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 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. See actual entry in rtecs for complete information. Export all images to powerpoint file add to my favorites. 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. 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. This includes testicular cancer, soft tissue sarcoma, osteosarcoma, bladder cancer, small cell lung cancer, cervical cancer, and ovarian cancer. Carcinogenesis and mutagenesis treatment with ifosfamide involves the risk of secondary tumors and their precursors as late sequelae.
Definition from the nci drug dictionary detailed scientific definition and other names for this drug. Ifosfamide, like cyclophosphamide, is an oxazophosphorine alkylating agent. 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. Pubchemthe exact mechanism of ifosfamide has not been determined, but appears to be similar to other alkylating agents. There is a black box warning for this drug as shown here. Mesnex is indicated as a prophylactic agent in reducing. Ifosfamide treatment as a 10day continuous intravenous infusion. Link to the pdf file there and select the pdf file, then ok. Common adverse reactions include alopecia, nausea and vomiting, leukopenia, anemia, cns toxicity, hematuria, and infection. Ifosfamide has a similar spectrum of antitumor activity but has different pharmacokinetics that could provide advantages in efficacy. One patient developed severe encephalopathy at day 6 total dose 18 g ifosfamide with complete recovery after cessation of the infusion.
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. 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. These may be responsible for the toxicity of the drug. In cases of febrile neutropenia or grade 4 hematological toxicity, cisplatin, and ifosfamide doses were reduced by 20% for the further cycles. Each 20 mg vial contains 20 mg idarubicin hydrochloride, usp and 200 mg of lactose nf hydrous as an orangered, lyophilized powder. Mesnex is indicated as a prophylactic agent in reducing the. The recommendations in this online publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Ifosfamide is a chemotherapeutic agent chemically related to the nitrogen mustards and a synthetic analog of cyclophosphamide. The recommended dosing schedule is outlined below in table 1. We studied this regimen in adult and adolescent patients with bone and soft tissue sarcomas. By continuing to browse this site you are agreeing to our use of cookies.
Ifosfamide is embryotoxic to rabbits receiving 88 mgm2day doses from the 6th through the 18th day. Stability of ifosfamide in solutions for multiday infusion b. The high incidence of this toxicity requires uroprotection with aggressive hydration, frequent bladder emptying, and the concurrent use of mesna, a uroprotective agent. Only select registry of toxic effects of chemical substances rtecs data is presented here. Clinical manifestations of encephalopathy range from fatigue and confusion to coma. Ifex ifosfamide dosing, indications, interactions, adverse. A new method to quantify ifosfamide blood levels using dried. Please click here for important safety information, including boxed warning regarding hepatic impairment, and click here 3 for full prescribing information.
Dosage may be reduced, delayed or discontinued in patients with bone marrow. Ifosfamide can cause severe neurotoxicity resulting in encephalopathy and death. Ifosfamide may lower your bodys resistance and there is a chance you might get the infection the immunization is meant to prevent. The total daily dose of mesnex is 60% of the ifosfamide dose. Ifosfamide mustard significantly decreased the growth of both cancer cell lines in a dosedependent manner p. Ifosfamide is a newly available analog of cyclophosphamide in the oxazaphosphorine drug class. 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. 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. Ifosfamide side effects, dosage, interactions drugs. Please click here for important safety information, including boxed warning regarding hepatic impairment, and click here 2 for full prescribing information. Ifosfamide mustard significantly decreased the growth of both cancer cell lines in a dosedependent manner p ifosfamide solution for injection drug summary. How to insert a pdf into powerpoint online tech tips. This drug may lower the ability of the bone marrow to make blood cells that the body needs. Ifosfamide neurotoxicity and potential treatment with.
Ifosfamide also marketed as ifex is a nitrogen mustard alkylating agent used in the treatment of cancerin vitro. Continuous infusion high dose ifosfamide at 1gmm2day over 14 days is highly active and well tolerated in a heavily pretreated cohort. A randomized clinical trial of adjuvant chemotherapy with. Ifosfamide is also being studied in the treatment of other types of cancer. Ifosfamide belongs to the category of mustard gas derivatives. Guidelines for the administration of mesna with ifosfamide. Reduce bladder toxicity with conventional uroprophylaxis e. It is a positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent. Ifosfamide ifo, sold under the brand name ifex among others, is a chemotherapy medication used to treat a number of types of cancer. Idamycin idarubicin hydrochloride for injection, usp. Alkylating agents are most active in the resting phase of the cell. Ifosfamide is an antineoplastic agent useful in the treatment of a wide range of cancers including sarcomas, gynecologic cancers, lymphoma and testicular cancers. Ifex ifosfamide side effects, images, uses, dosage.
Store intact vials at room temp or under refrigeration. Use the quantity of diluent shown below to constitute the product. In some cases, health care professionals may use the trade name ifex when referring to the generic drug name ifosfamide. Myelosuppression can be severe and lead to fatal infections 5. Voorma, ingevolge het besluit van het college voor promoties. 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. Ifosfamide fda prescribing information, side effects and. Save money on your ifosfamide injection prescription by switching to tevas fdaapproved generic version. 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. Ifosfamide is a cancer medication that interferes with the growth and spread of cancer cells in the body. We have confirmed reports of activity in patients previously treated with ifosfamide. The number of anomalies was also significantly increased over the.
