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Ifosfamide is used with other medicines to treat testicular cancer in men.
Ifosfamide is usually given after other treatments have failed.
Ifosfamide may also be used for purposes not listed in this medication guide.
You should not receive ifosfamide if you have a medical condition that causes urination problems (such as an enlarged prostate).
Ifosfamide affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, cough, mouth sores, or unusual bleeding or bruising.
Ifosfamide can affect your kidneys or nervous system. Call your doctor at once if you have urination problems, blood in your urine, problems with your hearing or vision, unusual thoughts or behavior, hallucinations, or a seizure.
You should not be treated with ifosfamide if you are allergic to it, or if you have a medical condition that causes urination problems (such as an enlarged prostate).
Tell your doctor if you have ever had:
kidney disease;
heart disease;
a bladder infection;
treatment with busulfan; or
radiation treatment of your bladder.
Using ifosfamide may increase your risk of developing other cancers, such as leukemia. Ask your doctor about this risk.
Ifosfamide can cause birth defects if a woman is exposed to it during pregnancy.
Use effective birth control to prevent pregnancy, whether you are a man or a woman. Ifosfamide use by either parent may cause birth defects. Keep using birth control for at least 6 months after treatment.
This medication may affect fertility (your ability to have children), whether you are a man or a woman. Some women using ifosfamide have stopped having periods, or started having symptoms of early menopause.
A woman receiving ifosfamide should not breast-feed.
Your doctor will perform blood and urine tests to make sure you do not have conditions that would prevent you from safely using ifosfamide.
Ifosfamide is given as an infusion into a vein. A healthcare provider will give you this injection.
If this medicine accidentally gets on your skin, wash it thoroughly with soap and warm water.
Ifosfamide is given in a 21-day treatment cycle, but you will receive the medicine only during the first 5 days of each cycle. Your doctor will determine how many cycles you should receive.
Drink plenty of liquids while you are taking ifosfamide.
Your blood will need to be tested often. Your heart, kidney function, liver function, or nerve and muscle function may also need to be checked. Your cancer treatments may be delayed based on the results.
Ifosfamide can have long lasting effects on your body. You may also need medical tests for a short time after your last dose.
Call your doctor for instructions if you miss an appointment for your ifosfamide injection.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Avoid driving or hazardous activity until you know how ifosfamide will affect you. Your reactions could be impaired.
Drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting.
Grapefruit may interact with ifosfamide and lead to unwanted side effects. Avoid the use of grapefruit products.
Do not receive a "live" vaccine while using ifosfamide, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
This medicine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
You may get infections more easily, even serious or fatal infections. Call your doctor right away if you have signs of infection such as:
fever, chills, flu symptoms;
mouth and throat ulcers;
skin sores, pale skin, cold hands and feet;
easy bruising, unusual bleeding;
rapid heart rate, shallow breathing; or
feeling light-headed or short of breath.
Call your doctor at once if you have any of these side effects:
confusion, unusual thoughts or behavior, hallucinations, seizure (convulsions);
little or no urination, painful or difficult urination, blood in your urine;
loss of bladder control;
a seizure;
muscle movements you cannot control;
problems with your hearing or vision, ringing in your ears;
sudden chest pain, wheezing, dry cough;
dark urine, jaundice (yellowing of the skin or eyes); or
a wound that will not heal.
Common side effects may include:
nausea and vomiting;
confusion, vision problems, thinking problems;
numbness, tingling, burning pain;
infections;
urination problems; or
hair loss.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Testicular Cancer:
1.2 g/m2 IV over at least 30 minutes daily for 5 consecutive days; repeat every 3 weeks or after recovery from hematologic toxicity
Comments:
-To prevent bladder toxicity, this drug should be given with extensive hydration (at least 2 liters of oral or IV fluid daily).
-Mesna should be used to reduce hemorrhagic cystitis.
Use: For use in combination with other antineoplastic agents for third-line chemotherapy of germ cell testicular cancer
Using ifosfamide with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Many drugs can affect ifosfamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Ifosfamide (www.drugs.com/mtm/ifosfamide.html).
Commonly reported side effects of ifosfamide include: central nervous system toxicity, confusion, drowsiness, and hallucination. See below for a comprehensive list of adverse effects.
Applies to ifosfamide: intravenous powder for solution, intravenous solution
Intravenous route (Powder for Solution)
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.
