Ifosfamide: High Dose for SCT (Generic Name)

Other Names: Ifex®

About this drug

Ifosfamide is used to treat cancer. It may be included in pretransplant chemotherapy. Ifosfamide is frequently given to patients who will receive peripheral stem cell transplants. This drug is given intravenously (IV) with the drug mesna.

Possible side effects (More Common)

  • Nausea and vomiting. These symptoms may occur within one to two hours after you receive the drug and may last up to 48 to 72 hours.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression usually occurs seven days after the drug is given and may increase your risk of infection, fatigue, and bleeding. Transfusions of blood products may be required.
  • Tiredness that may last up to eight hours after the drug is stopped.
  • Congestive heart failure. You may be short of breath.  Your arms, hands, legs and feet may swell.
  • Changes in the tissue of the heart. Some changes may occur that can cause your heart to have less ability to pump blood. Changes may also lead to an abnormal heart beat. Your heart function will be checked as needed.
  • Changes in your central nervous system can occur. The central nervous system is made up of your brain and spinal cord. You could experience extreme tiredness, agitation, confusion, hallucinations, difficulty understanding or speaking, loss of control of your bowels or bladder, vision changes, numbness or weakness to your arms, legs, face, or body, and coma. If you start to experience any of these symptoms let your doctor know right away.
  • Hair loss. Most patients experience scalp and body hair loss. You may notice hair thinning five to seven days after receiving this drug. Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Effects on the bladder. This drug may cause irritation and bleeding in the bladder. You may have blood in your urine. To help prevent this, you will receive extra fluids to help you pass more urine. You may receive a drug called mesna, which helps to prevent irritation and bleeding.
  • Confusion
  • Decreased appetite
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.

Possible side effects (Less Common)

  • Changes in liver enzymes. Liver enzymes will be monitored as needed.
  • Phlebitis, which is redness and tenderness of a vein
  • Electrolyte changes.  Your blood will be checked for electrolyte changes as needed.
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations. In women, menstrual bleeding may become irregular or stop while you are receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
    • Breast feeding warning Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating side effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated. Drinking fluids will also help to protect your bladder from irritation and bleeding.
  • Mouth care is very important. Your mouth care should consist of gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon salt in 8 ounces of water or 1/2 teaspoon sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Speak with your nurse about obtaining a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good...Feel Better” program close to where you live. It is a free program where women undergoing chemotherapy learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.

Food and drug interactions

There are no known interactions of ifosfamide with food. This drug may interact with other medication. Tell your doctor and pharmacist about all of the medication and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s advice.

When to call the doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Fever of 100.5 F (38 C) or above; chills
  • Unusual bleeding or bruising
  • Painful urination or notice blood in your urine
  • Lower back or side pain
  • Difficulty breathing
  • Extreme thirst that might be associated with dehydration
  • Unusual heart beat (fluttering or feeling like your heart skips a beat) or chest pain
  • Seizures
  • Confusion; agitation; hallucinations
  • Nausea that prevents you from eating or drinking
  • Vomiting more than twice in one day

Revised February 2012

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