How it is administered

Ifosfamide is given as an intravenous (IV) infusion. This means it is administered directly into a vein, usually in a hospital or clinic setting by a healthcare professional.

The typical dose is 1.2 grams per square meter of body surface area per day, given over at least 30 minutes, for 5 consecutive days. This cycle is usually repeated every 3 weeks or after recovery from blood cell count changes.

To reduce the risk of bladder toxicity, it is important to receive plenty of fluids (at least 2 liters per day) and a protective medication called mesna alongside ifosfamide. The medication comes in single-dose vials that are mixed with sterile water and further diluted before use.

How it works

Ifosfamide is a type of chemotherapy known as an alkylating agent. It is considered a prodrug, which means it needs to be activated by the liver before it can work. Once activated, ifosfamide forms substances that attach to the DNA in cancer cells. This process, called alkylation, causes cross-links in the DNA, which prevents the cancer cells from dividing and growing. As a result, the cancer cells eventually die.

Because ifosfamide affects DNA, it can also impact normal, healthy cells, especially those that divide quickly, such as blood cells, hair follicles, and cells lining the digestive tract. This is why side effects like low blood counts, hair loss, and nausea can occur. The medication is mostly removed from the body through the urine, and its effects can vary from person to person depending on how their body processes the drug.

Who Should take it

Ifosfamide is approved for use in adults as part of combination chemotherapy for certain types of cancer, specifically for third-line treatment of germ cell testicular cancer. In blood cancers, it may sometimes be used off-label as part of combination regimens for lymphomas, including T-cell lymphomas, when other treatments have not worked or as part of clinical trials.

Your doctor may consider ifosfamide if you have a type of cancer that has not responded to standard treatments, or if you are participating in a clinical trial for blood cancers such as Adult T-cell Leukemia/Lymphoma. It is always used under the supervision of an oncologist experienced in chemotherapy.

Who should not take it

You should not take ifosfamide if you have had a previous severe allergic reaction to it, or if you have a blockage in your urinary tract that prevents you from urinating properly.

Ifosfamide is also not recommended for people with severely depressed bone marrow function, very low white blood cell or platelet counts, or active infections unless absolutely necessary. It should be used with caution in people with kidney, liver, or heart problems, and is not recommended during pregnancy or breastfeeding due to the risk of harm to the baby. Always discuss your full medical history with your doctor before starting treatment.

Commonly used with

Ifosfamide is almost always used in combination with other chemotherapy drugs. For testicular cancer, it is combined with cisplatin and either etoposide or vinblastine. In blood cancers, it may be used with other agents like doxorubicin, vincristine, or etoposide, depending on the specific treatment protocol.

Mesna is always used alongside ifosfamide to protect the bladder from damage. Supportive medications to prevent nausea and manage side effects are also commonly given.

Commonly tested with

Ifosfamide has been tested in combination with several other chemotherapy drugs, including cisplatin, etoposide, and vinblastine, especially in clinical trials for testicular cancer and lymphomas. In blood cancers, it is often part of multi-drug regimens being studied for relapsed or refractory disease.

Ongoing research continues to test ifosfamide with new agents and in different combinations to improve outcomes for patients with difficult-to-treat cancers.