IFOSFAMIDE (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
Category
Description
Ifosfamide (eye-FOS-fa-mide) belongs to the group of medicines calledalkylating agents. It is used to treat cancer of the testicles as well assome other kinds of cancer. Another medicine, called mesna, is usually givenalong with ifosfamide to prevent bladder problems that can be caused by ifosfamide.
Ifosfamide interferes with the growth of cancer cells, which are eventuallydestroyed. Since the growth of normal body cells may also be affected by ifosfamide,other effects will also occur. Some of these may be serious and must be reportedto your doctor. Other effects, like hair loss, may not be serious but maycause concern. Some effects may not occur until months or years after themedicine is used.
Before you begin treatment with ifosfamide, you and your doctor shouldtalk about the good this medicine will do as well as the risks of using it.
Ifosfamide is to be administered only by or under the immediate supervisionof your doctor. It is available in the following dosage form:
Parenteral- Injection (U.S. and Canada)
Before Using This Medicine
In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For ifosfamide, thefollowing should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to ifosfamide.
Pregnancy?Tell your doctor if you are pregnant or if you intendto have children. There is a chance that this medicine may cause birth defectsif either the male or female is taking it at the time of conception or ifit is taken during pregnancy. Ifosfamide causes birth defects in animals.In addition, many cancer medicines may cause sterility that could be permanent.Although sterility has not been reported with this medicine, the possibilityshould be kept in mind.
Be sure that you have discussed this with your doctor before taking thismedicine. It is best to use some kind of birth control while you are receivingifosfamide. Tell your doctor right away if you think you have become pregnantwhile receiving ifosfamide.
Breast-feeding?Tell your doctor if you are breast-feeding or ifyou intend to breast-feed during treatment with this medicine. Because ifosfamidemay cause serious side effects in the nursing infant, breast-feeding is generallynot recommended while you are receiving it.
Children?Although there is no specific information comparinguse of ifosfamide in children with use in other age groups, this medicineis not expected to cause different side effects or problems in children thanit does in adults.
Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults or if they cause different side effectsor problems in older people. There is no specific information comparing useof ifosfamide in the elderly with use in other age groups.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingifosfamide, it is especially important that your health care professionalknow if you are taking any of the following:
- Amphotericin B by injection (e.g., Fungizone) or
- Antithyroid agents (medicine for overactive thyroid) or
- Azathioprine (e.g., Imuran) or
- Chloramphenicol (e.g., Chloromycetin) or
- Colchicine or
- Flucytosine (e.g., Ancobon) or
- Ganciclovir (e.g., Cytovene) or
- Interferon (e.g., Intron A, Roferon-A) or
- Plicamycin (e.g., Mithracin) or
- Zidovudine (e.g., AZT, Retrovir) or
- If you have ever been treated with x-rays or cancer medicines?Ifosfamidemay increase the effects of these medicines or radiation therapy on the blood
Other medical problems?The presence of other medicalproblems may affect the use of ifosfamide. Make sure you tell your doctorif you have any other medical problems, especially:
- Chickenpox (including recent exposure) or
- Herpes zoster (shingles)?Risk of severe disease affecting otherparts of the body
- Infection?Ifosfamide can decrease your body's ability to fightinfection
- Kidney disease?Effects may be increased because of slower removalof ifosfamide from the body
- Liver disease?Effects may be increased or decreased becausethe liver both makes ifosfamide work and removes it from the body
Proper Use of This Medicine
Ifosfamideis sometimes given together with certain other medicines. If you are usinga combination of medicines, make sure that you take each one at the propertime and do not mix them. Ask your health care professional to help you plana way to remember to take your medicines at the right times.
While you are receiving ifosfamide, it is important that you drink extrafluids so that you will pass more urine. Also, empty your bladder frequently,including at least once during the night. This will help prevent kidney andbladder problems and keep your kidneys working well. Ifosfamide passes fromthe body in the urine. If too much of it appears in the urine or if the urinestays in the bladder too long, it can cause dangerous irritation. Follow yourdoctor's instructions carefully about how much fluid to drink every day. Somepatients may have to drink up to 7 to 12 cups (3 quarts) of fluid a day.
