Alkylating agents are most active in the resting phase of the cell. Ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Ifosfamide, carboplatin, and etoposide ice in combination with.
Mesna can be given as an intravenous iv injection or as a tablet. Etopophos is a topoisomerase inhibitor indicated for the treatmentof patients with. Fda label information for this drug is available at dailymed. Aprepitant is a novel and selective antiemetic that antagonizes substance pneurokinin 1 nk1 receptors with high affinity. These highlights do not include all the information needed to use ifex safely and. Ifosfamide neurotoxicity may become manifest within a few hours to a few days after first administration and in most cases resolves within 48 to 72 hours of ifosfamide discontinuation. For outlook, click inside of the body of an item, such as an email message or calendar event.
Following activation in the liver, ifosfamide interferes with dna through formation of phosphotriesters and dnadna crosslinks, thereby inhibiting protein synthesis and dna synthesis. To the best of our knowledge, this is the first case of ifosfamide induced encephalopathy presented 16 days after ifosfamide exposure. Idamycin idarubicin hydrochloride for injection, usp. Mesna equivalent of 40% total daily ifosfamide dose given as iv bolus postifosfamide mesna equivalent of 40% total daily ifosfamide dose given orally 2 and 6 hours after the end of the ifosfamide infusion. Use the quantity of diluent shown below to constitute the product.
Voorma, ingevolge het besluit van het college voor promoties. Daunorubicin hydrochloride injection must be given into a rapidly flowing intravenous infusion. The interaction of ifosfamide and aprepitant in gynecologic. Jul 30, 2018 ifosfamide for injection ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Jun 12, 20 ifosfamide requires activation through 4hydroxyifosfamide to ifosforamide to exert cytotoxicity.
The 15mg ixempra is constituted with 8 ml of diluent and the 45mg ixempra is constituted with 23. Ifosfamide manufacturers, ifosfamide suppliers, exporters, india. This includes testicular cancer, soft tissue sarcoma, osteosarcoma, bladder cancer, small cell lung cancer, cervical cancer, and ovarian cancer. Ifosfamide, carboplatin, and cisplatin can cause renal complications, including acute tubular dysfunction, although carboplatin is less nephrotoxic than cisplatin.
Pdf successful treatment of ifosfamide neurotoxicity with. Ifosfamide, like cyclophosphamide, is an oxazophosphorine alkylating agent. Ifosfamide can pass into breast milk and may harm a nursing baby. The remaining seven phase studies ii, 29 34 used ifosfamide in combinations that did not include an anthracycline.
Incorporation of ifosfamide into various essential oils based. Two of s the rct 10, 12 reported that the addition of ifosfamide to an anthracycline regimen either doxorubicin, or doxorubicin and dtic significantly. Based on the observed toxicities, the dose should be reduced to 75%. Ifosfamide is extensively metabolized in humans and the metabolic pathways appear to be saturated at high doses. Ifosfamide ifo, sold under the brand name ifex among others, is a chemotherapy medication used to treat a number of types of cancer. Oct 24, 2016 ifosfamide is passed into the breast milk and may cause neutropenia, thrombocytopenia, low haemoglobin concentrations and diarrhea in children.
Ifosfamide is contraindicated for breastfeeding see section 4. Ifosfamide can be toxic to the bladder, and may cause hemorrhagic cystitis, a condition associated with bladder irritation and blood in the urine. This medication is given by injection into a vein by a health care professional. Mesnex tablets are given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6 hours after each dose of ifosfamide. Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020. Pdf successful treatment of ifosfamide neurotoxicity. Ifa is a racemic mixture of two enantiomeric forms, rifa and sifa with a stereoselective metabolism by cyp3a4 and cyp2b6, leading either to bioactive or to toxic pathways. Ifosfamide investigated as a drug, mutagen, reproductive effector, and tumorigen. Several payment sources exist for cancer drugs in ontario, depending on the drug, disease indication, and how and where it is. The total daily dose of mesnex is 100% of the ifosfamide dose. No dosage adjustment provided in the manufacturers labeling. The molecular formula is c 7 h 15 cl 2 n 2 o 2 p and its molecular weight is 261. You may be able to overcome this with stronger flavored herbs such as basil, sage, or thyme. Used as an antineoplastic agent in treatment of leukemia, lymphoma, and cancers of the lung, ovary, testes, and other organs.
