II. Indications
- FDA Approved
- Testicular Cancer (germ-cell)
- Off-Label
III. Mechanism
- Synthetic analog of the nitrogen mustard, antineoplastic akylating agent, Cyclophosphamide
- Like Cyclophosphamide, Ifosfamide is a prodrug, metabolized in the liver by hepatic microsomal enzymes to its active forms
- As with other Alkylating Agents including Cyclophosphamide, cross-binds DNA, blocking cell replication and other cellular functions
IV. Dosing
- See other references for disease specific dosing protocols
V. Medications
- Powders in 1 g, 3 g vials for reconstitution in solution
- Injection Solutions (50 mg/ml): 20 and 60 ml vials
VI. Adverse Effects
- Alopecia
- Bone Marror Suppression (severe, including Leukopenia)
- Hemorrhagic Cystitis
- Maximize hydration near drug administration
- Consider concurrent Mesna administration when high dose Cyclophosphamide is administered
- Neurologic changes (confusion, encephalopathy, coma)
- Nephrotoxicity
- Secondary Malignancy
VII. Safety
- Avoid in Lactation
- Avoid in Pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
- Complete Blood Count
- Renal Function tests
- Urinalysis
- Observe for Microscopic Hematuria
VIII. Resources
- Ifosfamide Injection Powder for Solution (DailyMed)
- Ifosfamide (Stat Pearls)