Ifosfamide

Ifosfamide is used along with other medicines to treat testicular cancer in men.

Ifosfamide is typically given after other treatments have not been successful.

Ifosfamide may also be used for other reasons not mentioned in this medication guide.

Your doctor will do blood and urine tests to ensure you do not have any conditions that would prevent you from safely using ifosfamide.

Ifosfamide is given as an infusion into a vein. A healthcare provider will administer this injection.

If this medicine accidentally touches your skin, wash it off thoroughly with soap and warm water.

Ifosfamide is given in a 21-day treatment cycle, but you will receive the medicine only during the first 5 days of each cycle. Your doctor will decide how many cycles you should have.

Drink plenty of liquids while you are taking ifosfamide.

Your blood will need to be tested frequently. Your heart, kidney function, liver function, or nerve and muscle function may also need to be checked. The results may cause delays in your cancer treatments.

Ifosfamide can have long-lasting effects on your body. You may also need medical tests for a short period after your last dose.

You should not receive ifosfamide if you have a medical condition that causes urination problems (such as an enlarged prostate).

Ifosfamide affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, cough, mouth sores, or unusual bleeding or bruising.

Ifosfamide can affect your kidneys or nervous system. Call your doctor at once if you have urination problems, blood in your urine, problems with your hearing or vision, unusual thoughts or behavior, hallucinations, or a seizure.

You should not be treated with ifosfamide if you are allergic to it or if you have a medical condition that causes urination problems (such as an enlarged prostate).

Tell your doctor if you have ever had:

• kidney disease;
• heart disease;
• a bladder infection;
• treatment with busulfan; or
• radiation treatment of your bladder.

Using ifosfamide may increase your risk of developing other cancers, such as leukemia. Ask your doctor about this risk.

Ifosfamide can cause birth defects if a woman is exposed to it during pregnancy.

Use effective birth control to prevent pregnancy, whether you are a man or a woman. Ifosfamide use by either parent may cause birth defects. Keep using birth control for at least 6 months after treatment.

This medication may affect fertility (your ability to have children), whether you are a man or a woman. Some women using ifosfamide have stopped having periods or started having symptoms of early menopause.

A woman receiving ifosfamide should not breast-feed.

Get emergency medical help if you notice signs of an allergic reaction (hives, trouble breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

You may get infections more easily, including serious or fatal infections. Call your doctor right away if you have signs of infection such as:

• fever, chills, flu symptoms;
• mouth and throat ulcers;
• skin sores, pale skin, cold hands and feet;
• easy bruising, unusual bleeding;
• rapid heart rate, shallow breathing; or
• feeling light-headed or short of breath.

Call your doctor immediately if you experience any of these side effects:

• confusion, unusual thoughts or behavior, hallucinations, seizure (convulsions);
• little or no urination, painful or difficult urination, blood in your urine;
• loss of bladder control;
• a seizure;
• muscle movements you cannot control;
• problems with your hearing or vision, ringing in your ears;
• sudden chest pain, wheezing, dry cough;
• dark urine, jaundice (yellowing of the skin or eyes); or
• a wound that will not heal.

Common side effects of ifosfamide may include:

• nausea and vomiting;
• confusion, vision problems, thinking problems;
• numbness, tingling, burning pain;
• infections;
• urination problems; or
• hair loss.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Testicular Cancer:

1.2 g/m2 IV over at least 30 minutes daily for 5 consecutive days; repeat every 3 weeks or after recovery from hematologic toxicity Comments:-To prevent bladder toxicity, this drug should be given with extensive hydration (at least 2 liters of oral or IV fluid daily). -Mesna should be used to reduce hemorrhagic cystitis. Use: For use in combination with other antineoplastic agents for third-line chemotherapy of germ cell testicular cancer

Call your doctor for guidance if you miss an appointment for your ifosfamide injection.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid driving or hazardous activity until you know how ifosfamide will affect you. Your reactions could be impaired.

Drinking alcohol can increase certain side effects of ifosfamide, especially nausea and vomiting.

Grapefruit may interact with ifosfamide and lead to unwanted side effects. Avoid the use of grapefruit products.

Do not receive a "live" vaccine while using ifosfamide, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Using ifosfamide with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can change the blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect ifosfamide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.