Along with its needed effects, ifosfamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking ifosfamide:
More common
Less common
Rare
Some side effects of ifosfamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Applies to ifosfamide: intravenous powder for injection, intravenous solution
Very common (10% or more): Hemorrhagic cystitis, hematuria, dysuria, urinary frequency, urinary incontinence, urinary retention
Frequency not reported: Infertility, ovarian failure, premature menopause, amenorrhea, ovulation disorder, azoospermia, oligospermia
Very common (10% or more): Renal dysfunction, acute renal failure
Frequency not reported: Acute renal failure, chronic renal failure, aminoaciduria, phosphaturia, Fanconi syndrome, tubulointerstitial nephritis, renal structural damage, nephrogenic diabetes insipidus, polyuria, enuresis, feeling of residual urine
Very common (10% or more): Leukopenia (44%), anemia (38%)
Common (1% to 10%): Thrombocytopenia
Frequency not reported: Agranulocytosis, hemolytic anemia, methemoglobinemia, febrile bone marrow aplasia, disseminated intravascular coagulation, hemolytic uremic syndrome, neonatal anemia
Very common (10% or more): Nausea/vomiting (47%)
Uncommon (0.1% to 1%): Diarrhea, stomatitis
Frequency not reported: Enterocolitis, pancreatitis, ileus, GI hemorrhage, mucosal ulceration, constipation, abdominal pain, salivary hypersecretion
Very common (10% or more): CNS toxicity (e.g., abnormal behavior, affect lability aggression, agitation, anxiety, aphasia, asthenia, ataxia, cerebellar syndrome, cerebral function deficiency, cognitive disorder, coma, confusional state, convulsions, cranial nerve dysfunction, depressed state of consciousness, depression, disorientation, dizziness, electroencephalogram abnormal, encephalopathy, flat affect. hallucinations, headache, ideation, lethargy, memory impairment, mood change, motor dysfunction, muscle spasms, myoclonus, progressive loss of brainstem reflexes, psychotic reaction, restlessness, somnolence, tremor, urinary incontinence) (15%)
Uncommon (0.1% to 1%): Peripheral neuropathy
Very common (10% or more): Alopecia
Rare (0.01% to 0.1%): Dermatitis, papular rash
Frequency not reported: Angioedema, urticaria, toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome, palmar-plantar erythrodysesthesia syndrome, radiation recall dermatitis, skin necrosis, facial swelling, rash, pruritus, erythema, skin hyperpigmentation, hyperhidrosis, nail disorder
Common (1% to 10%): Hepatotoxicity (increases in liver enzymes, i.e., serum alanine aminotransferase, serum aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase and lactate dehydrogenase), increased bilirubin, jaundice, hepatorenal syndrome
Frequency not reported: Hepatic failure, veno-occlusive liver disease, portal vein thrombosis, cytolytic hepatitis
Frequency not reported: Respiratory failure, acute respiratory distress syndrome, pulmonary hypertension, interstitial lung disease (as manifested by pulmonary fibrosis), pneumonitis, pulmonary edema, pleural effusion, dyspnea, hypoxia, cough
Frequency not reported: Hypersensitivity, anaphylactic reaction
Uncommon (0.1% to 1%): Cardiotoxicity (e.g., congestive heart failure, tachycardia, pulmonary edema), hypotension
Frequency not reported: Arrythmia (including supraventricular and ventricular arrhythmia), atrial fibrillation, premature atrial contractions, bradycardia, cardiac arrest, myocardial infarction, cardiac failure, myocardial hemorrhage, angina pectoris, cardiomyopathy (including congestive cardiomyopathy), electrocardiogram ST-segment abnormal, electrocardiogram T-wave inversion, electrocardiogram QRS complex abnormal
Frequency not reported: Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Very common (10% or more): Infection (10%)
Frequency not reported: Sepsis, septic shock, immunosuppression
Frequency not reported: Injection/infusion site reactions
Frequency not reported: Rhabdomyolysis, osteomalacia, rickets, growth retardation, myalgia, arthralgia, muscle twitching
Frequency not reported: Visual impairment, conjunctivitis, eye irritation
Common (1% to 10%): Anorexia
Frequency not reported: Tumor lysis syndrome, metabolic acidosis, hypokalemia, hypocalcemia, hypophosphatemia, hyperglycemia, polydipsia
Frequency not reported: Mutism, mental status change (e.g., mania, paranoia, delusion, delirium, catatonia, amnesia, panic attack), echolalia, perseveration
Frequency not reported: Secondary malignancies, myelodysplastic alterations, acute leukemia, lymphoma, thyroid cancer, sarcomas
Frequency not reported: Secondary tumors (e.g., urinary tract carcinoma, myelodysplastic syndrome, acute leukemia, acute lymphocytic leukemia, lymphoma [Non-Hodgkin's lymphoma], sarcomas, renal cell carcinoma, thyroid cancer), progressions of underlying malignancies, deafness tinnitus, vertigo, fetal growth retardation, phlebitis, fatigue, malaise, multiorgan failure, general physical deterioration, edema, pain, pyrexia, chills
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Ifosfamide (www.drugs.com/mtm/ifosfamide.html).
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