Malignant neoplastic disease

Indication for Ifosfamide

Population group: Suitable for both men and women, only adults (18 years old or older)

Ifosfamide is a cytotoxic drug for the treatment of malignant disease. As a single agent it has successfully produced objective remissions in a wide range of malignant conditions. Ifosfamide is also frequently used in combination with other cytotoxic drugs, radiotherapy and surgery.

For this indication, competent medicine agencies globally authorize below treatments:

5-12 g/m² once a day

Route of admnistration


Defined daily dose

5 - 12 g per m² of body surface area (BSA)

Dosage regimen

From 5 To 12 g per m² of body surface area (BSA) once every day

Detailed description

A guide to the dosage regimens used for most indications is given below:

  • 8-12 g/m² equally fractionated as single daily doses over 3-5 days every 2-4 weeks.
  • 5-6 g/m² (maximum 10 g) given as a 24 hour infusion every 3–4 weeks.

The frequency of dosage is determined by the degree of myelosuppression and the time taken to recover adequate bone marrow function. The usual number of courses given is 4, but up to 7 (6 by 24 hour infusion) courses have been given. Re-treatment has been given following relapse.

During or immediately after administration, adequate amounts of fluid should be ingested or infused to force diuresis in order to reduce the risk of urothelial toxicity.

For prophylaxis of haemorrhagic cystitis, ifosfamide should be used in combination with mesna.

Active ingredient

Ifosfamide is an antineoplastic, a cytotoxic alkylating agent. It is a prodrug and shows no in vitro cytotoxic activity until activated by microsomal enzymes. The cytotoxic activity of ifosfamide (alkylation of the nucleophilic centres in the cells) is associated with the activated oxazaphosphorine ring hydroxylated at the C4 atom which interacts with DNA-DNA cross linking. This activity manifests itself by blocking the late S and early G2 phases of the cell cycle.

Read more about Ifosfamide

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