Difference between revisions of "Ifosfamide (Ifex)"

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m (Text replacement - "Uterine cancer" to "Endometrial cancer")
m (Text replacement - "please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [https://online.lexi.com/lco/action/login UpToDate Lexidrug], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information" to "please refer to your preferred pharmacopeias or the prescribing information")
 
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==General information==
 
==General information==
Class/mechanism: Nitrogen mustard, alkylator. Metabolites of ifosfamide interact with DNA to produce phosphotriesters and formation of DNA cross-links. Ifosfamide requires metabolic activation by microsomal liver enzymes to form its active metabolites.<ref name="insert">[https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/076657s017s021s025lbl.pdf Ifosfamide (Ifex) package insert]</ref><ref>[[Media:ifosfamide.pdf | Ifosfamide (Ifex) package insert (locally hosted backup)]]</ref>
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Class/mechanism: Nitrogen mustard, alkylator. Metabolites of ifosfamide interact with DNA to produce phosphotriesters and formation of DNA cross-links. Ifosfamide requires metabolic activation by microsomal liver enzymes to form its active metabolites.<ref name="insert">[https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019763s017lbl.pdf Ifosfamide (Ifex) package insert]</ref><ref>[[:File:ifosfamide.pdf | Ifosfamide (Ifex) package insert (locally hosted backup)]]</ref>
 
<br>Route: IV
 
<br>Route: IV
 
<br>Extravasation: [[irritant]] or [[neutral]], depending on reference
 
<br>Extravasation: [[irritant]] or [[neutral]], depending on reference
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*A protective agent such as [[Mesna (Mesnex)]] should be used concurrently with ifosfamide to help prevent hemorrhagic cystitis.
 
*A protective agent such as [[Mesna (Mesnex)]] should be used concurrently with ifosfamide to help prevent hemorrhagic cystitis.
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>  
+
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.<ref name="insert"></ref>  
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==Diseases for which it is established ''(work in progress)''==
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*[[Osteosarcoma]]
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*[[Testicular cancer]]
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
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*[[B-cell acute lymphoblastic leukemia, Ph-positive, pediatric]]
 
*[[Burkitt lymphoma]]
 
*[[Burkitt lymphoma]]
 
*[[CNS lymphoma]]
 
*[[CNS lymphoma]]
 
*[[Cervical cancer]]
 
*[[Cervical cancer]]
 
*[[Diffuse large B-cell lymphoma]]
 
*[[Diffuse large B-cell lymphoma]]
*[[Ewing's sarcoma]]
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*[[Endometrial cancer]]
*[[Extranodal NK/T-cell lymphoma, nasal type]]
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*[[Ewing sarcoma]]
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*[[Extranodal NK- and T-cell lymphoma, nasal type]]
 
*[[HIV-associated lymphoma]]
 
*[[HIV-associated lymphoma]]
*[[Hodgkin lymphoma]]
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*[[Classical Hodgkin lymphoma]]
 
*[[Mantle cell lymphoma]]
 
*[[Mantle cell lymphoma]]
*[[NK/T-cell lymphoma]]
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*[[Neuroblastoma]]
*[[Osteosarcoma]]
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*[[NK- and T-cell lymphoma]]
 
*[[Penile cancer]]  
 
*[[Penile cancer]]  
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*[[Rhabdomyosarcoma]]
 
*[[Soft tissue sarcoma]]  
 
*[[Soft tissue sarcoma]]  
 
*[[Small cell lung cancer]]
 
*[[Small cell lung cancer]]
*[[Testicular cancer]]
 
 
*[[Thymoma]]
 
*[[Thymoma]]
*[[Endometrial cancer]]
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*[[T-cell acute lymphoblastic leukemia, pediatric]]
 
==Diseases for which it was used==
 
==Diseases for which it was used==
 
*[[Non-small cell lung cancer_-_historical|Non-small cell lung cancer]]
 
*[[Non-small cell lung cancer_-_historical|Non-small cell lung cancer]]
  
 
==Patient drug information==
 
==Patient drug information==
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*[https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019763s017lbl.pdf Ifosfamide (Ifex) package insert]<ref name="insert"></ref>
 
*[http://chemocare.com/bio/ifosfamide.asp Ifosfamide (Ifex) patient drug information (Chemocare)]<ref>[http://chemocare.com/bio/ifosfamide.asp Ifosfamide (Ifex) patient drug information (Chemocare)]</ref>
 
*[http://chemocare.com/bio/ifosfamide.asp Ifosfamide (Ifex) patient drug information (Chemocare)]<ref>[http://chemocare.com/bio/ifosfamide.asp Ifosfamide (Ifex) patient drug information (Chemocare)]</ref>
 
*[http://www.uptodate.com/contents/ifosfamide-patient-drug-information Ifosfamide (Ifex) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/ifosfamide-patient-drug-information Ifosfamide (Ifex) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/ifosfamide-patient-drug-information Ifosfamide (Ifex) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/ifosfamide-patient-drug-information Ifosfamide (Ifex) patient drug information (UpToDate)]</ref>
  
 
==History of changes in FDA indication==
 
==History of changes in FDA indication==
* 12/30/1988: Initial FDA approval
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* 1988-12-30: Initial approval in combination with certain other approved antineoplastic agents 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. ''(Based on Loehrer et al. 1986)''
 
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==History of changes in EMA indication==
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*1976-07-13: EURD
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==History of changes in PMDA indication==
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*2012-03-21: New additional indication and a new dosage for the treatment of [[:Category:Lymphomas|malignant lymphoma]].
 
