III. Mechanism

  1. Synthetic analog of the nitrogen mustard, antineoplastic akylating agent, Cyclophosphamide
  2. Like Cyclophosphamide, Ifosfamide is a prodrug, metabolized in the liver by hepatic microsomal enzymes to its active forms
  3. As with other Alkylating Agents including Cyclophosphamide, cross-binds DNA, blocking cell replication and other cellular functions

IV. Dosing

  1. See other references for disease specific dosing protocols

V. Medications

  1. Powders in 1 g, 3 g vials for reconstitution in solution
  2. Injection Solutions (50 mg/ml): 20 and 60 ml vials

VI. Adverse Effects

  1. Alopecia
  2. Bone Marror Suppression (severe, including Leukopenia)
  3. Hemorrhagic Cystitis
    1. Maximize hydration near drug administration
    2. Consider concurrent Mesna administration when high dose Cyclophosphamide is administered
  4. Neurologic changes (confusion, encephalopathy, coma)
  5. Nephrotoxicity
  6. Secondary Malignancy

VII. Safety

  1. Avoid in Lactation
  2. Avoid in Pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function tests
    3. Urinalysis
      1. Observe for Microscopic Hematuria

VIII. Resources

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