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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Related Studies

Ontology: Ifosfamide (C0020823)

Definition (NCI) A synthetic analogue of the nitrogen mustard cyclophosphamide with antineoplastic activity. Ifosfamide alkylates and forms DNA crosslinks, thereby preventing DNA strand separation and DNA replication. This agent is a prodrug that must be activated through hydroxylation by hepatic microsomal enzymes. (NCI04)
Definition (NCI_NCI-GLOSS) A drug that is used with other drugs to treat germ cell testicular cancer that did not respond to previous treatment with other drugs. It is also being studied in the treatment of other types of cancer. Ifex attaches to DNA in cells and may kill cancer cells. It is a type of alkylating agent and a type of antimetabolite.
Definition (MSH) Positional isomer of CYCLOPHOSPHAMIDE which is active as an alkylating agent and an immunosuppressive agent.
Definition (CSP) 2-oxo-N,3-bis-(2-chloroethyl) tetrahydro-2H-1,3,2-oxazaphosphorin- 2-amine; cyclophosphamide analog with two alkylating groups, used as a DNA strand crosslinker and antineoplastic.
Definition (PDQ) A synthetic analogue of the nitrogen mustard cyclophosphamide with antineoplastic activity. Ifosfamide alkylates and forms DNA crosslinks, thereby preventing DNA strand separation and DNA replication. This agent is a prodrug that must be activated through hydroxylation by hepatic microsomal enzymes. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40024&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40024&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C564" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organophosphorus Compound (T115)
MSH D007069
SnomedCT 108757000, 386904003
LNC LP65841-6, LP65832-5
English Ifosfamide, Iphosphamide, Iso-Endoxan, Isofosfamide, Isophosphamide, ifosfamide, 2H-1,3,2-Oxazaphosphorin-2-amine, N,3-bis(2-chloroethyl)tetrahydro-, 2-oxide, Iso Endoxan, 2-oxo-N,3-bis-(2-chloroethyl) tetrahydro-2H-1,3,2-oxazaphosphorin- 2-amine, 3-(2-chloroethyl)-2-[(2-chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorin-2-oxide, N,3-bis(2-chloroethyl)tetrahydro-2H-1,3,2-oxazaphosphorin-2-amine 2-oxide, Iphosphamid, Isoendoxan, ifosfamide (medication), IFOSFAMIDE, Ifosfamide [Chemical/Ingredient], ipps, ipp, isofosfamide, Ifosfamide (product), Ifosfamide (substance), IPP, IFX, Naxamide, iphosphamide, isophosphamide, IFF, IFO
Swedish Ifosfamid
Czech ifosfamid
Finnish Ifosfamidi
Russian IFOSFAMID, IZOFOSFAMID, ИЗОФОСФАМИД, ИФОСФАМИД
Japanese イフォスファマイド, イソホスファミド, イソフォスファミド, イホスファミド
Polish Ifosfamid
Spanish ifosfamida (producto), ifosfamida (sustancia), ifosfamida, Ifosfamida, Isofosfamida
French Ifosfamide
German Ifosfamid, Isofosfamid, Isophosphamid
Italian Ifosfamide
Portuguese Ifosfamida, Isofosfamida