Aug, 2018 ifex ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Combination chemotherapy with etoposide vp16, ifosfamide. Ifosfamide is passed into the breast milk and may cause neutropenia, thrombocytopenia, low haemoglobin concentrations and diarrhea in children. Dec 17, 2018 mesnex mesna is a detoxifying agent to inhibit the hemorrhagic cystitis induced by ifosfamide.
The authors and the publisher have exerted every effort. Clinical pharmacology of ifosfamide and metabolites. Ice chemotherapy consisted of ifosfamide 1,500 mgm2, days 14. Nov 30, 2019 commonly reported side effects of ifosfamide include.
Ifosfamide is 32chloroethyl22chloroethylaminotetrahydro2h1,3,2oxazaphosphorine 2oxide. Ifosfamide is approved to be used with other drugs to treat. Ifosfamide for injection ifosfamide for injection, usp singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Solubilizing the ifo in the essential oilsbased ne has ameliorated the antitumor efficacy of ifo. While the use of methylene blue is a known antidote, symptomatic treatment of the central nervous system cns effects. Refractory testicular tumors, in combination with other chemotherapeutic drugs. Ifosfamide comes as powder to be mixed with liquid to be injected over at least 30 minutes intravenously into a vein by a doctor or nurse in a medical facility. With a suitable syringe, aseptically withdraw the diluent and slowly inject it into the ixempra for injection vial. The acute tubular dysfunction can be manifested by increased excretion of potassium, phosphorus, and magnesium. Mesnex is indicated as a prophylactic agent in reducing the. Ifosfamide is 32chloroethyl22chloroethylaminotetrahydro2h1,3,2. Because of the potential for serious adverse events and the tumorigenicity shown for ifosfamide in animal studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Deactivation of ifosfamide leads to the release of the potentially neurotoxic chloracetaldehyde kerbusch et al. Clear solution mixed into larger bags of fluids drug monograph. Find patient medical information for ifosfamidemesna intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Ifosfamide has also been assessed in combination with other drugs such as doxorubicin and dacarbazine dtic.
Ifosfamide manufacturers, ifosfamide suppliers, exporters. Severe local tissue necrosis will occur if there is extravasation during administration. Ixempra ixabepilone dosing and administration guide. The manufactured ranges of ifosfamide are known for their durability. The active ingredient, mesna, is a synthetic sulfhydryl compound designated as sodium2mercaptoethane sulfonate with a molecular formula of c 2 h 5 nao 3 s 2 and a molecular weight of 164. Ifex ifosfamide for injection, usp singledose vials for constitution and administration by. Save money on your ifosfamide injection prescription by switching to tevas fdaapproved generic version. By continuing to browse this site you are agreeing to our use of cookies.
Ifex ifosfamide for injection singledose vials for constitution and administration by intravenous infusion each contain 1 gram or 3 grams of sterile ifosfamide. Urotoxic side effects, especially hemorrhagic cystitis, as well as cns. Ifex ifosfamide dosing, indications, interactions, adverse. Ifosfamide requires activation through 4hydroxyifosfamide to ifosforamide to exert cytotoxicity. Time from end of ifosfamide infusion route dose of mesna example t 0 iv bolus 40% daily ifosfamide dose 3gm. Get emergency medical help if you have signs of an allergic. Mesnex mesna is a detoxifying agent to inhibit the hemorrhagic cystitis induced by ifosfamide. Nov 09, 2018 ifosfamide can pass into breast milk and may harm a nursing baby. Always consult your healthcare provider if you have questions or concerns. Definition from the nci drug dictionary detailed scientific definition and other names for this drug. Ifosfamide is a white crystalline powder soluble in water. Medlineplus information on ifosfamide a lay language summary of important information about this drug that may include the following. How to import adobe pdf files to publisher on a pc. It must neverbe given by the intramuscular or subcutaneous route.
Clinical pharmacology of cyclophosphamide and ifosfamide. Ifosfamide is chemically related to the nitrogen mustards and is similar in chemical structure to cyclophosphamide. Ifosfamide information, side effects, warnings and recalls. Mesnex injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage ww at the time of ifosfamide administration. Mesnex is indicated as a prophylactic agent in reducing. Risk factors for ifosfamide nephrotoxicity include. The information on this website is intended for informational purposes only and is not a substitute for medical advice. It is used in patients who have already been treated with two other types of chemotherapy ifosfamide is also being studied in the treatment of other types of cancer. Ifosfamide fda prescribing information, side effects and uses. Ifosfamide fda prescribing information, side effects and. The dosage is based on your medical condition, body size, and response to treatment. Although ifosfamide has been administered to a small number of patients with compromised hepatic andor renal function, studies to establish optimal dose schedules of ifosfamide in such patients have not been conducted.
