ifosfamide at a glance
Medicine class
Cytotoxic alkylating agent and prodrug
Usual role
Specialist treatment of malignant disease, often as part of combination therapy
Administration
Given into a vein by a trained oncology team
Bladder protection
Mesna, hydration and urine monitoring reduce urinary-tract toxicity
What is ifosfamide used for?
The selected product is licensed broadly for treating malignant disease.
It may be used as a single anticancer agent.
It is frequently used with other cytotoxic treatments, radiotherapy or surgery.
How does ifosfamide work?
Liver enzymes convert ifosfamide into active metabolites. These form cross-links within DNA, disrupting DNA replication and cell division; rapidly dividing cancer cells are particularly affected.
ifosfamide preparations and strengths
Injection
Route: Parenteral
Strengths: 1 g, 2 g
How to take ifosfamide
Ifosfamide is prepared and given intravenously by trained staff under specialist oncology supervision. Mesna and intravenous fluids are normally given for bladder protection, with blood tests, kidney assessment, fluid-balance checks and urine monitoring. Follow the treatment centre's instructions about drinking, urine checks and caring for any infusion pump or line.
Tell staff immediately if the infusion site becomes painful, swollen or starts burning.
Check with the oncology team before taking new prescription, non-prescription or herbal products.
Avoid alcohol if it worsens nausea or vomiting.
ifosfamide side effects
Common or expected effects
- Reduced white cells and platelets, increasing infection, bruising or bleeding risk
- Nausea and vomiting
- Hair loss
- Bladder irritation, blood in the urine or altered kidney function
- Reduced appetite
Get urgent medical advice
- Severe infection or sepsis
- Encephalopathy causing confusion, unusual drowsiness, behavioural change, hallucinations, seizures or coma
- Haemorrhagic cystitis or kidney failure
- Severe allergic reaction
- Serious heart, lung or liver toxicity
- Severe electrolyte disturbances or tumour lysis syndrome
ifosfamide in pregnancy
Ifosfamide can harm a developing baby and is advised against during pregnancy, particularly during the first trimester, unless a specialist judges that the expected benefit outweighs the fetal risk. Discuss pregnancy, suspected pregnancy and contraception with the oncology team. Effective contraception is advised during treatment and afterwards, with different periods specified for women and men.
ifosfamide while breastfeeding
Breastfeeding is contraindicated during treatment because ifosfamide passes into breast milk and could cause serious blood-cell and gastrointestinal effects in the infant. Discuss feeding plans with the oncology and maternity teams before treatment.
ifosfamide interactions
The oncology team should review all medicines, supplements, recent treatments and planned vaccinations. Important examples include:
Cisplatin, carboplatin and other nephrotoxic medicines
May increase kidney, blood or other toxicities; cisplatin-related hearing loss may also worsen.
Sedatives, opioids, antihistamines and centrally acting antiemetics
May add to drowsiness and other brain effects, particularly if encephalopathy develops.
Carbamazepine, phenytoin, phenobarbital, rifampicin and St John's wort
Enzyme induction may change the formation of active and toxic ifosfamide metabolites.
Common questions about ifosfamide
Answers are fully visible for fast scanning and source review.
Why is mesna given with ifosfamide?
Ifosfamide metabolites can irritate and cause bleeding in the bladder lining. Mesna binds harmful urinary metabolites and is used with hydration and urine monitoring to reduce this risk.
Can ifosfamide affect the brain?
Yes. Ifosfamide-associated encephalopathy can cause confusion, sleepiness, personality or behavioural changes, hallucinations, seizures or reduced consciousness. New neurological changes need immediate assessment.
What should I do if I see blood in my urine?
Contact the oncology team immediately. Blood, pain or reduced urine output may indicate bladder or kidney toxicity even when mesna is being used.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.