Ifosfamide should only be administered when there are facilities for regular monitoring of clinical, biochemical and haematological parameters before, during and after administration and under the direction of a specialist oncology service by physicians experienced with this drug. For certain toxicities, an initial dose reduction of 20% should be made, followed by an additional. Ixempra ixabepilone dosing and administration guide. How to insert a pdf into powerpoint online tech tips.
Ifosfamide has a similar spectrum of antitumor activity but has different pharmacokinetics that could provide advantages in efficacy. Ifosfamide also marketed as ifex is a nitrogen mustard alkylating agent used in the treatment of cancerin vitro. Aug, 2018 ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Ifosfamide is an antineoplastic agent useful in the treatment of a wide range of cancers including sarcomas, gynecologic cancers, lymphoma and testicular cancers. In cases of febrile neutropenia or grade 4 hematological toxicity, cisplatin, and ifosfamide doses were reduced by 20% for the further cycles. Ifosfamide treatment as a 10day continuous intravenous. Ifosfamide neurotoxicity may become manifest within a few hours to a few days after first administration and in most cases resolves within 48 to 72 hours of ifosfamide discontinuation. Pdr drug summaries are concise pointofcare prescribing, dosing and administering information to help phsyicans more efficiently and accurately prescribe in their practice pdr s drug summaries are available free of charge and serve as a great resource for us based mds, dos, nps and pas in patient practice. Mesnex is indicated as a prophylactic agent in reducing the. Ifosfamide is also sometimes used to treat bladder cancer, lung cancer, cancer of the ovaries cancer that begins in the female reproductive organs where eggs are formed, cancer of the cervix, and certain types of soft tissue or bone sarcomas cancer that forms in muscles and bones. Link to the pdf file there and select the pdf file, then ok.
These may be responsible for the toxicity of the drug. Dosage may be reduced, delayed or discontinued in patients with bone marrow. Ifosfamide is an alkylating agent that is fda approved for the treatment of germ cell testicular cancer. The number of anomalies was also significantly increased over the. The total daily dose of mesnex is 60% of the ifosfamide dose. Ifosfamide may cause neurotoxicity in 10% to 30% of treated patients. Clinical pharmacology of ifosfamide and metabolites. Ifosfamide investigated as a drug, mutagen, reproductive effector, and tumorigen. Oct 24, 2016 ifosfamide should only be administered when there are facilities for regular monitoring of clinical, biochemical and haematological parameters before, during and after administration and under the direction of a specialist oncology service by physicians experienced with this drug. In the adult population, retrospective series demonstrate promise in patients and even in patients previously treated with ifosfamide. Only select registry of toxic effects of chemical substances rtecs data is presented here. Following activation in the liver, ifosfamide interferes with dna through formation of phosphotriesters and dnadna crosslinks, thereby inhibiting protein synthesis and dna synthesis. Ifosfamide is a cancer medication that interferes with the growth and spread of cancer cells in the body.
The high incidence of this toxicity requires uroprotection with aggressive hydration, frequent bladder emptying, and the concurrent use of mesna, a uroprotective agent. In addition, other persons living in your house should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Ifosfamide is only found in individuals that have used or taken this drug. Ifex ifosfamide for injection, intravenous use warning. Ifosfamide neurotoxicity and potential treatment with. Ifex ifosfamide for injection, usp singledose vials for constitution and. Encephalopathy is a potentially fatal toxicity of ifosfamide. When the vials are first removed from the refrigerator, a white precipitate may be observed in the diluent vial. Ifex ifosfamide dosing, indications, interactions, adverse. Continuous infusion high dose ifosfamide has shown efficacy and tolerability in pediatric patients with sarcoma. Ifosfamide is also being studied in the treatment of other types of cancer. Physical and chemical stability of highdose ifosfamide and mesna for prolonged 14day continuous infusion article pdf available in journal of oncology pharmacy practice 201 march 20 with. The total daily dose of mesnex is 100% of the ifosfamide dose. Methylene blue reversal of ifosfamiderelated encephalopathy.
Ifosfamide is a parenterally administered alkylating agent similar to cyclophosphamide that is used in the treatment of several forms of cancer including lymphomas, sarcoma and advanced forms of solid organ cancer such as breast, testicular, ovarian, gastric and lung cancer. Case reports of subacute interstitial pneumonias can be found in the literature, although the responsibility of ifosfamide remains unclear, as it was used in. Ifosfamide fda prescribing information, side effects and uses. The stability of ifosfamide in ringer lactate buffer solution either alone or. Save money on your ifosfamide injection prescription by switching to tevas fdaapproved generic version. A new method to quantify ifosfamide blood levels using dried. Aprepitantifosfamideencephalopathydrug interaction. This drug may lower the ability of the bone marrow to make blood cells that the body needs. Guidelines for the administration of mesna with ifosfamide. Ifosfamide is structurally related to cyclophosphamide and has been used in the treatment of a variety of solid tumors, including lung, testicular, and breast cancer. It is a positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent.
