{"id":4525,"date":"2025-03-31T18:12:11","date_gmt":"2025-03-31T18:12:11","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/ifosfamide-txt\/"},"modified":"2025-03-31T18:12:11","modified_gmt":"2025-03-31T18:12:11","slug":"ifosfamide-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/ifosfamide-txt\/","title":{"rendered":"ifosfamide.txt"},"content":{"rendered":"

ifosfamide <\/h1>\n

CLINICAL USE <\/H3>
\nAntineoplastic agent:Treatment of solid tumours, lymphomas and soft tissue sarcoma

DOSE IN NORMAL RENAL FUNCTION <\/H3>Usual total dose for each course is either 8\u201312 g\/m2, equally divided as single daily doses over 3\u20135 days, or 5\u20136 g\/m2 (maximum 10 g) given as a 24 hour infusionOr according to local protocol

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :261.1<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :0<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 12\u201318<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.4\u20130.64<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :4\u20138\/\u2013

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>>60 80% of normal dose30\u201360 80% of normal dose15\u201330 80% of normal dose<15 60% of normal dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR<15 mL\/min. Following dose, do not perform
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: exchange for 12 hours<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR<15 mL\/min. Dose at minimum of 12 hours before next\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : session
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR<15 mL\/min. Dose at minimum of 12 hours before next HDF session
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=15\u201330 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Anticoagulants: possibly enhanced effect of coumarins\n
  • Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>Reconstitute 1 g vial with 12.5 mL water for injection. Reconstitute 2 g vial with 25 mL water for injection. The resultant solution of 8% ifosfamide should NOT be injected directly into the vein

    Route <\/H4>IV injection: dilute to less than a 4% solution

    IV infusion <\/H4>: dilute as detailed below

    Rate of Administration <\/H4>

    IV infusion <\/H4>: Infuse in glucose 5% or sodium \u2014chloride 0.9% over 30\u2013120 minutes, or Inject directly into a fast running \u2014infusion, orMade up in 3 L of glucose 5% or \u2014sodium chloride 0.9%; each litre should be given over 8 hours

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>Nephrotoxicity may occur with oliguria, raised uric acid, increased BUN and serum creatinine, and decreased creatinine clearanceIfosfamide is known to be more nephrotoxic than cyclophosphamide; hence greater caution is advisedSPC contraindicates the use of ifosfamide if serum creatinine >120 \u00b5mol\/LIf patient is anuric and on dialysis, neither the ifosfamide nor its metabolites nor mesna should appear in the urinary tract. The use of mesna may therefore be unnecessary, although this would be a clinical decisionIf the patient is passing urine, mesna should be given to prevent urothelial toxicityIfosfamide is a prodrug \u2013 converted by hepatic microsomal enzymes to alkylating metabolites. Excretion is primarily renal. Approximately 80% of dose is excreted as parent compound.372 iFosFAMidEDoses from Kintzel PE, Dorr RT. Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Can Treat Rev. 1995; 21: 33\u201364:GFR > 60 mL\/min 80% of doseGFR = 45\u201360 mL\/min 75% of doseGFR = 30\u201345 mL\/min 70% of dose
    \n","protected":false},"excerpt":{"rendered":"

    ifosfamide CLINICAL USE Antineoplastic agent:Treatment of solid tumours, lymphomas and<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4525","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4525","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4525"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4525\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4525"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4525"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4525"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}