to urinate)

Grapefruit and grapefruit juice may interact with ifosfamide and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking ifosfamide, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to ifosfamide, cyclophosphamide (Cytoxan), any other medications, or any of the ingredients in ifosfamide injection
• have liver problems
• have heart problems
• have kidney problems
• have problems urinating
• have previously received treatment with other chemotherapy medications or if you have previously received radiation therapy
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. You should not become pregnant while you are receiving ifosfamide. Use a reliable method of birth control to prevent pregnancy while you are receiving ifosfamide and for 6 months after treatments. If you are male, you and your female partner should continue to use birth control for 6 months after you stop receiving ifosfamide injection. If you become pregnant while receiving ifosfamide, call your doctor immediately. Ifosfamide may harm the unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Ifosfamide has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from ifosfamide a choice should be made whether to stop nursing or to stop the use of this medication. The importance of the drug to the mother should be considered.

Take ifosfamide exactly as prescribed.

This medication is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

This medication is available in an injectable form to be dosed by a healthcare professional.

Ifosfamide injection should be administered into the vein at a dose of 1.2 grams per m2 (body surface area measurement) per day for 5 consecutive days. Treatment is repeated every 3 weeks or after recovery from toxicities that may occur.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

Myelosuppression can be severe and lead to fatal infections. Monitor blood counts prior to and at intervals after each treatment cycle. CNS toxicities can be severe and result in encephalopathy and death. Monitor for CNS toxicity and discontinue treatment for encephalopathy. Nephrotoxicity can be severe and result in renal failure. Hemorrhagic cystitis can be severe and can be reduced by the prophylactic use of mesna.