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Action/Kinetics:
Synthetic analog of cyclophosphamide that must be converted in the liver to active metabolites. The alkylated metabolites of ifosfamide then interact with DNA.
t
1/2, elimination: 7 hr. Excreted in the urine both as unchanged drug and metabolites.
Uses:
As third-line therapy, in combination with other antineoplastic drugs, for germ cell testicular cancer. Always give with mesna to prevent ifosfamide-induced hemorrhagic cystitis.
Investigational: Cancer of the breast, lung, pancreas, ovary, and stomach. Also for sarcomas, acute leukemias (except AML), malignant lymphomas.
Contraindications:
Severe bone marrow depression. Lactation.
Special Concerns:
Use with caution in clients with compromised bone marrow reserve, impaired renal function, and during lactation. Safety and efficacy have not been established in children. May interfere with wound healing.
Additional Side Effects:
GU:
Hemorrhagic cystitis hematuria, dysuria, urinary frequency.
CNS: Confusion, depressive psychosis, somnolence, hallucinations. Less frequently: dizziness, disorientation, cranial nerve dysfunction,
seizures, coma.
GI: Salivation, stomatitis.
Miscellaneous: Myelosuppression, alopecia, infection, liver dysfunction, phlebitis, fever of unknown origin, dermatitis, fatigue, hypertension, hypotension, polyneuropathy, pulmonary symptoms,
cardiotoxicity interference with normal wound healing.
Laboratory Test Alterations:
Liver enzymes, bilirubin.
Overdose Management:
Symptoms: See
Additional Side Effects.
Treatment: General supportive measures.
How Supplied:
Powder for injection: 1 g, 3 g
Dosage
?IV
Testicular cancer.
1.2 g/m
2/day for 5 consecutive days. Treatment may be repeated q 3 weeks or if platelet counts are at least 100,000/mm
3 and WBCs are at least 4,000/mm
3.