Review of advances in uroprotective agents for cyclophosphamide. Grapefruit may interact with ifosfamide and lead to unwanted side effects. Methylene blue reversal of ifosfamiderelated encephalopathy. However, as this emedtv segment explains, your ifosfamide dosage will be calculated using your weight, height, and other medical conditions, among other factors. Cyclophosphamide has been marketed for 32 years, and it remains a highly effective agent for a. Although ifosfamide has several significant toxic effects, the doselimiting toxicity is hemorrhagic cystitis. A comparative effectiveness study is warranted to compare costbenefit and patient preference between 14 day and 7 day regimens. Ifosfamide injection 1g summary of product characteristics. The total daily dose of mesnex is 100% of the ifosfamide dose. Although ifosfamide has been substituted for cyclophosphamide in many therapeutic regimens, it has not been proven superior to cyclophosphamide in any cancer. Risk factors for the development of cns toxicity include the following. The stability of ifosfamide in ringer lactate buffer solution either alone or. 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.
If you have any questions, contact a member of your healthcare team directly. Ifosfamide intravenous route precautions mayo clinic. 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. Also, avoid persons who have taken oral polio vaccine within the. Ifosfamide side effects, dosage, interactions drugs everyday health search. Medlineplus information on ifosfamide a lay language summary of important information about this drug that may include the following. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Following activation in the liver, ifosfamide interferes with dna through formation of phosphotriesters and dnadna crosslinks, thereby inhibiting protein synthesis and dna synthesis.
For certain toxicities, an initial dose reduction of 20% should be made, followed by an additional. Drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting. Ifosfamide has a broad spectrum of antineoplastic activity. Ifosfamide is an anticancer antineoplastic or cytotoxic chemotherapy drug. Aprepitantifosfamideencephalopathydrug interaction. 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 fda prescribing information, side effects and uses. The usual recommended dosage of ifosfamide for treating testicular cancer is 1.
Ifex ifosfamide for injection singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Find patient medical information for ifosfamide intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. For treating sarcomas, testicular cancer lymphoma or other types of cancers. 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. Encephalopathy is a potentially fatal toxicity of ifosfamide. Additional 20% dose reduction if toxicities recur 25 mgm2 iv over 3 hours every 3 weeks. Ifosfamide, carboplatin and etoposide in children with poorrisk. Common adverse reactions include alopecia, nausea and vomiting, leukopenia, anemia, cns toxicity.
Myelosuppression, neurotoxicity, and urotoxicity see full prescribing information for complete boxed warning. Cyclophosphamide and ifosfamide are widely used drugs for. Each of the above chemotherapy agents ifosfamide, etoposide and carboplatin has been. Find patient medical information for ifosfamidemesna intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Clinical pharmacology of ifosfamide and metabolites. 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. Ifex ifosfamide for injection, usp singledose vials for constitution and. Ifosfamide, like cyclophosphamide, is an oxazophosphorine. Ifex ifosfamide for injection, intravenous use warning. Aprepitant ifosfamideencephalopathydrug interaction. Insert pdf file content into a powerpoint presentation powerpoint. Ifosfamide drug monograph pediatric care online aap. Ifosfamide treatment as a 10day continuous intravenous.
This typically regresses after completing treatment. When the vials are first removed from the refrigerator, a white precipitate may be observed in the diluent vial. 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. Several payment sources exist for cancer drugs in ontario, depending on the drug, disease indication, and how and where it is delivered. Ifosfamide is given intravenously by iv usually once a day for five days every three weeks. Ifosfamide is chemically related to the nitrogen mustards and is similar in chemical structure to cyclophosphamide. Case reports of subacute interstitial pneumonias can be found in the literature, although the responsibility of ifosfamide remains unclear, as it. Data sources include ibm watson micromedex updated 28 feb 2020, cerner multum updated 2 mar 2020. Do not receive a live vaccine while using ifosfamide, or you could develop a serious infection.
Dailymed ifex ifosfamide injection, powder, for solution. 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. 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. 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. Supportive therapy should be maintained until their complete resolution. 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. Ifosfamide is only found in individuals that have used or taken this drug. Variations, taking into account individual circumstances, may. Ifosfamide investigated as a drug, mutagen, reproductive effector, and tumorigen.
Ifosfamide also marketed as ifex is a nitrogen mustard alkylating agent used in the treatment of cancer in vitro. Continuous infusion high dose ifosfamide has shown efficacy and tolerability in pediatric patients with sarcoma. Ixempra ixabepilone dosing and administration guide. Ifex 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. Open your powerpoint presentation on the page you want to insert the pdf within.
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 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. In summary, a tolerable ifosfamide dose using this regimen in this previously largely untreated patient group appears to be 12000 mg m2 day1 for 10 days. 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. You may be able to overcome this with stronger flavored herbs such as basil, sage, or thyme. Ifex ifosfamide dose, indications, adverse effects. Ifosfamide may cause neurotoxicity in 10% to 30% of treated patients. Two cases of fatal encephalopathy related to ifosfamide.
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