Brands, Medical Use, Clinical Data
Drug Category
- Antineoplastic Agents
- Immunosuppressive Agents
Dosage Forms
- Powder for constitution and administration by intravenous infusion
Brands / Synonyms
Asta Z 4942; Cyfos; Holoxan 1000; I-Phosphamide; Ifex; Ifex/Mesnex Kit; Ifosfamid; Ifosfamide Sterile; Ifosfamide/Mesna Kit; Ifsofamide; Iphosphamid; Iphosphamide; Isoendoxan; Isofosfamide; Isophosphamide; Mitoxana; Naxamide
Indications
For third line chemotherapy of germ cell testicular cancer. It should ordinarily be used in combination with a prophylactic agent for hemorrhagic cystitis, such as mesna.
Pharmacology
Ifosfamide selectively inhibits the synthesis of deoxyribonucleic acid (DNA). The guanine and cytosine content correlates with the degree of ifosfamide-induced cross-linking. At high concentrations of the drug, cellular RNA and protein synthesis are also suppressed.
Mechanism of Action
After metabolic activation, active metabolites of ifosfamide alkylate or bind with many intracellular molecular structures, including nucleic acids. The cytotoxic action is primarily due to cross-linking of strands of DNA and RNA, as well as inhibition of protein synthesis.
Absorption
Not Available
Toxicity
LD50 (mouse) = 390-1005 mg/kg, LD50 (rat) = 150-190 mg/kg. Side effects include nausea, vomiting and myelosuppression. Toxic effects include central nervous system toxicity (confusion, hallucinations) and urotoxic effects (cystitis, blood in urine).
Biotrnasformation / Drug Metabolism
Primarily hepatic
Contraindications
Continued use of IFEX is contraindicated in patients with severely depressed bone marrow function. IFEX is also
contraindicated in patients who have demonstrated a previous hypersensitivity to it.
Drug Interactions
The physician should be alert for possible combined drug actions, desirable or undesirable, involving ifosfamide
even though ifosfamide has been used successfully concurrently with other drugs, including other cytotoxic drugs.
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