Ifosfamide, like cyclophosphamide, is an oxazophosphorine alkylating agent. If you have any questions, contact a member of your healthcare team directly. Ifosfamide treatment as a 10day continuous intravenous infusion. Ifosfamide side effects, dosage, interactions drugs. However, as this emedtv segment explains, your ifosfamide dosage will be calculated using your weight, height, and other medical conditions, among other factors. The recommendations in this online publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Ifosfamide side effects, dosage, interactions drugs everyday health search.
We studied this regimen in adult and adolescent patients with bone and soft tissue sarcomas. Common adverse reactions include alopecia, nausea and vomiting, leukopenia, anemia, cns toxicity. This includes testicular cancer, soft tissue sarcoma, osteosarcoma, bladder cancer, small cell lung cancer, cervical cancer, and ovarian cancer. The recommended dosing schedule is outlined below in table 1. Also, avoid persons who have taken oral polio vaccine within the. Reduce bladder toxicity with conventional uroprophylaxis e. Cyclophosphamide has been marketed for 32 years, and it remains a highly effective agent for a.
Apr 25, 2008 ifosfamide is an antineoplastic agent useful in the treatment of a wide range of cancers including sarcomas, gynecologic cancers, lymphoma and testicular cancers. Pubchemthe exact mechanism of ifosfamide has not been determined, but appears to be similar to other alkylating agents. Ifosfamide, carboplatin and etoposide in children with poorrisk. Common adverse reactions include alopecia, nausea and vomiting, leukopenia, anemia, cns toxicity, hematuria, and infection.
A randomized clinical trial of adjuvant chemotherapy with. Carcinogenesis and mutagenesis treatment with ifosfamide involves the risk of secondary tumors and their precursors as late sequelae. A comparative effectiveness study is warranted to compare costbenefit and patient preference between 14 day and 7 day regimens. Ifosfamide ifo, sold under the brand name ifex among others, is a chemotherapy medication used to treat a number of types of cancer. Find patient medical information for ifosfamidemesna intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Case reports of subacute interstitial pneumonias can be found in the literature, although the responsibility of ifosfamide remains unclear, as it. Ifosfamide belongs to the category of mustard gas derivatives. Jul 26, 2018 ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Although ifosfamide has several significant toxic effects, the doselimiting toxicity is hemorrhagic cystitis. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Stability of ifosfamide in solutions for multiday infusion b. Mesna equivalent of 40% total daily ifosfamide dose given as iv bolus postifosfamide mesna equivalent of 40% total daily ifosfamide dose given orally 2 and 6 hours after the end of the ifosfamide infusion. Two cases of fatal encephalopathy related to ifosfamide. Ifosfamide drug monograph pediatric care online aap. Variations, taking into account individual circumstances, may. Jul 01, 2019 discontinue ifosfamide or reduce dosage in patients who develop hematuria 50 erythrocyteshpf while receiving usual dosages of ifosfamide in conjunction with mesna. Ifosfamide mustard significantly decreased the growth of both cancer cell lines in a dosedependent manner p. Aprepitant ifosfamideencephalopathydrug interaction.
Ifosfamide can cause severe neurotoxicity resulting in encephalopathy and death. Ifosfamide injection 1g summary of product characteristics. Ifosfamide also marketed as ifex is a nitrogen mustard alkylating agent used in the treatment of cancer in vitro. Ifosfamide is a synthetic structural isomer of cyclophosphamide that has been approved for concurrent use with other drugs usually cisplatin, etoposide, or vinblastine in the treatment of metastatic germcell testicular cancer and some especially pediatric sarcomas. One patient developed severe encephalopathy at day 6 total dose 18 g ifosfamide with complete recovery after cessation of the infusion. Dailymed ifex ifosfamide injection, powder, for solution. Clinical manifestations of encephalopathy range from fatigue and confusion to coma. The break in treatment allows your blood cell counts to recover, as ifosfamide can cause bone marrow suppression when the bone marrow does not make adequate amounts of blood cells. Medlineplus information on ifosfamide a lay language summary of important information about this drug that may include the following. Myelosuppression, neurotoxicity, and urotoxicity see full prescribing information for complete boxed warning. Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight ww at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. Risk factors for the development of cns toxicity include the following. Grapefruit may interact with ifosfamide and lead to unwanted side effects. Prior to constituting ixempra for injection, the kit should be removed from the refrigerator and allowed to stand at room temperature for approximately 30 minutes.
