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IFOS

IFOSFAMIDE · by A. J. MIRZA

ANTINEOPLASTICS Alkylating agent A. J. MIRZA

Composition

Inj 500 mg/1 gm/2 gm: Ifosfamide 500 mg/1 gm/2 gm; vial.

Indications & Dosage

Malignant disease: BY IV INF: Adult: 1.2 gm/m2/ day IV for 5 days. Repeat every 3 wk.

Administration

Administer slow IVP, IVP Bolus over 30 min to several hours or continuous IV infusion over 5 days. Dilute powder with SWFI or NS to a conc of 50 mg/ml. Further dilution in 50-100 ml D5W or NS is recommended for IV Infusion.

Compatibility

Stable in D5LR, D5NS, D5W, LR, 1/2NS, NS; incompatible with bacteriostatic SWI or bacteriostatic NS.

Stability

Store at 20C-25C (68E-77E). Protect from tem-peratures above 30C (86E). Constituted solution or constituted and further diluted solutions of ifosfamide should be refrigerated and used within 24 hours. Solutions reconstituted with bacteriostatic WFI are stable for 1 week at room temperature or 3 weeks under refrigeration and diluted solutions are chemically stable for up to 1 week at room tem-perature and for up to 6 weeks under refrigeration in glass containers or plastic bags. Preservative-free solutions should be used within 24 hours.

Contraindications

Severe bone marrow suppression, acute infection, urinary-tract infection, urinary-tract obstruction, urothelial damage

Precautions

Impaired renal function, compromised bone marrow function, avoid in acute porphyrias, diabetes mellitus

Interactions

Phenobarbital, carbamazepine, phenytoin.

Pregnancy

Positive evidence of risk: Avoid

Lactation

Contraindicated. Discontinue breast-feeding

Side Effects

Confusion, disorientation, drowsiness, psychosis, renal toxicity (may lead to tubular dysfunction, Fanconis syndrome, or diabetes insipidus), restlessness, urothelial toxicity, severe encephalopathy, acute pancreatitis, alopecia, arrhythmias, bone-marrow suppression, extravasation, heart failure, hyperuricaemia, male sterility, nausea, oralmucositis, premature menopause, secondary malignancy, thromboembolism, tumourlysis syndrome, vomiting. Rare: Anorexia, constipation, convulsions, diarrhoea