Alkylating Agents Includes

Mechlorethamine ,Chlorambucil, Melphalan, Ifosamide,Cyclophosphamide, Urasil Mustard, Lomustine, Carmustine, Streptozocin, Thiotepa, Busulfan, Pipobroman, Cisplatin, Carboplatin 

Alkylating Agents Includes

Mechlorethamine ,Chlorambucil, Melphalan, Ifosamide,Cyclophosphamide, Urasil Mustard, Lomustine, Carmustine, Streptozocin, Thiotepa, Busulfan, Pipobroman, Cisplatin, Carboplatin

Testicular cancer

Dose limiting toxicites are myelosuppression and urotoxicity. Alopecia, nausea, vomiting,CNS toxicities.

Continued use in patients with severely depressed bone marrow function, hypersensitivity to Ifosfamide.

Special precautions:

Administer cautiously to patients with compromised bone marrow reserve as indicated by leuopenia, granulocytopenia, extensive bone marrow metastases, prior therapy with radiation or other cytotoxic agents.

Indication-

Testicular cancer

Dosage-

Give by slow i.v. infusion over at least 30 minutes 1.2g/m2 per day for 5 consecutive days, repeat every every 3 weeks or after haematological recovery platelets > 100000/microlitre WBC > 4000/microlitre

Refer Chlorambucil- Alkylating agents

1.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to ifosfamide. Also tell your doctor if youare allergic to any other substances, such as foods, presrvatives or dyes.

2.Pregnancy - before taking this medicine make sure your doctor knows if you are pregnant or if you become pregnant. Although sterility has not been reported with this medicine the possibility should be kept in mind.

3.Breast feeding- because ifosfamide may cause serious side effects , breast feeding is generally not recommended while you are receiving it.

4 Children - this medicine is not expected to cause different side effects or problems in children than in adults.

5. Elderly- no specific information comparing use of ifosfamide in the elderly with use in other age groups.

6. Other medicines - Let your doctor know what other medicines you are taking, so that he can advice you accordingly. Amphotericin B b injection or Antithyroid agents or Azathioprine or Chloramphenicol or Colchicine or Flucytosine or Ganciclovir or Interferon or Plicamycin or Zidovudine or - if you have ever ben treated with x-rays or canceer medicines - ifosfamide may increase the effects of these medicines or radiation therapy on the blood.

7. Other medical problems - Tell your doctor if you have any other medical problems especially - Chickenpox or Herpes zoster - risk of severe disease affecting other parts of the body Infection- ifosfamide can decrease your bodys ability to fight infection Kidney disease - effects may be increased because of slower removal of ifosamide from the body Liver disease - effects may be increased or decreased because the liver both makes ifosamide work and removes it from the body.

8. Missed dose - If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.

9. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.

10. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.

Pharmacology:

Ifosfamide is a chemotherapeutic agent chemically related to the nitrogen mustard and a synthetic analog of cyclophosphamide. Activation occurs by hydroxylation to form the unstable internediate 4-hydroxyifosfamide. The alkylated metabolites of ifosfamide interact with DNA.

Pharmacokinetics:

Ifosfamide is extensively metabolised, and the metabolic pathways appear to be saturated at high doses.

Not available

Refer Chlorambutil- Alkylating agents