Each of the above chemotherapy agents ifosfamide, etoposide and carboplatin has been. Ifosfamide is an anticancer antineoplastic or cytotoxic chemotherapy drug. This typically regresses after completing treatment. See actual entry in rtecs for complete information. Find medication information including related drug classes, side effects, patient statistics and answers to frequently asked questions. Review of advances in uroprotective agents for cyclophosphamide. There is a black box warning for this drug as shown here. Ifex ifosfamide side effects, images, uses, dosage. Additional 20% dose reduction if toxicities recur 25 mgm2 iv over 3 hours every 3 weeks. Ifex ifosfamide for injection singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Ifosfamide mustard significantly decreased the growth of both cancer cell lines in a dosedependent manner p ifosfamide solution for injection drug summary. Insert pdf file content into a powerpoint presentation powerpoint.
Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage ww at the time of ifosfamide administration. Mesnex tablets are given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6 hours after each dose of ifosfamide. Ifosfamide is given intravenously by iv usually once a day for five days every three weeks. Ifosfamide intravenous route precautions mayo clinic. Ifosfamide is embryotoxic to rabbits receiving 88 mgm2day doses from the 6th through the 18th day. Export all images to powerpoint file add to my favorites.
Ifosfamide is a newly available analog of cyclophosphamide in the oxazaphosphorine drug class. Ifosfamide for injection ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. If youre a patient at msk and you need to reach a provider after 5. Although ifosfamide has been substituted for cyclophosphamide in many therapeutic regimens, it has not been proven superior to cyclophosphamide in any cancer. Ifosfamide fda prescribing information, side effects and. Ifosfamide is a chemotherapeutic agent chemically related to the nitrogen mustards and a synthetic analog of cyclophosphamide.
Insert pdf content into your presentation either as a picture that shows on your slide, or as a document that you can open during your slide show. Each 20 mg vial contains 20 mg idarubicin hydrochloride, usp and 200 mg of lactose nf hydrous as an orangered, lyophilized powder. Ifex ifosfamide dose, indications, adverse effects. For treating sarcomas, testicular cancer lymphoma or other types of cancers. Cyclophosphamide and ifosfamide are widely used drugs for. Please click here for important safety information, including boxed warning regarding hepatic impairment, and click here 3 for full prescribing information. Data sources include ibm watson micromedex updated 28 feb 2020, cerner multum updated 2 mar 2020. You may be able to overcome this with stronger flavored herbs such as basil, sage, or thyme. Aug, 2018 drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting. Voorma, ingevolge het besluit van het college voor promoties. Several payment sources exist for cancer drugs in ontario, depending on the drug, disease indication, and how and where it is delivered.
Mesnex is indicated as a prophylactic agent in reducing. Supportive therapy should be maintained until their complete resolution. We have confirmed reports of activity in patients previously treated with ifosfamide. In some cases, health care professionals may use the trade name ifex when referring to the generic drug name ifosfamide. Drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting.
Ifosfamide is chemically related to the nitrogen mustards and is similar in chemical structure to cyclophosphamide. Zinecard is a cytoprotective agent indicated for reducing the incidence and severity of cardiomyopathy associated with doxorubicin administration in women with metastatic breast cancer who have received a cumulative doxorubicin dose of 300 mgm 2 and who will continue to receive doxorubicin therapy to maintain tumor control. By continuing to browse this site you are agreeing to our use of cookies. Idamycin idarubicin hydrochloride for injection, usp. Ifosfamide has a broad spectrum of antineoplastic activity. Find patient medical information for ifosfamide intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Store intact vials at room temp or under refrigeration. Alkylating agents are most active in the resting phase of the cell.
Ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Ifosfamide, like cyclophosphamide, is an oxazophosphorine. The usual recommended dosage of ifosfamide for treating testicular cancer is 1. Please click here for important safety information, including boxed warning regarding hepatic impairment, and click here 2 for full prescribing information. Continuous infusion high dose ifosfamide at 1gmm2day over 14 days is highly active and well tolerated in a heavily pretreated cohort. Do not receive a live vaccine while using ifosfamide, or you could develop a serious infection.