Ifosfamide often causes nausea and vomiting. However, it is very importantthat you continue to receive the medicine even if you begin to feel ill. Askyour health care professional for ways to lessen these effects.
Dosing?The dose of ifosfamide will be different fordifferent patients. The dose that is used may depend on a number of things,including what the medicine is being used for, the patient's size, and whetheror not other medicines are also being taken. If you arereceiving ifosfamide at home, follow your doctor's orders or the directionson the label. If you have any questions about the proper dose of ifosfamide,ask your doctor.
Precautions While Using This Medicine
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check forunwanted effects.
While you are being treated with ifosfamide, and after you stop treatmentwith it, do not have any immunizations (vaccinations)without your doctor's approval. Ifosfamide may lower your body's resistanceand there is a chance you might get the infection the immunization is meantto prevent. In addition, other persons living in your house should not takeoral polio vaccine since there is a chance they could pass the polio viruson to you. Also, avoid persons who have taken oral polio vaccine within thepast several months. Do not get close to them, and do not stay in the sameroom with them for very long. If you cannot take these precautions, you shouldconsider wearing a protective face mask that covers the nose and mouth.
Ifosfamide can temporarily lower the number of white blood cells in yourblood, increasing the chance of getting an infection. It can also lower thenumber of platelets, which are necessary for proper blood clotting. If thisoccurs, there are certain precautions you can take to reduce the risk of infectionor bleeding:
- If you can, avoid people with infections. Checkwith your doctor immediately if you think you are getting an infectionor if you get a fever or chills, cough or hoarseness, lower back or side pain,or have painful or difficult urination.
- Check with your doctor immediately ifyou notice any unusual bleeding or bruising; black, tarry stools; blood inurine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick.Your medical doctor, dentist, or nurse may recommend other ways to clean yourteeth and gums. Check with your medical doctor before having any dental workdone.
- Do not touch your eyes or the inside of your nose unless you havejust washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects suchas a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injurycould occur.
Side Effects of This Medicine
Along with their needed effects,medicines like ifosfamide can sometimes cause unwanted effects such as bloodproblems, loss of hair, and problems with the bladder. These and others aredescribed below. Also, because of the way these medicines act on the body,there is a chance that they might cause other unwanted effects that may notoccur until months or years after the medicine is used. These may includecertain types of cancer, such as leukemia. Discuss these possible effectswith your doctor.
Although not all of these side effects mayoccur, if they do occur they may need medical attention.
Other side effects may occur that usually do not need medical attention.These side effects may go away during treatment as your body adjusts to themedicine. Also, your health care professional may be able to tell you aboutways to prevent or reduce some of these side effects. Check with your doctorif any of the following side effects continue or are bothersome or if youhave any questions about them:
Ifosfamide often causes a temporary loss of hair. After treatment has ended,normal hair growth should return.
After you stop receiving ifosfamide, it maystill produce some side effects that need attention. During this period oftime, check with your doctor immediately if younotice the following side effect:
Blood in urine
Other side effectsnot listed above may also occur in some patients. If you notice any othereffects, check with your doctor.
Additional Information
Once a medicine has been approvedfor marketing for a certain use, experience may show that it is also usefulfor other medical problems. Although these uses are not included in productlabeling, ifosfamide is used in certain patients with the following medicalconditions:
- Acute lymphocytic leukemia (a type of cancer of the blood)
- Cancer of the bladder
- Cancer of the bone (including Ewing's sarcoma)
- Cancer of the breast
- Cancer of the cervix
- Cancer of the endometrium
- Cancers of the head and neck
- Cancer of the lung
- Cancer of the ovaries
- Lymphomas
- Neuroblastoma (a certain type of brain cancer)
- Thymoma and other cancer of the thymus (a small organ beneath thebreastbone)
- Tumors in the ovaries
- Wilms' tumor (a cancer of the kidneys occurring mainly in children)
Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.
Revised: 04/24/2002
