Ifosfamide is used on its own or together with other medicines to treat certain cancers such as cancer of the lung, ovary, uterus, pancreas, bone, soft tissue, and lymph glands.
It is also used together with other medicines to treat cancer of the testis (male reproductive gland that produces sperm and secretes testosterone).
This medicine reduces the size of the tumour by stopping cancer cells from growing.
Ifosfamide may be used to treat other conditions as decided by your doctor.
Ifosfamide injection is to be given intravenously (into the vein) over a period of time. It is delivered directly into the bloodstream via the blood vessel.
Your doctor or nurse will administer the injection for you.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.
Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Ifosfamide.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
Alert your doctor if you have the following conditions:
- trouble passing urine
- cystitis (inflammation of the urinary bladder)
- severely impaired bone marrow function (a condition in which the blood cells are low)
- kidney disease
- severe liver disease
- acute infections
as Ifosfamide may not be suitable for you.
Do not use this medicine if you are pregnant. If you become pregnant while on Ifosfamide therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.
It is important that you do not get pregnant while using this medicine. You must use proven birth control methods during Ifosfamide therapy. Men should not father a child for up to 6 months after stopping the treatment. You may wish to discuss birth control methods with your doctor or pharmacist.
Do not breastfeed while you are being treated with this medicine.
Inform your doctor if you have the following conditions:
- heart disease or conditions that may increase your risk for heart disease
- other infections e.g. urinary tract infection
- severe weakening of the immune system
- undergone previous radiation therapy
Inform your doctor if you have been recently vaccinated. Do not receive any vaccinations without first asking your doctor.
Maintain good oral hygiene to avoid stomatitis (inflammation of the mouth and lips).
Ensure adequate fluid intake of at least 2 litres per day.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- You may need to have routine blood tests (e.g. complete blood count, liver and kidney function tests) while you are being treated with Ifosfamide. Your doctor will advise you about how often you will need to have these tests.
- Urine test may be done before starting treatment.
- Regular monitoring of signs and symptoms of infections or toxicity may be needed during therapy.
Ifosfamide may impair mental alertness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: nausea, vomiting, diarrhoea, mouth sore, decreased appetite, tiredness, weakness, hair loss, skin swelling or lesions, impaired wound healing, and pain or swelling at the injection site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- pain in the bladder, change in the amount of urine output, difficulty in passing urine, or blood in the urine
- shortness of breath, difficulty in breathing, or cough
- irregular or abnormal heartbeat, lightheadedness, fainting, tiredness, swelling of the legs, ankles and feet
- sudden weight gain, liver pain, yellowing of the skin and whites of the eyes with stomach pain, persistent tiredness
- confusion, hallucinations (seeing, hearing or feeling things that are not existent) and seizures
- swelling of the face, lips, mouth, tongue or throat
To reduce the incidence of bladder problems, nausea and vomiting, Ifosfamide may be given with mesna (medicine for nausea and vomiting) during treatment.
Ifosfamide will cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin, phenobarbital
- rifampicin (medicine to treat lung infection known as TB)
- anti-inflammatory medicines e.g. prednisone
- medicines to treat fungal infection e.g. ketoconazole, fluconazole
- medicines for high blood pressure known as ACE inhibitors e.g. captopril, enalapril
- other medicines for cancer e.g. carboplatin, cisplatin, bleomycin, doxorubicin, busulfan
- natalizumab (medicine for multiple sclerosis)
- amiodarone (medicines for irregular heartbeat)
- medicines used to increase white blood cells after chemotherapy e.g. filgrastim, sargramostim
- aciclovir (medicine to treat viral infection)
- amphotericin B (medicine to treat fungal infection)
- certain antibiotics e.g. amikacin, gentamicin
- medicines for nausea or vomiting e.g. aprepitant
- medicines for cold or allergy e.g. diphenhydramine
- strong painkiller e.g. oxycodone
- medicines to induce sleep e.g. diazepam
- warfarin (blood-thinning medicine)
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Ifosfamide.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol. Consuming a large amount of alcohol is damaging to your liver.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store the powder for injection in a cool, dry place away from the reach of children.
Store the solution for injection in the refrigerator, between 2-8°C.
Medicines must not be used past the expiry date.
As Ifosfamide is a cancer medicine, always return any unused or expired medicine to the clinic, hospital or pharmacy for disposal. Do not throw it away in the household waste.