Ifosfamide is also being studied in the treatment of other types of cancer. The length of treatment depends on how well your body responds to treatment with. The amount of ifosfamide that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. For the ifosfamide and etoposide courses in the experimentaltherapy group, we planned to administer 1800 mg of ifosfamide per square meter per day for five days, given with mesna, and 100 mg of. Each 20 mg vial contains 20 mg idarubicin hydrochloride, usp and 200 mg of lactose nf hydrous as an orangered, lyophilized powder.
See below for a comprehensive list of adverse effects. Dailymed ifosfamide injection, powder, for solution. Cyclophosphamide compared with ifosfamide in consolidation. Ifosfamide is give through an infusion into a vein intravenous, iv.
Only select registry of toxic effects of chemical substances rtecs data is presented here. Johns wort may decrease ixabepilone plasma concentrations unpredictably and should be avoided safety information. This typically regresses after completing treatment. Ifosfamide belongs to the category of mustard gas derivatives. On the basis of these results, vimb combination appears to be. Ifosfamide injection 1g summary of product characteristics. Store intact vials at room temp or under refrigeration. Directory of topnotch ifosfamide manufacturers, ifosfamide suppliers and ifosfamide exporters based in india. In order to reduce the risk for this condition, ifosfamide is given in combination with a medication known as mesna mesnex.
Tell your doctor if you have ever had an unusual or allergic reaction to ifosfamide before receiving ifosfamide. Addition of ifosfamide and etoposide to standard chemotherapy. Ifosfamide can also cause hypophosphatemic rickets. Adjust dose accordingly if ifosfamide dose changes. Prolongation of ifosfamide elimination halflife in obese. Guidelines for the administration of mesna with ifosfamide.
Ifosfamide is a chemotherapeutic agent chemically related to the nitrogen mustards and a synthetic analog of cyclophosphamide. To the best of our knowledge, this is the first case of ifosfamideinduced encephalopathy presented 16 days after ifosfamide exposure. Ifosfamide should be administered as a slow intravenous infusion lasting a minimum of 30 minutes. Ifosfamide interferes with oogenesis and spermatogenesis. When you want to reuse the content of a pdf in microsoft publisher but you lack access to the file from which you produced it, you cant import the file directly. Ifosfamide is a synthetic structural isomer of cyclophosphamide that has been approved for concurrent use with other drugs usually cisplatin, etoposide, or vinblastine in the treatment of metastatic germcell testicular cancer and some especially pediatric sarcomas. In a randomized phase 2 trial that included 5 adults with soft tissue sarcoma, a higher response rate with less myelosuppression suggested. Mesnex mesna dosing, indications, interactions, adverse. Ifosfamide definition of ifosfamide by medical dictionary. Neurotoxicity related to the use of ifosfamide is a wellknown complication.
Gently swirl and invert the vial until the powder in ixempra is completely dissolved. As alkylating agents, cpa and ifo are usually combined with other. Successful treatment of ifosfamide neurotoxicity with dexmedetomidine article pdf available in journal of oncology pharmacy practice 164. The oxazaphosphorine cyclophosphamide cpa and ifosfamide ifo are two commonly. Background ewings sarcoma and primitive neuroectodermal tumor of bone are closely related, highly malignant tumors of children, adolescents, and young adults. Ifosfamide side effects, dosage, interactions drugs. Ifosfamidebased combination chemotherapy in advanced soft. Ifosfamide ifa is a potent alkylating antitumoral agent, but its use is limited by neurological side effects. Supportive therapy should be maintained until their complete resolution. Ifosfamide ifex oncology intravenous dilution data. The pharmacokinetics of intravenous ifosfamide were determined in 16 patients with carcinoma of the bronchus. After administration of doses of 5 gm2 of 14clabeled ifosfamide, from 70% to 86% of the dosed radioactivity was recovered in the urine, with about 61% of the dose excreted as parent compound. Ifex should be administered as a slow intravenous infusion lasting a minimum of 30 minutes. Dosage and duration of treatment andor treatment intervals depend on the.
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