What is Ifosfamide?

Ifosfamide is an alkylating chemotherapy agent; it is a nitrogen mustard derivative. Ifosfamide is to treat germ cell testicular cancer. It is also used to treat metastatic bladder cancer, recurrent or metastatic ovarian cancer, non-Hodgkin lymphomas, Ewings sarcoma, head and neck cancer, Hodgkin lymphoma, osteosarcoma, small cell lung cancer, soft tissue sarcomas and thymic cancers; however, these are all non-FDA approved, off-label indications. This medication works by inhibiting protein and DNA synthesis, thus preventing the cell from duplicating- causing tumor cell death.

How it is administered:

Ifosfamide is administered as an intravenous infusion. The length of infusion varies depending on indication; the range is anywhere from 30 minutes to 3 hours. Most typically, infusions last 3 hours. This medication is very toxic to the bladder; to prevent damage, the urinary protector Mesna is given in conjunction with ifosfamide. Additionally, increased hydration the day of infusion, either orally or intravenously is required in order to further protect the bladder. Ifosfamide can be nauseating; pre-medications are given prior to the start of this medications infusion to help prevent the occurrence of nausea.

What to expect:

Ifosfamide can cause anemia and reduce the body’s ability to fight infections. Additional side effects associated with this therapy include: encephalopathy, hair loss, nausea, vomiting, fever, increased liver enzymes, local administration site irritation and infections. Typically, medications to have on hand at home will be prescribed to help manage any nausea that may develop in the days following treatment. There are many other rare yet serious reactions that can occur. Laboratory tests will be performed routinely throughout the course of therapy to help manage and monitor the development of these side effects.