💊 DESCRIPTION
Ifosfamide is a cytotoxic alkylating agent used in chemotherapy. It is supplied as a sterile lyophilized powder that is reconstituted and administered via intravenous (IV) infusion.
- Form: Powder for Injection
- Strength: 1000 mg per vial
- Route: IV infusion
- Class: Alkylating agent (nitrogen mustard derivative)
- Indications:
- Testicular cancer (usually in combination regimens)
- Sarcomas (e.g., soft tissue and bone)
- Lymphomas
- Ovarian cancer
- Lung cancer
- Cervical and bladder cancers (off-label in some cases)
✅ ADVANTAGES
- Broad spectrum antitumor activity
- Often used in combination chemotherapy protocols (e.g., with mesna and other cytotoxic agents)
- Effective for aggressive or resistant tumors
- Allows dose-intensification protocols with mesna uroprotection
- Can achieve remission in testicular and sarcoma patients
🌿 NATURE
- Mechanism of Action:
- Ifosfamide is converted in the liver to active metabolites (like isophosphoramide mustard)
- These form DNA cross-links, inhibiting DNA replication and transcription, leading to cell death
- Works on dividing and resting cells, making it non–cell-cycle-specific
- Related compound: Cyclophosphamide (but with different activation/metabolism)
⚠️ PRECAUTIONS
- Bone marrow suppression: Common and dose-limiting – monitor CBC
- Hemorrhagic cystitis: Caused by acrolein, a toxic metabolite – always co-administer mesna and IV fluids
- Renal toxicity: Especially in children – monitor serum creatinine and electrolytes
- Neurotoxicity: Risk of encephalopathy (confusion, hallucinations, somnolence) – observe neurologic status
- Nausea/Vomiting: Highly emetogenic – premedicate with antiemetics
- Fertility effects: Potential for permanent infertility
- Teratogenic: Contraindicated in pregnancy and breastfeeding
- Secondary malignancies: Risk increases with prolonged use
🧊 STORAGE
- Before reconstitution:
- Store vials below 25°C (77°F)
- Protect from light and moisture
- After reconstitution:
- Use immediately, or within 24 hours if stored at 2–8°C
- Reconstituted solution should be diluted in IV fluids before administration
- Do not freeze
👨⚕️ PATIENT ADVICE
- Stay well-hydrated and urinate frequently during and after treatment to reduce bladder toxicity
- Expect blood tests before each dose to monitor bone marrow and organ function
- Report immediately: blood in urine, confusion, dizziness, fever, unusual tiredness, or shortness of breath
- Avoid pregnancy during and after treatment (use reliable contraception)
- Hair loss, nausea, and fatigue are common but temporary
- You may receive mesna and IV fluids to prevent bladder and kidney damage
- Do not miss appointments – close monitoring is essential
📦 PACKAGING
- Primary Packaging:
- Type I glass vial containing 1000 mg lyophilized powder
- Rubber stopper and flip-off seal or aluminum crimp
- Labeling: Includes drug name, strength, batch number, expiry date, storage info
- Secondary Packaging:
- Outer carton with patient information leaflet
- Clearly marked “Cytotoxic – Handle with care”