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 Ifosfamide (Ifex, Mitoxana)

Warning:  Ifosfamide has been known to cause severe side effects in patients so great care should be used when taking this drug.  Patients have experienced severe mood problems, urinary tract disorders, mental issues, and blood/bone marrow disorders.  If you notice any of the following symptoms, notify your doctor immediately.  These symptoms include easy bruising, fever, constant sore throat, pink coloring in excrement and urine, urination that is very painful, confusion, drowsiness that is excessive, or hallucinations.  Blood/bone marrow disorders should be addressed immediately because they can prevent your body from proper clotting or resisting infections.

Indications: Ifosfamide is used to treat many different cancers but is primarily used for patients who are battling sarcomas, testicular cancers, and lung cancers.  The drug is proven to stop cancer cell growth or slow it down significantly. 

Other cancers that the medication is used for include: 

  • breast cancer  
  • cervical cancer  
  • ovarian cancer  
  • bone cancer  
  • osteogenic sarcoma (also called osteosarcoma) 
  • Lymphoma (Hodgkin's and Non-Hodgkin's).   

The main adverse reactions that patients complain of are nausea, diarrhea, and vomiting.  You may also experience dehydration so it is important to make sure that you are consuming enough fluids to keep your body functioning properly.  Signs of dehydration include a loss of tears in your eyes, skin that is pale in color or develops a wrinkled appearance, a feeling of lightheadedness or being dizzy, a mouth that is continuously dry and cottony, and excessive thirst.  If you notice these signs, you call your doctor immediately.  Your doctor may also prescribe other drugs to counteract the effects of Ifosfamide if the nausea, vomiting, or diarrhea is severe enough or suggest changes in your eating habits.   

Dosage:  Ifosfamide is given by injection. Cancer Patients are given Ifosfamide through a needle which is inserted into a vein.  The amount of the drug administered will be determined by the doctor who will evaluate your reactions to other drugs taken, your health condition, and your body size.  Only medically trained professionals should be issuing the injection of this drug. 

The medication is eliminated by your bladder and kidneys. Therefore, it is important that you drink plenty of fluids every day during the treatment; 8 to 12 cups of water per day are recommended. It is also important to urinate every two hours throughout the period of akefulness and at least once during the night; this is necessary to prevent damage to the bladder and kidneys. If you still develop kidney problems, contact your physician so that he can prescribe you Mesna, a drug used to reduce side effects of cancer chemotherapy involving ifosfamide. 

Overdose:  Overdosing ifosfamide can cause serious health problems and even death. An overdose of ifosfamide can damage the bone marrow, leading to cause serious urinary problems or death. In fact, even at normal doses, ifosfamide can cause serious urinary side effects. During the treatment, drink plenty of fluids; keep all appointments with your doctor.  

Contraindications:  Pregnant and nursing women should not use this drug as it can cause harm to the baby.  It is important to notify your doctor if you are planning to become pregnant.  You should also avoid vaccinations or being around people who have been vaccinated.  Make sure that your doctor is also alerted to any past issues such as kidney disease, radiation treatment, low blood cell counts, liver disease, a current infection, or blood/bleeding disorders. 

Mechanism of action (MOA):   Ifosfamide belongs to the class of alkylating agents; it slows or stops the growth of cancer cells by attacking their DNA, a material essential for the reproduction of cells. 

Interactions:  it is important to always make sure that your doctor has a current and updated list of the drugs, herbs, and regular medicines that you are taking.  There is always a chance that a drug or herb can interfere with the strength of this drug and your doctor may need to adjust the dosage accordingly. 

Tell your health care provider if you are being treated with any of these medications: 

  • Interferons (Actimmune, Avonex, Betaseron, Rebif, and others) 
  • Aids/HIV medications such as didanosine (Videx) and stavudine (Zerit)
  • sulfinpyrazone (Anturane)
  • Probenecid  (Benuryl) 
  • Live vaccins vivants  
  • Ganciclovir - an antiviral drug 
  • Azathioprine - an immune system inhibitor  
  • Barbiturates - depressant drug that causes relaxation and sleepiness 
  • Cimetidine - a drug used to inhibit the production of acid in the stomach 
  • Colchicines -a medication used to treat pain of gouty arthritis 
  • Cyclophosphamide  (Cytoxan) - a medication of the alkylating agent family used to treat a variety of cancers  

Side effects: Ifosfamide not only attack cancer cells but also non malignant cells, which often leads, in most patients, to the following side effects:   

  • hair loss  
  • constipation  
  • diarrhea  
  • difficulty sleeping 
  • decreased appetite 
  • mild nausea and vomiting 
  • Unusual tiredness or fatigue.   

Contact your doctor immediately if you experience any of these symptoms:

  • anxiety
  • severe depression
  • painful urination or red urine  
  • black, tarry stools  
  • unusual bruising or bleeding  
  • persistent cough  
  • congestion  
  • signs of infections such as fever, chills, sore throat, and rash  
  • dizziness  
  • shortness of breath  
  • nausea and vomiting  
  • agitation, confusion, or hallucinations.   

 

Reference 

1 - nlm.nih.gov, Ifosfamide: side effects   

2 - santecheznous.com, Comment doit-on employer ce m├ędicament ?  (how to use this medication?)