Trade name

Holoxan^®

What Ifosfamide is and what it is used for?

• Ifosfamide is an alkylating agent. This medicine induces cross linking on the same strand of DNA and interferes with DNA replication and cell division. This stops the growth and spread of cancer cells in the body.
• Ifosfamide is used as a single agent or in combination with other medicines to treat testicular cancer and germ cell cancer, sarcomas, non-Hodgkin's lymphoma, Hodgkin's disease, non-small cell and small cell lung cancer, bladder cancer, head and neck cancer, cervix cancer, ovarian cancer.

How Ifosfamide is given?

• The infusion time is dependent on the treatment plan. It may be given over several hours for 3 to 5 consecutive days or as a continuous infusion over 24 hours.

What should I know while receiving Ifosfamide?

• Do not use ifosfamide when you are pregnant or breastfeeding.
• Men and women should use effective contraception during treatment and for at least 6 months after the treatment ends.
• This drug may affect fertility. You can talk to your doctor about methods of preserving fertility before treatment starts.
• Do not receive any kind of vaccination without doctor's approval.
• Your doctor will give you a medicine called mesna while receiving ifosfamide to help prevent side effects on the bladder.
• You will be checked regularly by your doctor to make sure you have enough blood cells and have adequate organ functions to receive this medicine. The timing of your treatment may be changed based on the test results or other side effects.
• The existing health problems may affect the use of ifosfamide. You should let your doctor know if you have any other medical problems, especially if you have liver, kidney or urination problems.

Common side effects

• Low white blood cell count

You may have a higher risk of getting infections. Try to stay away from crowds and wash hands often. Tell your doctor right away if you have repeated fevers, coughing, stuffy nose, a painful urination or wound that becomes red and swollen.

• Low red blood cell count

You may look pale and get tired more easily. Let your doctor know if you experience any difficulty breathing or dizziness when changing positions.

• Hair loss

It may begin 2-3 weeks after your first treatment. Your hair will usually grow back after treatment has finished.

• Nausea and vomiting

Medicines may be given before the treatment to prevent it happening. Eating and drinking often in small amounts may reduce the discomfort.

• Loss of appetite

Try to eat in small quantities and have frequent meals. If your appetite doesn't get any better after a few days, tell your doctor.

Less common side effects

• Blood in the urine (hemorrhagic cystitis)

Ifosfamide may irritate your bladder and may cause blood in the urine. Tell your doctor if you have a pain or burning feeling when you pass urine. Drinking plenty of water can help you pass more urine to prevent damage to the bladder.

• Low platelet count

You may have a higher risk of bleeding. Let your doctor know if you find red or purple dots on the skin, bleeding from the nose or gums, or any bruising or bleeding that you cannot explain.

• Nervous system problems

You may get very drowsy and sleepy or may have visual hallucinations while receiving ifosfamide. Problems may start within a few hours after getting this drug and may last for 2 to 3 days after stopping it. Tell your nurse if you begin to feel any of these symptoms.

• Stopped or missed periods

Ifosfamide can damage the ovaries and stop regular menstrual cycles. A woman may experience menopausal side effects, such as flushing, emotional changes, headaches or difficulty sleeping. Usually menstrual periods may return months or years after treatment is over. You can talk to your doctor about any health or emotional concerns.

• Low sperm count or no sperm

It often takes from months to years for sperm production to improve after treatment has ended. You can talk to your doctor about your fertility concerns.

Rare but serious side effects

• Secondary cancer

Ifosfamide may cause an increased risk of developing secondary cancer years later. Treatment benefits may outweigh the risk of secondary cancer. Your doctor can talk you about this.

More Information

• Many drugs may interact with ifosfamide. Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
• Avoid eating grapefruit or drinking beverages containing grapefruit. This is because grapefruits can affect how bortezomib works and can worsen the side effects.
• Alcohol and cigarettes may interfere with certain medicines or worsen side effects from chemotherapy treatment. It is wise to avoid alcohol and cigarette smoking during cancer treatment. If you have any problem about drinking alcohol and smoking, you should check with your doctor.
• Drink at least 6 to 8 glasses of water every day can help make your recovery a smoother process.