==Also known as==
 
==Also known as==
 +
*'''Brand names:'''
 
{| class="wikitable" style="text-align:center;"
 
{| class="wikitable" style="text-align:center;"
 
!colspan="5" align="center" style="background-color:#0066FF"| '''Synonyms'''
 
!colspan="5" align="center" style="background-color:#0066FF"| '''Synonyms'''
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[[Category:Drugs]]
 
[[Category:Drugs]]
 
[[Category:Intravenous medications]]
 
[[Category:Intravenous medications]]
[[Category:Irritant chemotherapy]]
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[[Category:Irritant]]
[[Category:Neutral chemotherapy]]
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[[Category:Neutral]]
  
 
[[Category:Nitrogen mustards]]
 
[[Category:Nitrogen mustards]]
  
 
[[Category:Burkitt lymphoma medications]]
 
[[Category:Burkitt lymphoma medications]]
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[[Category:B-cell acute lymphoblastic leukemia medications]]
 
[[Category:CNS lymphoma medications]]
 
[[Category:CNS lymphoma medications]]
 
[[Category:Cervical cancer medications]]
 
[[Category:Cervical cancer medications]]
 
[[Category:Diffuse large B-cell lymphoma medications]]
 
[[Category:Diffuse large B-cell lymphoma medications]]
[[Category:Ewing's sarcoma medications]]
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[[Category:Endometrial cancer medications]]
[[Category:Extranodal NK/T-cell lymphoma, nasal type medications]]
+
[[Category:Ewing sarcoma medications]]
 +
[[Category:Extranodal NK- and T-cell lymphoma, nasal type medications]]
 
[[Category:HIV-associated lymphoma medications]]
 
[[Category:HIV-associated lymphoma medications]]
[[Category:Hodgkin lymphoma medications]]
+
[[Category:Classical Hodgkin lymphoma medications]]
 
[[Category:Mantle cell lymphoma medications]]
 
[[Category:Mantle cell lymphoma medications]]
[[Category:NK/T-cell lymphoma medications]]
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[[Category:Neuroblastoma medications]]
 +
[[Category:NK- and T-cell lymphoma medications]]
 
[[Category:Osteosarcoma medications]]
 
[[Category:Osteosarcoma medications]]
 
[[Category:Penile cancer medications]]  
 
[[Category:Penile cancer medications]]  
 +
[[Category:Rhabdomyosarcoma medications]]
 
[[Category:Soft tissue sarcoma medications]]  
 
[[Category:Soft tissue sarcoma medications]]  
 
[[Category:Small cell lung cancer medications]]
 
[[Category:Small cell lung cancer medications]]
 
[[Category:Testicular cancer medications]]
 
[[Category:Testicular cancer medications]]
 
[[Category:Thymoma medications]]
 
[[Category:Thymoma medications]]
[[Category:Endometrial cancer medications]]
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[[Category:T-cell acute lymphoblastic leukemia medications]]
 +
 
 +
[[Category:Non-small cell lung cancer medications (historic)]]
  
 
[[Category:FDA approved in 1988]]
 
[[Category:FDA approved in 1988]]
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[[Category:EMA approved in 1976]]
 
[[Category:WHO Essential Cancer Medicine]]
 
[[Category:WHO Essential Cancer Medicine]]

Latest revision as of 01:01, 29 June 2024

General information

Class/mechanism: Nitrogen mustard, alkylator. Metabolites of ifosfamide interact with DNA to produce phosphotriesters and formation of DNA cross-links. Ifosfamide requires metabolic activation by microsomal liver enzymes to form its active metabolites.[1][2]
Route: IV
Extravasation: irritant or neutral, depending on reference

  • A protective agent such as Mesna (Mesnex) should be used concurrently with ifosfamide to help prevent hemorrhagic cystitis.

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.[1]

Diseases for which it is established (work in progress)

Diseases for which it is used

Diseases for which it was used

Patient drug information

History of changes in FDA indication

  • 1988-12-30: Initial approval in combination with certain other approved antineoplastic agents 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. (Based on Loehrer et al. 1986)

History of changes in EMA indication

  • 1976-07-13: EURD

History of changes in PMDA indication

  • 2012-03-21: New additional indication and a new dosage for the treatment of malignant lymphoma.

Also known as

  • Brand names:
Synonyms
Alquimid Duvaxan Fentul Fosfidex Haloxan
Holoxan Holoxane Ifex IFO Cell Ifocris
Ifolem Ifomida Ifomide Ifos Ifosfamida
Ifoxan IFX Ipamide Isophosphamide Isoxan
Macdafen Mitoxana Tronoxal

References