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Ifosfamide (MitoxanaŽ)

Introduction

Ifosfamide is chemotherapy that is given as a treatment for many different types of cancer. This section describes ifosfamide, how it is given and some of its possible side effects. It should ideally be read with CancerBACUP's general information on chemotherapy, which gives more information and advice.

You will see your doctor regularly while you have this treatment so that he or she can monitor the effects of the chemotherapy. This section should help you to discuss any queries about your treatment and its side effects with your doctor or chemotherapy nurse, as they are in the best position to help and advise you.

What it looks like

Ifosfamide is a clear fluid after being dissolved from powder with sterile water.

How it is given

Ifosfamide may be given:

Possible side effects

Each person's reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. The side effects described in this section will not affect everyone who is given ifosfamide, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common and the less common side effects, so you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed here, please discuss them with your doctor or chemotherapy nurse.

Temporary reduction in the production of blood cells by the bone marrow This can result in anaemia leading to tiredness; an increased risk of bruising or bleeding and an increased risk of infection. The number of cells in your blood may begin to reduce from about seven days after the treatment has been given and usually reaches its lowest point at 10-14 days after the chemotherapy. The number of blood cells will then increase steadily and will usually return to normal within 21-28 days.

The extent to which the number of your blood cells is reduced depends on the dose of ifosfamide you receive and which other chemotherapy drugs, if any, are given in combination. Your doctor can advise you how likely it is that your blood cells will be lowered by the chemotherapy. Your blood will be checked regularly to see how well your bone marrow is working.

If your temperature goes above 38°C (100.5°F), or you develop any unexplained bruising or bleeding, or you suddenly feel unwell, even with a normal temperature, contact your doctor or the hospital straight away.

Nausea (feeling sick) and vomiting There are now very effective anti-sickness drugs to prevent or greatly reduce this. If you do feel sick it may begin a couple of hours after the treatment is given and last for up to a couple of weeks. If the sickness is not controlled or continues tell your doctor, who can prescribe other drugs which may be more effective.

Hair loss usually starts 3-4 weeks after the first dose of ifosfamide, although it may happen earlier. Hair may be lost completely or may just thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and the hair will regrow once the treatment ends.

Tiredness and a general feeling of weakness It is important to allow yourself plenty of time to rest.

Irritation of the bladder It is important to try to drink plenty of fluids to prevent any irritation. You will usually be given fluids into your vein before and after the chemotherapy is given. You may also be given a drug called mesna to protect the bladder and kidneys.

While you are having the chemotherapy you will be encouraged to pass urine every 3-4 hours during the day, and last thing at night. Your urine will often be measured and tested for the presence of blood. If blood is present in the urine, further doses of mesna will be given.

Changes to nails Your nails may become ridged, but this change grows out over a few months once the treatment has finished.

Less common side effects

Your liver may be temporarily affected Ifosfamide may cause changes in the way that your liver works, which will return to normal when the treatment is finished. This is very unlikely to cause you any harm, but your doctor will monitor this carefully. Samples of your blood will be taken from time to time to check your liver function.

Skin changes Ifosfamide can cause a rash, which may be itchy. Your doctor can prescribe medicine to help with this. Your skin may darken, due to excess production of pigment. This usually returns to normal a few months after the treatment has finished.

Confusion, lethargy, sleepiness and loss of balance These are very rare and only occur with high-dose treatment. If you notice any of these effects it is important to tell your doctor.

Additional information

Some other medicines can be harmful to take when you are having chemotherapy. Always let your doctor know about any other medicine you are taking.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking ifosfamide as it may harm the developing foetus. It is important to use effective contraception whilst taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

References

This section has been compiled using information from a number of reliable sources including;

For futher references, please see general bibliography.

Content last reviewed: 01 March 2004
Page last modified: 20 June 2004