৳ 3,485.95/unit
Pack: ৳ 3,485.95
৳ 3,485.95/unit
Pack: ৳ 3,485.95
At a glance
Ifosfamide is used for third-line chemotherapy of germ cell testicular cancer and in combination with other agents for various cancers including blood, breast, lung, ovarian, pancreatic, testicular and lymph node cancers.
Indications
- Germ cell testicular cancer (third-line chemotherapy)
- Pancreatic cancer
- Ovarian cancer
- Breast cancer
- Non-small cell lung cancer
- Testicular cancer
- Blood cancer
- Lymphoma
- Sarcoma
- Solid tumours
Pharmacology
Ifosfamide is a prodrug that requires metabolic activation by hepatic cytochrome P450 isoenzymes. Activation occurs by hydroxylation at the ring carbon atom forming the unstable intermediate 4-hydroxyifosfamide, which decomposes to yield acrolein and an alkylating isophosphoramide mustard. The exact mechanism is not fully determined, but cytotoxic action is primarily through DNA crosslinks caused by alkylation at guanine N-7 positions.
Dosage
Adult Dose (Intravenous):
- Germ Cell Testicular Carcinoma: 1.2 g/m2/day for 5 days (slow infusion, minimum 30 minutes); repeat every 3 weeks or after recovery from hematologic toxicity; with mesna and adequate hydration (at least 2 L/day)
- Lymphoma/Sarcoma/Solid Tumours: Regimen 1: 8-12 g/m2 divided over 3-5 days; Regimen 2: 6 g/m2 divided over 5 days; Regimen 3: 5-6 g/m2 (max 10 g) as 24-hour infusion
Renal Dose: CrCl <10 mL/min: Administer 75% of dose
Child Dose: Safety and efficacy not established
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Anemia (low RBC count)
- Hair loss
- Decreased WBC count
- Infection
- Blood in urine (hemorrhagic cystitis)
- CNS toxicity (somnolence, confusion, hallucinations, seizures, coma)
Serious: Myelosuppression, sepsis, neurotoxicity, nephrotoxicity
Use in pregnancy
Use in Pregnancy: Unsafe; definite evidence of risk to developing baby; fetal growth retardation and neonatal anemia reported; animal studies show embryotoxicity and anomalies; if used during pregnancy or patient becomes pregnant, apprise of potential hazard to fetus.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Precautions & warnings
Precautions:
- Ifosfamide may affect your ability to drive (dizziness, drowsiness)
- Causes severe myelosuppression; regular blood tests required (WBC, platelets, hemoglobin)
- Careful monitoring for CNS toxicity (somnolence, confusion, hallucinations, seizures)
- Adequate hydration and mesna required to prevent renal and urothelial toxicity
- Use effective contraception to avoid pregnancy (during treatment and for 6 months after last dose)
- Monitor kidney, liver function and blood cells regularly
Overdose effects
Overdose: May cause myelosuppression, neurotoxicity, nephrotoxicity; provide symptomatic supportive treatment.
Storage conditions
Store vial in original carton at 2°-8°C; protect from light; keep out of reach of children.