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How it is administered
Ifosfamide is given as an intravenous (IV) infusion. It is supplied as a powder that is mixed with a liquid (diluent) and then administered slowly into a vein, usually over at least 30 minutes. The typical dosing schedule is 1.2 grams per square meter of body surface area per day, given for 5 consecutive days. This cycle is usually repeated every 3 weeks or after recovery from blood count changes.
To help prevent bladder toxicity, patients receive at least 2 liters of fluids per day (by mouth or IV) and a protective medication called mesna. Ifosfamide should always be prepared and administered by healthcare professionals experienced in chemotherapy.
How it works
Ifosfamide is a type of chemotherapy called an alkylating agent. It is a prodrug, meaning it needs to be activated by the liver. Once activated, it forms substances that attach to the DNA inside cancer cells. This attachment causes cross-links in the DNA, which prevents the cancer cells from dividing and growing. Eventually, this leads to the death of the cancer cells.
Because ifosfamide targets rapidly dividing cells, it can also affect some healthy cells in the body, which is why side effects can occur. The medication is processed by the liver and excreted mainly through the urine. Its effects on DNA make it effective against certain types of blood cancers, including some lymphomas.
Common side effects
Common side effects of ifosfamide include:
- Hair loss (alopecia)
- Nausea and vomiting
- Blood in the urine (hematuria)
- Low white blood cell counts (leukopenia)
- Low red blood cell counts (anemia)
- Central nervous system toxicity (confusion, sleepiness, hallucinations)
- Infections
Other possible side effects are kidney problems, bladder irritation, fatigue, diarrhea, and mouth sores. Some side effects can be serious, such as severe infections, kidney failure, or neurological symptoms. Your healthcare team will monitor you closely for these effects.
Who Should take it
Ifosfamide is used in adults, in combination with other approved chemotherapy medicines, for the treatment of certain cancers. While its main FDA-approved use is for third-line treatment of germ cell testicular cancer, it is sometimes used off-label for other cancers, including some types of blood cancers like lymphomas, when other treatments have not worked.
Your doctor may consider ifosfamide if you have a cancer that is not responding to standard therapies, or as part of a combination chemotherapy regimen. It is important that the decision to use ifosfamide is made by a healthcare provider experienced in cancer treatment, who will consider your overall health, type of cancer, and previous treatments.
Who should not take it
Ifosfamide should not be given to patients who have had a severe allergic reaction (hypersensitivity) to ifosfamide in the past. It is also contraindicated in patients with urinary outflow obstruction, which means any blockage that prevents urine from leaving the bladder.
If you have severely depressed bone marrow function (very low blood counts), active infections, or severe kidney or liver problems, your doctor may decide that ifosfamide is not safe for you. Women who are pregnant or breastfeeding should not take ifosfamide, as it can harm the baby. Always tell your doctor about all your medical conditions before starting treatment.
Commonly used with
Ifosfamide is almost always used in combination with other chemotherapy drugs. For blood cancers and lymphomas, it may be combined with medications such as cisplatin, etoposide, vinblastine, or doxorubicin, depending on the specific cancer type and treatment protocol.
Mesna is routinely given with ifosfamide to protect the bladder from irritation and bleeding. Supportive medications to prevent nausea, manage infections, or support blood counts may also be used.
Commonly tested with
Ifosfamide has been tested in combination with other chemotherapy agents, especially cisplatin, etoposide, and vinblastine. These combinations are used in various clinical trials and treatment regimens for cancers that have not responded to initial therapies.
In the context of blood cancers, ifosfamide is often studied as part of multi-drug regimens to improve effectiveness and manage side effects. Your healthcare provider will determine the best combination based on your specific diagnosis and treatment history.
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