Ifosfamide (Ifex)

==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.Ifosfamide (Ifex) package insert Ifosfamide (Ifex) package insert (locally hosted backup)
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. 
==Diseases for which it is established (work in progress)==
*Osteosarcoma
*Testicular cancer
==Diseases for which it is used==
*B-cell acute lymphoblastic leukemia, Ph-positive, pediatric
*Burkitt lymphoma
*CNS lymphoma
*Cervical cancer
*Diffuse large B-cell lymphoma
*Endometrial cancer
*Ewing sarcoma
*Extranodal NK- and T-cell lymphoma, nasal type
*HIV-associated lymphoma
*Classical Hodgkin lymphoma
*Mantle cell lymphoma
*Neuroblastoma
*NK- and T-cell lymphoma
*Penile cancer 
*Rhabdomyosarcoma
*Soft tissue sarcoma 
*Small cell lung cancer
*Thymoma
*T-cell acute lymphoblastic leukemia, pediatric
==Diseases for which it was used==
*Non-small cell lung cancer
==Patient drug information==
*Ifosfamide (Ifex) package insert
*Ifosfamide (Ifex) patient drug information (Chemocare)Ifosfamide (Ifex) patient drug information (Chemocare)
*Ifosfamide (Ifex) patient drug information (UpToDate)Ifosfamide (Ifex) patient drug information (UpToDate)
==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	Synonyms	Synonyms	Synonyms 	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==
Category:Drugs
Category:Intravenous medications
Category:Irritant
Category:Neutral
Category:Nitrogen mustards
Category:Burkitt lymphoma medications
Category:B-cell acute lymphoblastic leukemia medications
Category:CNS lymphoma medications
Category:Cervical cancer medications
Category:Diffuse large B-cell lymphoma medications
Category:Endometrial cancer medications
Category:Ewing sarcoma medications
Category:Extranodal NK- and T-cell lymphoma, nasal type medications
Category:HIV-associated lymphoma medications
Category:Classical Hodgkin lymphoma medications
Category:Mantle cell lymphoma medications
Category:Neuroblastoma medications
Category:NK- and T-cell lymphoma medications
Category:Osteosarcoma medications
Category:Penile cancer medications 
Category:Rhabdomyosarcoma medications
Category:Soft tissue sarcoma medications 
Category:Small cell lung cancer medications
Category:Testicular cancer medications
Category:Thymoma medications
Category:T-cell acute lymphoblastic leukemia medications
Category:Non-small cell lung cancer medications (historic)
Category:FDA approved in 1988
Category:EMA approved in 1976
Category:WHO Essential Cancer Medicine