Holoxan2gm/vial

Ifosfamide is used in the treatment of different kinds of cancers. It is given alone or in combination with other chemotherapy medicines, radiotherapy and surgery to treat cancer of blood, breast, lung, ovaries, pancreas, testes, and lymph nodes. Ifosfamide is usually given as a slow infusion (drip) into a vein (intravenously) over several hours. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. It is advised that you drink extra fluids so that you pass more urine. This will help prevent bladder and kidney problems and keep your kidneys working well. The most common side effects of this medicine include nausea, vomiting, anemia (low number of red blood cells), hair loss, decreased white blood cells count. If these bother you or appear serious, let your doctor know. There may be ways of reducing or preventing them. It is very strong medicine and some people may develop serious side effects while taking it. This medicine may lower your ability to fight infections and lead to problems with your blood, liver or kidneys. Before taking it, tell your doctor if you have liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. It may harm your baby. You and your partner should avoid becoming pregnant or fathering a child for several months after your treatment with it has stopped. Ifosfamide is an anti-cancer medication. It works by damaging the genetic material (DNA and RNA) of the cancer cells. This stops their growth and multiplication.

• Pancreatic cancer • Ovarian cancer • Breast cancer • Non-small cell lung cancer • Testicular cancer • Blood cancer

Ifosfamide is converted to its active metabolites via hepatic microsomal enzymes. These active metabolites act as alkylating agents, disrupting DNA and protein synthesis of the target cells. It is routinely given with mesna to reduce urothelial toxicity.

Adult Dose: Intravenous Germ cell testicular carcinoma Adult: 1.2 g/m2/day for 5 days via slow infusion over at least 30 minutes, repeat treatment every 3 wk or after recovery from haematological toxicity. To be given with mesna and adequate hydration of at least 2 L of oral or IV fluid per day. Lymphoma; Sarcoma; Solid tumours Adult: Different licensed dosage regimens are available. Regimen 1: 8-12 g/m2 divided over 3-5 days, repeat course every 2-4 wk. Regimen 2: 6 g/m2 divided over 5 days, repeat course every 3 wk. Regimen 3: 5-6 g/m2 (max: 10 g), give as a single 24-hr infusion, repeat course every 3-4 wkly. Child Dose: Safety and efficacy not established Renal Dose: Renal impairment: CrCl (ml/min) <10 Administer 75% of dose.

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Ifosfamide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Nausea • Vomiting • Anemia (low number of red blood cells) • Hair loss • Decreased white blood cell count • Infection • Blood in urine • CNS toxicity

[UNSAFE] Ifosfamide may cause side effects which could affect your ability to drive. Ifosfamide is used in combination with other chemotherapy medicines, radiotherapy and surgery to treat cancer of blood, breast, lung, ovaries, pancreas, testes, and lymph nodes. It is usually given as a slow infusion (drip) into a vein (intravenously) over several hours. Drink plenty of fluids while taking this medication to minimise damage to your bladder and kidneys. It may cause dizziness and sleepiness. Don't drive or do anything that requires mental focus until you know how it affects you. Use effective measures to avoid pregnancy during treatment with this medicine and for at least 6 months after your last dose as it can be harmful to an unborn baby. Your doctor may have your blood tested regularly to monitor your kidney, liver function and levels of blood cells in your blood.

Hypersensitivity; severe bone-marrow depression. Pregnancy, lactation.

Causes enhanced toxicity with allopurinol, cisplatin. Ifosfamide enhances the anticoagulant effect of warfarin. CYP2A6 inducers (e.g. amobarbital, pentobarbital, phenobarbital, rifampin and secobarbital) may reduce serum levels of ifosfamide while the inhibitors (e.g. isoniazid, methoxsalen and miconazole) may increase its serum levels. CYP3A4 inducers (e.g. aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins) may reduce serum levels of ifosfamide while the inhibitors (e.g. azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid) may increase its serum levels.

[UNSAFE] It is unsafe to consume alcohol with Ifosfamide.

[CONSULT YOUR DOCTOR] Ifosfamide is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[UNSAFE] Ifosfamide is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

[CAUTION] Ifosfamide should be used with caution in patients with kidney disease. Dose adjustment of Ifosfamide may be needed. Please consult your doctor. [CAUTION] Ifosfamide should be used with caution in patients with liver disease. Dose adjustment of Ifosfamide may be needed. Please consult your doctor.

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