Xifox 1

Indications

Ifosfamide is a chemotherapy medicine used to treat several cancers, including testicular cancer (germ cell tumours), soft tissue sarcomas, bone sarcomas, some lymphomas, and certain lung, cervical and ovarian cancers. It is usually given together with other anticancer medicines.

How It Works

Ifosfamide is an alkylating agent. After the liver converts it into its active form, it attaches to the DNA of cells and links the strands together, so the cells cannot divide and eventually die. Cancer cells, which divide quickly, are most affected.

Dosage and Administration

Ifosfamide is given only in hospital by a doctor or nurse, as an infusion into a vein over a set time. The dose depends on body surface area, the type of cancer and the treatment plan, and is given in cycles, exactly as prescribed by the cancer specialist. It is always given with Mesna, a medicine that protects the bladder, and with plenty of fluids. Drink fluids as advised and pass urine often.

Interactions

Many medicines can interact. Medicines that affect liver enzymes, such as Rifampicin, Carbamazepine, Phenytoin or Ketoconazole, may change its effect. Other medicines that harm the kidneys (such as Cisplatin or Aminoglycosides) or bone marrow can add to toxicity. Avoid live vaccines and grapefruit. Tell the team about all medicines, including herbal products.

Contraindications

Not used in people with severe bone marrow suppression, active urinary tract infection or blockage of urine flow, serious kidney problems, known allergy to Ifosfamide, or during pregnancy and breastfeeding, unless the specialist decides otherwise.

Side Effects

Common effects include nausea, vomiting, hair loss, tiredness, low blood counts with higher risk of infection and bleeding, bladder irritation with blood in the urine, and kidney effects. Some people develop confusion, drowsiness or hallucinations (encephalopathy), which is usually reversible when the drug is stopped. Fertility may be reduced.

Get urgent medical help if you have fever or chills, blood in the urine or pain on passing urine, confusion, severe sleepiness, seizures, unusual bleeding, shortness of breath or signs of a severe allergic reaction.

Pregnancy and Lactation

Ifosfamide can seriously harm an unborn baby. Use reliable contraception during treatment and for the period advised afterwards (both women and men). Do not breastfeed during treatment. Discuss fertility preservation before starting if relevant.

Precautions and Warnings

Blood counts, kidney function, urine and mental state are checked regularly. Tell the team about any kidney, liver or heart disease or past radiotherapy. Avoid alcohol and do not drive if you feel drowsy or confused. Wash hands well and avoid people with infections.

Overdose

Because it is given in hospital, overdose is managed by the treating team. It may cause severe bone marrow suppression, bladder bleeding, kidney damage and confusion or coma; supportive care and specific treatments are given.

Therapeutic Class

Antineoplastic, alkylating agent (oxazaphosphorine).

Storage

Stored by the hospital pharmacy as directed on the pack, usually below 25 to 30°C, away from light and out of the reach of children.